墨西哥2例抗lgi1自身免疫性脑炎报告

Luis Carlos Reyes-Sosa, Daniela Alexia León-Castillo, Juan Carlos Jiménez-Islas, Crhistian Alejandro Aguilar-Vázquez
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引用次数: 0

摘要

背景:抗lgi1脑炎的特点是主要影响边缘系统的炎症模式,它是攻击神经元表面抗原的自身免疫性脑炎的一部分。它的特点是亚急性痴呆、肌张力障碍危象和低钠血症,对免疫治疗有很好的反应。本文的目的是通过临床病例描述两例抗lgi1脑炎患者的临床演变和6个月的功能结局。临床病例:病例1:62岁男性,症状8周,表现为情绪改变、定向障碍和局灶性运动癫痫。病例2:72岁女性,MRI表现为快速进展性痴呆、低钠血症和双颞部高信号,病程5个月。在这两种情况下,由于临床怀疑,类固醇和免疫球蛋白的急性双重免疫治疗有了实质性的改善。随后证实脑脊液中存在抗lgi1抗体。虽然两名患者在住院期间都接受了一定剂量的利妥昔单抗,但只有第一例患者继续每年两次服用利妥昔单抗。第二例患者最初不考虑继续长期免疫调节治疗,并经历了复发。结论:这些临床小插曲呈现读者与经典的特点,这种疾病。这有助于其识别和及时开始治疗,改善患者的功能预后。
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[Report of two cases of anti-LGI1 autoimmune encephalitis in Mexico].

Background: Anti-LGI1 encephalitis is characterized by a pattern of inflammation that predominantly affects the limbic system It is part of the autoimmune encephalitis that attack neuronal surface antigens. It is characterized by the triad of subacute dementia, faciobrachial dystonic crises, and hyponatremia, presenting an excellent response to immunotherapy. The aim of this article is to describe the clinical evolution and functional outcome at 6 months of two patients with anti-LGI1 encephalitis using clinical cases.

Clinical cases: Case 1: 62-year-old man with 8-week symptoms manifested by changes in mood, disorientation, and focal motor seizures. Case 2 A 72-year-old woman with a 5-month evolution of rapidly progressive dementia, hyponatremia and bitemporal hyperintensities on MRI. In both, due to clinical suspicion, acute dual immunotherapy with steroid and immunoglobulin was given with substantial improvement. Subsequently, the existence of anti-LGI1 antibodies in cerebrospinal fluid was confirmed. Although both patients received a dose of rituximab during their hospitalization, only the patient in the first case continued biannual doses of rituximab. The second patient was not initially considered to continue long-term immunomodulatory treatment and experienced a relapse.

Conclusions: These clinical vignettes present the reader with the classic characteristics of this disease. This can facilitate its recognition and timely initiation of treatment, improving the functional prognosis of patients.

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