可能的自身免疫性脑炎表现为紧张症在一个年轻女性:一个病例报告和文献复习。

IF 1.3 4区 医学 Q4 PSYCHIATRY
Nancy M Gonzalez, Vishwa S Shah, Dafe Jessa, Reza Safavi
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引用次数: 0

摘要

目的报告一例可能的自身免疫性脑炎最初误诊为原发性精神障碍。方法本文报告1例产后6个月的年轻女性出现紧张症,可能为自身免疫性脑炎。结果患者于外院就诊,诊断为原发性精神疾病,送精神科住院,因不稳定高血压被拒绝入院。在进入医疗服务(和ICU)后,她对劳拉西泮有反应,并在静脉注射甲基强的松龙、静脉注射免疫球蛋白(IVIG)和利妥昔单抗联合治疗后几周内完全康复。结论生命体征不稳定、有自身免疫家族史、无精神病史的新发精神病患者应怀疑为自身免疫性脑炎。其他重要的诊断考虑包括抗精神病药恶性综合征,物质诱导精神病,或继发于感染后免疫介导脑炎的紧张症。当首次精神病发作应该被考虑时,自主神经不稳定、紧张症、癫痫发作或运动障碍在年轻女性产后的出现应该提示彻底的医学和神经检查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Probable Autoimmune Encephalitis Presenting With Catatonia in a Young Woman: A Case Report and Review of the Literature.

ObjectiveTo present a case of probable autoimmune encephalitis initially misdiagnosed as a primary psychiatric disorder.MethodA case of probable autoimmune encephalitis presenting with catatonia in a young woman 6 months post-partum is described in this article.ResultsThe patient was admitted to an outside hospital, diagnosed with a primary psychiatric condition, and sent to psychiatric inpatient, where she was denied admission due to labile hypertension. After admission to the medical service (and ICU), she responded to a lorazepam challenge, and made a complete recovery within several weeks after combination treatment with IV methylprednisolone, IV immunoglobulin (IVIG), and rituximab.ConclusionAutoimmune encephalitis should be suspected in patients presenting with labile vital signs, family history of autoimmunity, and new psychosis without prior history of psychiatric problems. Other important diagnostic considerations include neuroleptic malignant syndrome, substance-induced psychosis, or catatonia secondary to post-infectious immune-mediated encephalitis. While a first psychotic break should always be considered, the presence of autonomic instability, catatonia, seizures, or dyskinesias in a young woman postpartum should prompt a thorough medical and neurological work-up.

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来源期刊
CiteScore
3.00
自引率
5.00%
发文量
55
审稿时长
6-12 weeks
期刊介绍: The International Journal of Psychiatry in Medicine (IJPM) bridges the gap between clinical psychiatry research and primary care clinical research. Providing a forum for addressing: The relevance of psychobiological, psychological, social, familial, religious, and cultural factors in the development and treatment of illness; the relationship of biomarkers to psychiatric symptoms and syndromes in primary care...
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