中国现代神经疾病杂志 ›› 2021, Vol. 21 ›› Issue (5): 335-338. doi: 10.3969/j.issn.1672-6731.2021.05.001

• 专论 • 上一篇    下一篇

2 应重视无菌性脑膜炎及抗体阴性的自身免疫性脑炎的诊断

王佳伟1,2, 曹阳月1   

  1. 1 100730 首都医科大学附属北京同仁医院神经内科;
    2 100730 首都医科大学附属北京同仁医院中心实验室
  • 收稿日期:2021-05-12 出版日期:2021-05-25 发布日期:2021-05-28
  • 通讯作者: 王佳伟,Email:wangjwcq@163.com
  • 基金资助:

    国家重点研发计划项目(项目编号:2016YFC0904502);国家自然科学基金资助项目(项目编号:81771313);国家自然科学基金青年科学基金资助项目(项目编号:81301029);北京市自然科学基金资助项目(项目编号:7192040);北京市科技计划课题“首都特色”项目(项目编号:Z171100001017039);首都卫生发展科研专项项目(项目编号:2014-1-1101);首都卫生发展科研专项项目(项目编号:首发2020-2-2056);首都医科大学附属北京同仁医院“重点医学发展计划”专项项目(项目编号:trzdyxzy201704)

Challenge of the diagnosis of aseptic meningitis and antibody negative autoimmune meningitis

WANG Jia-wei1,2, CAO Yang-yue1   

  1. 1 Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;
    2 Medical Research Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2021-05-12 Online:2021-05-25 Published:2021-05-28
  • Supported by:

    This study was supported by National Program on Key Research and Development Research Project (No. 2016YFC0904502), the National Natural Science Foundation of China (No. 81771313), the National Natural Science Foundation for Young Scientists of China (No. 81301029), Beijing Municipal Natural Science Foundation (No. 7192040), Beijing Science and Technology Project Characteristics of the Capital Project (No. Z171100001017039), Key Projects of Capital Medical Development (No. 2014-1-1101, 2020-2-2056), and Beijing Tongren Hospital, Capital Medical University Key Medical Development Plan (No. trzdyxzy201704).

摘要:

随着对自身免疫相关脑膜脑炎的认识和诊断技术的提高,其诊断与治疗水平显著提高,然而对于未找到明确病原体且自身免疫抗体呈阴性的患者,常过度诊断为抗体阴性的自身免疫性脑炎,忽视无菌性脑膜炎的诊断,延误治疗。本文从不同视角对无菌性脑膜炎与抗体阴性的自身免疫性脑炎的发病机制、临床症状、诊断与治疗、预后等方面进行阐述,以期提高临床鉴别诊断能力。

关键词: 脑膜炎, 无菌性, 脑膜炎, 自身免疫疾病, 诊断, 鉴别, 综述

Abstract:

In recent years, with the improvement of the understanding and diagnosis of autoimmune-associated meningoencephalitis, the diagnosis and treatment of the disease has been significantly improved. However, for patients who have not found a clear pathogen and have negative autoimmune antibodies, they are often overdiagnosed as autoimmune encephalitis with negative antibodies, while diagnosis of aseptic meningitis is neglected which causes a delay of treatment. This article discusses pathogenesis, clinical symptoms, diagnostic techniques and prognosis of aseptic meningitis and antibody negative autoimmune encephalitis from different perspectives, in order to improve the clinical differential diagnosis ability.

Key words: Meningitis, aseptic, Meningitis, Autoimmune diseases, Diagnosis, differential, Review