婴幼儿人类疱疹病毒6型重症脑炎继发抗N-甲基-D-天冬氨酸受体脑炎1例  

A case of human herpesvirus 6 severe encephalitis followed by secondary anti-N-methyl-D-aspartate receptor encephalitis in an infant

作　　者：张田田 张礼萍[1] 王诗雨 张颖[2] Zhang Tiantian;Zhang Liping;Wang Shiyu;Zhang Ying(Department of Pediatrics,Xuanwu Hospital of Capital Medical University,Beijing 100053,China;Department of Pediatrics,Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]首都医科大学宣武医院儿科,北京100053 [2]青岛大学附属医院儿科,青岛266003

出　　处：《中华神经科杂志》2023年第10期1179-1183,共5页Chinese Journal of Neurology

摘　　要：人类疱疹病毒6型脑炎(HHV-6)在免疫功能正常的儿童中相对少见,继发自身免疫性脑炎更是罕见报道。本文报道1例既往体健的1岁患儿以发热、抽搐、部分性癫痫发作持续状态起病,通过脑脊液病原二代测序确诊为HHV-6重症脑炎,予积极抗病毒治疗后症状好转,后病情再次反复,频繁不自主运动,脑脊液抗N-甲基-D-天冬氨酸受体(NMDAR)抗体IgG阳性(1∶10),诊断为继发抗NMDAR脑炎,予丙种球蛋白、大剂量激素冲击及利妥昔单抗等治疗后病情稳定,但遗留脑软化灶、发育落后及难治性癫痫。Human herpesvirus 6 encephalitis(HHV-6)is relatively rare in children with normal immune function,and its secondary autoimmune encephalitis is even more rarely reported.A previously healthy 1-year-old boy who presented with fever,convulsions and partial status epilepticus was reported.He was diagnosed with severe HHV-6 encephalitis by next generation sequencing of cerebrospinal fluid pathogens.After aggressive antiviral treatment,the symptoms improved,but his condition recurred again with frequent involuntary movements and was finally diagnosed with secondary anti-N-methyl-D-aspartate receptor encephalitis.After treatment with gamma globulin,high-dose cortico-steroids and rituximab,his condition got stable but was left with encephalomalacia,developmental delay and intractable epilepsy in the long term.

关 键 词：疱疹病毒6型 人 婴儿 脑炎 神经系统自身免疫疾病 癫痫 

分 类 号：R742.9[医药卫生—神经病学与精神病学] R752.1[医药卫生—临床医学]