重叠性 EBV 脑炎与自身免疫性胶质纤维酸性蛋白星形胶质细胞病。
Overlapping Epstein-Barr virus encephalitis and autoimmune glial fibrillary acidic protein astrocytopathy.
机构信息
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
J Neuroimmunol. 2023 Sep 15;382:578174. doi: 10.1016/j.jneuroim.2023.578174. Epub 2023 Aug 7.
We describe three cases of overlapping Epstein-Barr virus (EBV) Encephalitis and Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy (GFAP-A). The three cases all presented with initial symptoms of fever, headache, coma, and posture tremor of the upper limbs, then followed by limb weakness and dysuria. All of the three cases were on ventilators. Case 1 and 2 improved dramatically after intravenous methylprednisoloneand immunoglobulin treatment. However, case 3 presented dyspneic, and died from gastrointestinal hemorrhage. The GFAP-A triggered by EBV intracranial infection could initially masquerade as EBV encephalitis only, and the detection of GFAP antibody is essential for differentiation.
我们描述了三例重叠的 EBV 脑炎和自身免疫性胶质纤维酸性蛋白星形胶质细胞病（GFAP-A）。这三个病例均以发热、头痛、昏迷和上肢姿势性震颤为初始症状，随后出现四肢无力和排尿困难。这三个病例都需要呼吸机支持。例 1 和例 2 在静脉注射甲基强的松龙和免疫球蛋白治疗后明显改善。然而，例 3 出现呼吸困难，并因胃肠道出血而死亡。由 EBV 颅内感染引发的 GFAP-A 最初可能仅表现为 EBV 脑炎，因此 GFAP 抗体的检测对于鉴别诊断至关重要。
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