Autoimmune encephalitis: proposed recommendations for symptomatic and long-term management.
Autoimmune encephalitis: proposed recommendations for symptomatic and long-term management.
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DOI：
10.1136/jnnp-2020-325302
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发表时间：
2021-03-01
期刊：
影响因子：
--
通讯作者：
Autoimmune Encephalitis Alliance Clinicians Network
中科院分区：
文献类型：
--
作者：
Abboud H;Probasco J;Irani SR;Ances B;Benavides DR;Bradshaw M;Christo PP;Dale RC;Fernandez-Fournier M;Flanagan EP;Gadoth A;George P;Grebenciucova E;Jammoul A;Lee ST;Li Y;Matiello M;Morse AM;Rae-Grant A;Rojas G;Rossman I;Schmitt S;Venkatesan A;Vernino S;Pittock SJ;Titulaer M;Autoimmune Encephalitis Alliance Clinicians Network
这篇文章的目的是评估自身免疫性脑炎治疗中每一步可用的证据，并在证据不足时提供专家意见。这篇论文将自身免疫性脑炎作为一个广泛的类别来探讨，而不是关注单个抗体综合征。来自自身免疫性脑炎联盟临床医生网络的核心作者回顾了文献并开发了第一稿。在缺乏证据或存在争议的情况下，向所有成员分发了一份电子调查问卷，以征求个别成员的答复。来自17个国家的68名成员回答了这项调查。38%的应答者选择口服泼尼松锥体疗法，而46%的应答者选择美罗华是最受欢迎的维持疗法。对于神经元表面抗体(70%)或血清阴性自身免疫性脑炎(61%)的患者，大多数应答者在第二次复发后考虑维持免疫抑制，而与之相对的是那些患有神经元抗体的患者(29%)。大多数应答者选择对患有神经元表面抗体(49%)或边缘脑炎(46%)的患者进行为期4年的癌症筛查，而不是非边缘血清阴性的自身免疫性脑炎(36%)。详细的调查结果在手稿中提出，诊断和治疗建议的摘要在结论中提出。
The objective of this paper is to evaluate available evidence for each step in autoimmune encephalitis management and provide expert opinion when evidence is lacking. The paper approaches autoimmune encephalitis as a broad category rather than focusing on individual antibody syndromes. Core authors from the Autoimmune Encephalitis Alliance Clinicians Network reviewed literature and developed the first draft. Where evidence was lacking or controversial, an electronic survey was distributed to all members to solicit individual responses. Sixty-eight members from 17 countries answered the survey. The most popular bridging therapy was oral prednisone taper chosen by 38% of responders while rituximab was the most popular maintenance therapy chosen by 46%. Most responders considered maintenance immunosuppression after a second relapse in patients with neuronal surface antibodies (70%) or seronegative autoimmune encephalitis (61%) as opposed to those with onconeuronal antibodies (29%). Most responders opted to cancer screening for 4 years in patients with neuronal surface antibodies (49%) or limbic encephalitis (46%) as opposed to non-limbic seronegative autoimmune encephalitis (36%). Detailed survey results are presented in the manuscript and a summary of the diagnostic and therapeutic recommendations is presented at the conclusion.
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作者：
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作者：
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DOI：
10.1016/s1474-4422(15)00401-9
发表时间：
2016-04
期刊：
The Lancet. Neurology
影响因子：
--
作者：
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通讯作者：
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