隐球菌性脑炎合并抗N-甲基-D-天冬氨酸受体脑炎一例  

Cryptococcal Encephalitis Complicating Anti-N-methyl-D-aspartate Receptor Encephalitis in an Immunosuppressed Patient

作　　者：刘东明 许宏伟[1] 易芳[1] LIU Dongming;XU Hongwei;YI Fang(Department of Geriatric Neurology,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院老年神经科,长沙410008

出　　处：《中国医学科学院学报》2020年第3期417-420,共4页Acta Academiae Medicinae Sinicae

基　　金：湖南省自然科学基金青年基金(2018JJ3828)。

摘　　要：隐球菌性脑炎是一种致命的中枢神经系统感染性疾病,抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎则是发生在人体组织内的一种以精神、行为异常、痫性发作及运动障碍为主要表现的自身免疫性疾病,两种疾病的病理及发病机制完全不同,但都能导致认知功能障碍及精神行为异常,而抗NMDAR脑炎还可以情绪及精神障碍为核心表现。中南大学湘雅医院收治了1例肾病综合征患者,同时合并隐球菌性脑炎和抗NMDAR脑炎,首次证实两种疾病可以共存于同一患者,并推测其原因可能与其他感染后诱发抗NMDAR脑炎的机制类似。Cryptococcal encephalitis is a fatal central nervous system infectious disease,whereas anti-N-methyl-D-aspartate(NMDA)receptor encephalitis(NMDARE)is an autoimmune syndrome associated with psychological symptoms,behavioural abnormalities,seizures,and dyskinesias.Despite their distinct pathologies and pathogenic mechanisms,both of them can lead to cognitive dysfunction and abnormal behaviors,although anti-NMDARE can also have mood and mental disorders as its core manifestations.A patient with nephrotic syndrome accompanied by both cryptococcal encephalitis and anti-NMDARE was treated in our center,which for the first confirmed that these two conditions could coexist in one patient.The underlying mechanism may be similar to that of anti-NMDARE after other infections.

关 键 词：隐球菌性脑炎 抗N-甲基-D-天冬氨酸受体脑炎 免疫缺陷者 共存 

分 类 号：R741[医药卫生—神经病学与精神病学]