2型单纯疱疹病毒诱发的抗N-甲基-D-天冬氨酸受体脑炎对免疫球蛋白单药治疗有反应。

IF 2.3 4区 医学 Q3 NEUROSCIENCES Journal of NeuroVirology Pub Date : 2024-08-19 DOI:10.1007/s13365-024-01228-5
Er-Chuang Li, Qi-Lun Lai, Tian-Yi Zhang, Bing-Qing Du, Jing Zhao, Meng-Ting Cai, Yin-Xi Zhang, Gao-Li Fang
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引用次数: 0

摘要

免疫功能正常的成年人患单纯疱疹病毒-2型脑炎(HSV2E)极为罕见,而在HSV2E发病后继发自身免疫性脑炎则更为罕见。本报告介绍了中国首例由 HSV2E 诱发的抗 N-甲基-D-天冬氨酸受体脑炎(NMDARE),并通过元基因组下一代测序(mNGS)得到证实。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 康复后出现新的或复发性神经症状的患者中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 单药治疗可以有效治疗 HSV2 诱发的 NMDARE,尤其是在类固醇治疗禁忌的情况下,是一种可行的替代疗法。
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Type 2 herpes simplex virus-induced anti-N-methyl-D-aspartate receptor encephalitis responsive to immunoglobulin monotherapy.

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.

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来源期刊
Journal of NeuroVirology
Journal of NeuroVirology 医学-病毒学
CiteScore
6.60
自引率
3.10%
发文量
77
审稿时长
6-12 weeks
期刊介绍: The Journal of NeuroVirology (JNV) provides a unique platform for the publication of high-quality basic science and clinical studies on the molecular biology and pathogenesis of viral infections of the nervous system, and for reporting on the development of novel therapeutic strategies using neurotropic viral vectors. The Journal also emphasizes publication of non-viral infections that affect the central nervous system. The Journal publishes original research articles, reviews, case reports, coverage of various scientific meetings, along with supplements and special issues on selected subjects. The Journal is currently accepting submissions of original work from the following basic and clinical research areas: Aging & Neurodegeneration, Apoptosis, CNS Signal Transduction, Emerging CNS Infections, Molecular Virology, Neural-Immune Interaction, Novel Diagnostics, Novel Therapeutics, Stem Cell Biology, Transmissable Encephalopathies/Prion, Vaccine Development, Viral Genomics, Viral Neurooncology, Viral Neurochemistry, Viral Neuroimmunology, Viral Neuropharmacology.
期刊最新文献
Atypical disseminated herpes zoster infections in patients with demyelinating disease treated with dimethyl fumarate. Upregulation of microRNAs correlates with downregulation of HERV-K expression in Parkinson's disease. Greater humoral EBV response may be associated with choroid plexus inflammation in progressive MS. Regulation of voltage-gated sodium channels by TNF-α during herpes simplex virus latency establishment. Type 2 herpes simplex virus-induced anti-N-methyl-D-aspartate receptor encephalitis responsive to immunoglobulin monotherapy.
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