Adult acute disseminated encephalomyelitis associated with poststreptococcal infection.
Adult acute disseminated encephalomyelitis associated with poststreptococcal infection.
复制标题
与链球菌后感染相关的成人急性播散性脑脊髓炎。
DOI：
10.1016/j.jocn.2004.03.030
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Sheen,VL
中科院分区：
文献类型：
--
作者：
Ning,MM;Smirnakis,S;Furie,KL;Sheen,VL
急性播散性脑脊髓炎（ADEM）是一种双相性疾病，被认为是由抗原模拟与神经系统中的宿主表位具有交叉反应性的抗体引起的。1该疾病通常发生在暴露性或近期病毒感染之后。2，3相反，细菌性链球菌感染后的并发症更常见于儿科人群，包括西登哈姆舞蹈病，儿童自身免疫性神经精神疾病和ADEM。4我们提出了一个新的情况下，记录链球菌性咽炎和抗脱氧核糖核酸酶B（ADNB）滴度升高的成人引起ADEM。此外，MRI上基底神经节异常的缺失和CSF中白细胞增多的程度将成人形式的ADEM与儿童ADEM和成人病毒性脱髓鞘疾病区分开来。
Acute disseminated encephalomyelitis (ADEM) is a monophasic illness that is thought to develop from antigenic mimicry with antibodies having cross-reactivity to host epitopes in the nervous system.1The disorder typically follows an exanthematous or recent viral infection.2,3In contrast, complications from bacterial poststreptococcal infections more commonly give rise to disorders in the pediatric population including Sydenham’s chorea, pediatric autoimmune neuropsychiatric disorders, and ADEM.4We present the novel case of documented streptococcal pharyngitis and elevated antideoxyribonuclease B (ADNB) titers in an adult giving rise to ADEM. Furthermore, the absence of basal ganglia abnormalities on MRI and the degree of leukocytosis in the CSF distinguish the adult form of ADEM from childhood ADEM and adult viral demyelinating diseases.