解放军医学院学报2017，Vol.38Issue(7)：634-638,5.DOI:10.3969/j.issn.2095-5227.2017.07.011
11例早期误诊为自身免疫性脑炎的胶质瘤患者临床资料分析
Glioma misdiagnosed as autoimmune encephalitis in early stage: An analysis of 11 cases
邵龙 1郑娜 1王威 1蒋胶胶 1张家堂1
作者信息
摘要
Abstract
Objective To understand the difference in clinical characteristics between glioma in the early stage and autoimmune encephalitis(AE),and provide basis for differential diagnosis.Methods In the study,11 cases with glioma who misdiagnosed as AE in the early stage and 13 cases with confirmed AE from 2011 to 2016 in our hospital were enrolled.Their demographic data,clinical manifestation,lesion location,cerebrospinal fluid (CSF) analysis results,imaging features and treatment were reviewed and compared.Results There was no significant difference between the two groups in age,gender,clinical symptoms and cerebrospinal fluid analysis results,and no difference in lesion location,and features of enhancement on MRI.Magnetic resonance spectroscopy (MRS) analysis showed decreased NAA peak and increased Cho peak were more common in glioma compared with AE,and the Cho/NAA and Cho/Cr ratios of glioma were significantly higher than those of AE (P ＜ 0.01,respectively).Immunosuppressive therapy was not effective for patients with glioma,but effevtive in patients with AE.Conclusion In the early diagnosis of AE,especially when the antibody screening results are absence or negative,we can't rule out the possibility of glioma only by multiple lesions or no enhancement on MRI.MRS is valuable in early differentiation between gfioma and AE.For patients who can not be definitively diagnosed as AE,MRS is recommended for differential diagnosis with glioma.When immunotherapy is not effective,we should consider the possibility of gliorna.关键词
自身免疫性脑炎/胶质瘤/鉴别诊断Key words
autoimmune encephalitis/glioma/differential diagnosis分类
医药卫生引用本文复制引用
邵龙,郑娜,王威,蒋胶胶,张家堂..11例早期误诊为自身免疫性脑炎的胶质瘤患者临床资料分析[J].解放军医学院学报,2017,38(7):634-638,5.
