自身免疫性脑炎临床鉴别诊断（精选）.pdf

2012 年 11 月第 32 卷第 11 期中国实用内科杂志 835
专题笔谈·自身免疫性脑炎
自身免疫性脑炎临床鉴别诊断
张华,母艳蕾
文章编号� 1005 - 2194� 2012� 11 - 0835 - 04 中图分类号� R512. 3 文献标志码� A
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提要自身免疫性脑炎是一组可能由某些自身抗体、活性细胞或者相关因子与中枢神经系统神经元表面的蛋白等
相互作用而导致的疾病。该组疾病中各个疾病典型的临床表现分别与目前已知的某个特异性抗体相对应,病情通
常与抗体水平相关,少数病例可能与某些潜在的肿瘤有关。目前已知的自身免疫性脑炎常见的有边缘叶脑炎( lim-
bic encephalitis,LE) 、莫万综合征( movan's syndrome,MOS) 、桥本脑病( Hashimoto's encephalitis) 以及抗 NMDA 受体
脑炎等,广义的讲还包括免疫相关疾病的脑炎表现。疾病分类复杂,诊断主要依靠临床表现和有关特异性检查( 免
疫标记物、影像) 等做出,本文将对目前这一组疾病的诊断和鉴别做一总结。
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关键词自身免疫; 免疫介导; 脑炎
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The clinical diagnosis of auto immune encephalopathies. ZHANG Hua MU Yan-lei. Department of Neurology Bei-
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jing Hospital of Hygiene Department Beijing 100730 China
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Summary The auto immune encephalopathies refer to a group of diseases caused by the interaction of some autoantibodies
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with active cells or correlation factors with the protein on neuron surface of central nervous system. In this group of diseases
the typical clinical features of each disease may be associated with a known specific antibody. The disease conditions are u-
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sually correlated with the levels of antibodies but a few cases may be with potential tumor. At present monly known
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autoimmune encephalopathy are limbic encephalitis LE Movan's syndrome MOS Hashimoto's encephalitis and
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NMDAR encephalitis etc. Broadly speaking it also includes the enceph