We report an atypical case of anti-N-methyl-D-aspartate receptor encephalitis(ANMDARE). A 27-year-old man diagnosed with ANMDARE received immunotherapy and had a good recovery. However, within one month, he developed ...We report an atypical case of anti-N-methyl-D-aspartate receptor encephalitis(ANMDARE). A 27-year-old man diagnosed with ANMDARE received immunotherapy and had a good recovery. However, within one month, he developed severe status epilepticus and decreased level of conscience with new hyperpyrexia and dyspnea, and was admitted to the emergency intensive care unit. Acinetobacter baumanii were found in the sputum culture; and anti-NMDAR antibodies were positive(titer: 1/80) in the cerebrospinal fluid. Repeated immunotherapy was administered with antibacterial agents, and the patient recovered except for mild psychiatric sequelae. This is the first report of ANMDARE that aggravates after acinetobacter baumannii pneumonia. Awareness and knowledge of this disorder should be extended, especially in the emergency medicine community.展开更多
ANTI-N-METHYL-D-ASPARTATE (NMDA) receptorencephalitis is a newly recognized autoimmunedisease. It is predominantly described in youngwomen with a series of symptoms, includingpersonality change, memory loss, seizures,...ANTI-N-METHYL-D-ASPARTATE (NMDA) receptorencephalitis is a newly recognized autoimmunedisease. It is predominantly described in youngwomen with a series of symptoms, includingpersonality change, memory loss, seizures, involuntarymovements, autonomic dysfunction et al.1 It is commonlyassociated with mature ovarian teratomas.2 Since its firstdenomination by Dalmau et al,1 many scientific publicationshave emerged on anti-NMDA receptor encephalitis, butonly a few focused on the anesthetic management ofpatients with this disease.3-5 Herein we reported two caseswith anti-NMDA receptor encephalitis in association withovarian teratoma and discussed the anesthetic managementand the outcomes of these patients.展开更多
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a rare disease with uncertain etiology and pathogenesis that affects young women. Its diagnosis can be delayed because of the nonspecific neuropsychiatric symp...Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a rare disease with uncertain etiology and pathogenesis that affects young women. Its diagnosis can be delayed because of the nonspecific neuropsychiatric symptoms in the foreground. This article describes the details of a recent complicated case of a patient with this condition which is related to an ovarian teratoma. Correct diagnostic and prompt treatment of anti-NMDA receptor encephalitis remains a serious clinical challenge due to its unspecific manifestations and varying response to treatments. The information will be of interest to clinicians working with encephalitis patients.展开更多
COVID-19 is a new challenge in clinical medicine. Although typical presentations include fever and pneumonia, we describe a case of COVID-19 presenting with neurological symptoms of encephalitis and infectious-related...COVID-19 is a new challenge in clinical medicine. Although typical presentations include fever and pneumonia, we describe a case of COVID-19 presenting with neurological symptoms of encephalitis and infectious-related syndrome of inappropriate anti-diuretic hormone secretion. Because of the epidemic health problems, it is crucial to identify these patients as early as possible to follow the isolation procedures. We suggest that unclear neurological clinical presentations of patients should be considered for COVID-19.展开更多
1例67岁男性患者因“阵发性抽搐发作2周余”入院,诊断为抗γ-氨基丁酸B型受体(GABA_(B)R)抗体相关脑炎。入院后给予免疫治疗,治疗过程中出现癫痫持续状态、肺部感染、低蛋白血症、凝血功能异常等。临床药师结合患者病情,在免疫治疗方案...1例67岁男性患者因“阵发性抽搐发作2周余”入院,诊断为抗γ-氨基丁酸B型受体(GABA_(B)R)抗体相关脑炎。入院后给予免疫治疗,治疗过程中出现癫痫持续状态、肺部感染、低蛋白血症、凝血功能异常等。临床药师结合患者病情,在免疫治疗方案的选择上给予甲泼尼龙联合静脉注射免疫球蛋白,在需要抗感染治疗时给予美罗培南(1 g q8h ivgtt);应用多烯磷脂酰胆碱护肝,给予氨溴索联合布地奈德改善肺功能,应用低分子量肝素钙预防血栓形成,对患者的营养和电解质平衡方面进行监护,给予患者全程化监护,最终患者病情好转出院。展开更多
文摘We report an atypical case of anti-N-methyl-D-aspartate receptor encephalitis(ANMDARE). A 27-year-old man diagnosed with ANMDARE received immunotherapy and had a good recovery. However, within one month, he developed severe status epilepticus and decreased level of conscience with new hyperpyrexia and dyspnea, and was admitted to the emergency intensive care unit. Acinetobacter baumanii were found in the sputum culture; and anti-NMDAR antibodies were positive(titer: 1/80) in the cerebrospinal fluid. Repeated immunotherapy was administered with antibacterial agents, and the patient recovered except for mild psychiatric sequelae. This is the first report of ANMDARE that aggravates after acinetobacter baumannii pneumonia. Awareness and knowledge of this disorder should be extended, especially in the emergency medicine community.
文摘ANTI-N-METHYL-D-ASPARTATE (NMDA) receptorencephalitis is a newly recognized autoimmunedisease. It is predominantly described in youngwomen with a series of symptoms, includingpersonality change, memory loss, seizures, involuntarymovements, autonomic dysfunction et al.1 It is commonlyassociated with mature ovarian teratomas.2 Since its firstdenomination by Dalmau et al,1 many scientific publicationshave emerged on anti-NMDA receptor encephalitis, butonly a few focused on the anesthetic management ofpatients with this disease.3-5 Herein we reported two caseswith anti-NMDA receptor encephalitis in association withovarian teratoma and discussed the anesthetic managementand the outcomes of these patients.
文摘Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a rare disease with uncertain etiology and pathogenesis that affects young women. Its diagnosis can be delayed because of the nonspecific neuropsychiatric symptoms in the foreground. This article describes the details of a recent complicated case of a patient with this condition which is related to an ovarian teratoma. Correct diagnostic and prompt treatment of anti-NMDA receptor encephalitis remains a serious clinical challenge due to its unspecific manifestations and varying response to treatments. The information will be of interest to clinicians working with encephalitis patients.
文摘COVID-19 is a new challenge in clinical medicine. Although typical presentations include fever and pneumonia, we describe a case of COVID-19 presenting with neurological symptoms of encephalitis and infectious-related syndrome of inappropriate anti-diuretic hormone secretion. Because of the epidemic health problems, it is crucial to identify these patients as early as possible to follow the isolation procedures. We suggest that unclear neurological clinical presentations of patients should be considered for COVID-19.
文摘1例67岁男性患者因“阵发性抽搐发作2周余”入院,诊断为抗γ-氨基丁酸B型受体(GABA_(B)R)抗体相关脑炎。入院后给予免疫治疗,治疗过程中出现癫痫持续状态、肺部感染、低蛋白血症、凝血功能异常等。临床药师结合患者病情,在免疫治疗方案的选择上给予甲泼尼龙联合静脉注射免疫球蛋白,在需要抗感染治疗时给予美罗培南(1 g q8h ivgtt);应用多烯磷脂酰胆碱护肝,给予氨溴索联合布地奈德改善肺功能,应用低分子量肝素钙预防血栓形成,对患者的营养和电解质平衡方面进行监护,给予患者全程化监护,最终患者病情好转出院。
