CD8 脑炎：诊断难题

CD8 Encephalitis: A Diagnostic Dilemma.

作者信息

Sharma Rohan, Spradley Thomas, Campbell Morgan, Biyani Shubham, Singhal Pulkit, Elkhider Hisham, Nalleballe Krishna, Gokden Murat, Kumar Manoj, Kapoor Nidhi

机构信息

Department of Neurocritical Care, Mayo Clinic in Florida, Jacksonville, FL 32224, USA.

Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.

出版信息

Diagnostics (Basel). 2022 Nov 4;12(11):2687. doi: 10.3390/diagnostics12112687.

DOI:10.3390/diagnostics12112687

PMID:36359530

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9689240/

Abstract

CD8+ encephalitis is a subacute encephalopathy associated with HIV infection. Pathophysiology is thought to be auto-reactive CD8+ cells attacking on HIV infected CD4+ cells and 'viral escape' phenomena (replication of CD8+ cells in CSF). We present a case of a 45-year-old man with well controlled HIV who developed CD8 encephalitis following Herpes simplex encephalitis. He had persistent encephalopathy for several weeks with status epilepticus and agitated delirium, and diagnosis remained elusive until a brain biopsy confirmed the diagnosis.

摘要

CD8+ 脑炎是一种与HIV感染相关的亚急性脑病。其病理生理学被认为是自身反应性CD8+ 细胞攻击HIV感染的CD4+ 细胞以及“病毒逃逸”现象（CD8+ 细胞在脑脊液中复制）。我们报告一例45岁男性病例，其HIV病情控制良好，在患单纯疱疹性脑炎后发生了CD8脑炎。他持续脑病数周，伴有癫痫持续状态和激越性谵妄，在脑活检确诊之前诊断一直不明。