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以精神病性症状为首发表现的长期误诊的抗GAD65自身免疫性脑炎:一则典型病例及文献综述

Psychotic Symptoms as the Initial Presentation of a Long-Lasting Misdiagnosed Anti-GAD65 Autoimmune Encephalitis: An Emblematic Case and Literature Review.

作者信息

Wang Jianjun, Gong Shenglan, Kong Fanxin, Cai Dongbin, Huang Binqing, Zheng Haotao, Lin Songjun, Li Jinfang, Zhang Tianfeng

机构信息

Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China.

Department of Neurology and Psychology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.

出版信息

Front Psychiatry. 2022 Feb 23;13:754938. doi: 10.3389/fpsyt.2022.754938. eCollection 2022.

DOI:10.3389/fpsyt.2022.754938
PMID:35280166
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8905188/
Abstract

OBJECTIVE

To present a long-lasting misdiagnosed case of anti-GAD65 autoimmune encephalitis (AE) and promote the early identification of reversible psychotic symptoms in AE.

METHODS

The case report was generated through detailed assessment of clinical characteristics, cerebral magnetic resonance images, and laboratory results. Meanwhile, a literatures review related to the topic was conducted.

RESULTS

Psychotic symptoms could be presented in the early stage of anti-GAD65 autoimmune encephalitis. Even though there exists a transdisciplinary gap that hinder the timely recognition of early psychiatric symptoms as components of organic disease, a few strategies could be introduced to enable the earlier recognition and appropriate treatment.

CONCLUSIONS

Our report intends to raise awareness to promote the early identification of immune-mediated "symptomatic" forms of psychosis.

摘要

目的

呈现一例抗GAD65自身免疫性脑炎(AE)长期误诊病例,并促进对AE中可逆性精神症状的早期识别。

方法

通过对临床特征、脑磁共振图像和实验室结果的详细评估生成病例报告。同时,对该主题相关文献进行综述。

结果

抗GAD65自身免疫性脑炎早期可出现精神症状。尽管存在跨学科差距阻碍将早期精神症状及时识别为器质性疾病的组成部分,但可引入一些策略以实现更早识别和恰当治疗。

结论

我们的报告旨在提高认识,促进对免疫介导的“症状性”精神病形式的早期识别。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ef0/8905188/e6c4ab97ecbe/fpsyt-13-754938-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ef0/8905188/1f3ca94c8ff5/fpsyt-13-754938-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ef0/8905188/e6c4ab97ecbe/fpsyt-13-754938-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ef0/8905188/1f3ca94c8ff5/fpsyt-13-754938-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ef0/8905188/e6c4ab97ecbe/fpsyt-13-754938-g0002.jpg

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J Neurol. 2020 Jul;267(7):2083-2089. doi: 10.1007/s00415-020-09807-2. Epub 2020 Mar 28.
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Neurologic syndromes related to anti-GAD65: Clinical and serologic response to treatment.
与抗 GAD65 相关的神经综合征:临床和血清学治疗反应。
Neurol Neuroimmunol Neuroinflamm. 2020 Mar 2;7(3). doi: 10.1212/NXI.0000000000000696. Print 2020 May.
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