School of Clinical Medicine, University of Cambridge, Cambridge, UK
School of Clinical Medicine, University of Cambridge, Cambridge, UK.
BMJ Case Rep. 2022 Apr 22;15(4):e246290. doi: 10.1136/bcr-2021-246290.
A man in his 60s presented with a worsening headache, confusion and expressive dysphasia which, on admission, progressed to a falling Glasgow Coma Score and seizures. He was subsequently admitted to the intensive care unit. The clinical diagnosis was antibody-negative autoimmune encephalitis. Despite immunotherapy, the patient died 5 months after initial presentation and postmortem examination revealed he had CD8 encephalitis. This case demonstrates that CD8 encephalitis can present similarly to autoimmune encephalitis both clinically and on imaging. A brain biopsy would have revealed the diagnosis in life, although this would not have altered his treatment.
一位 60 多岁的男性患者出现进行性加重的头痛、意识混乱和表达性言语障碍，入院时格拉斯哥昏迷评分下降并出现癫痫发作。随后，他被收入重症监护病房。临床诊断为抗体阴性自身免疫性脑炎。尽管进行了免疫治疗，但患者在初次发病后 5 个月死亡，尸检显示他患有 CD8 脑炎。本例表明 CD8 脑炎在临床和影像学上均与自身免疫性脑炎表现相似。如果进行脑活检，本可在生前明确诊断，但这并不会改变他的治疗方案。
