Department of Neurology, Taikang Ningbo Hospital, Ningbo, 315042, China.
Department of Neurology, Zhejiang Hospital, Hangzhou, 310013, China.
J Neurovirol. 2024 Aug;30(4):445-449. doi: 10.1007/s13365-024-01228-5. Epub 2024 Aug 19.
Herpes simplex virus-2 encephalitis (HSV2E) in immunocompetent adults is exceptionally rare, and the subsequent onset of autoimmune encephalitis after HSV2E is even less common. This report presents the inaugural Chinese case of anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) induced by HSV2E, confirmed via metagenomic next-generation sequencing (mNGS). The patient demonstrated a favorable response to intravenous immunoglobulin (IVIG) monotherapy. This case emphasizes the importance of considering autoimmune encephalitis in patients exhibiting new or recurrent neurological symptoms after HSV2E recovery. Comprehensive mNGS and neuronal antibody testing are essential for timely diagnosis. Moreover, IVIG monotherapy can serve as an effective treatment for NMDARE induced by HSV2, providing a viable alternative, particularly when steroid therapy is contraindicated.
单纯疱疹病毒 2 型脑炎（HSV2E）在免疫功能正常的成年人中极为罕见，而 HSV2E 后继发自身免疫性脑炎则更为罕见。本报告介绍了首例经宏基因组下一代测序（mNGS）证实的单纯疱疹病毒 2 型脑炎（HSV2E）诱导的抗 N-甲基-D-天冬氨酸受体脑炎（NMDARE）的中国病例。该患者对静脉注射免疫球蛋白（IVIG）单药治疗反应良好。该病例强调了在 HSV2E 恢复后出现新的或复发的神经症状的患者中，应考虑自身免疫性脑炎的重要性。全面的 mNGS 和神经元抗体检测对于及时诊断至关重要。此外，IVIG 单药治疗可作为 HSV2 诱导的 NMDARE 的有效治疗方法，提供了一种可行的替代方案，特别是在类固醇治疗禁忌的情况下。
