二代测序诊断EB病毒性脑炎继发自身免疫性脑炎1例报道

病毒性脑炎与自身免疫性脑炎在临床中常难以鉴别,临床表现较为相似,但治疗方案不同,因此早期识别尤为重要。本文报道1例影像学提示边缘叶脑炎,经二代测序技术确诊为EB病毒感染的病毒性脑炎患者,治疗后6个月继发癫痫,自身免疫性抗体抗谷氨酸受体(NMDA型)抗体阳性,诊断为成人病毒性脑炎后自身免疫性脑炎(PVEAE)。结合相关文献,本文描述了二代测序技术早期诊断病毒性脑炎及自身免疫性脑炎的临床应用,讨论病毒性脑炎继发自身免疫性脑炎的临床特征,旨在更好地实现二者的早期诊断与鉴别,改良患者诊疗方案,为患者带来更好的预后结局。

Second generation sequencing diagnosis of autoimmune encephalitis secondary to EB virus encephalitis:a case report

Viral encephalitis and autoimmune encephalitis are often difficult to distinguish in clinical practice,the clinical manifestations are similar,but the treatment schemes are different.Therefore,early identification is particularly important.This paper reports a case of viral encephalitis diagnosed as EB virus infection by second generation sequencing after imaging diagnosis of marginal lobe encephalitis.Six months after treatment,the patient developed epilepsy and was diagnosed as adult post viral encephalitis autoimmune encephalitis(PVEAE)with autoimmune antibody against glutamate receptor(NMDA type)antibody positive.Combined with relevant literature,this paper describes the clinical application of second generation sequencing technology in early diagnosis of viral encephalitis and autoimmune encephalitis,discusses the clinical characteristics of viral encephalitis secondary to autoimmune encephalitis,in order to better realize the early diagnosis and differentiation of the two,improve the diagnosis and treatment scheme of patients,and bring better prognosis for patients.