BACKGROUND It is not uncommon to develop viral encephalitis.Epidemic Japanese B encephalitis infection combined with contactin-associated protein-like 2(CASPR-2)antibody-positive autoimmune encephalitis has not been r...BACKGROUND It is not uncommon to develop viral encephalitis.Epidemic Japanese B encephalitis infection combined with contactin-associated protein-like 2(CASPR-2)antibody-positive autoimmune encephalitis has not been reported at present.In clinical work,we need to consider more options.CASE SUMMARY A 32-year-old male worker presented with headache,fever and call-unresponsive presentation.Complete cranial magnetic resonance image showed symmetrical abnormal signals in bilateral medial temporal lobe,bilateral thalamus and basal ganglia.Improved lumbar puncture showed that cerebrospinal fluid protein and cell count increased significantly.Viral encephalitis was considered,and the patient's consciousness still increased rapidly after antiviral treatment.Further detection of Cerebrospinal fluid Japanese B encephalitis virus Polymerase Chain Reaction positive,serum autoimmune encephalitis antibody showed CASPR-2 antibody positive(1:320),the patient's condition gradually improved after plasma exchange treatment.3 mo later,the serum CASPR-2 antibody was negative and the patient's condition was stable.CONCLUSION This article reports the world’s first case of Epidemic Japanese B encephalitis infection combined with CASPR-2 antibody-positive autoimmune encephalitis,with a view to raising awareness.展开更多
目的分析儿童抗接触蛋白相关蛋白-2(contactin-associated protein 2,Caspr2)抗体相关自身免疫性脑炎的临床特点、诊疗过程及预后情况,以期提高儿科医生对此病的认识。方法回顾性收集2019年6月至2022年6月山东大学附属儿童医院收治的抗C...目的分析儿童抗接触蛋白相关蛋白-2(contactin-associated protein 2,Caspr2)抗体相关自身免疫性脑炎的临床特点、诊疗过程及预后情况,以期提高儿科医生对此病的认识。方法回顾性收集2019年6月至2022年6月山东大学附属儿童医院收治的抗Caspr2抗体相关脑炎患儿4例,分析其临床资料的特征并进行随访。结果男女患儿各2例,年龄为1.3~7.0岁。4例均呈亚急性发病,首发症状表现为发热、惊厥发作4例,表现为自主神经功能障碍2例、头痛1例、精神行为异常1例;主要临床表现为意识障碍3例,言语障碍、运动障碍各2例,睡眠增多、反复头痛各1例。4例患儿头颅MRI检查和脑电图检查结果均存在异常。3例脑脊液Caspr2抗体阳性,4例血清Caspr2抗体阳性(其中1例复发时呈阳性)。3例行糖皮质激素联合免疫球蛋白治疗,1例行支持治疗,出院时病情均好转。出院后18~28个月进行随访,1例出现复发,4例改良Rankin评分0~2分。结论儿童抗Caspr2抗体相关脑炎临床表现不典型,常表现为意识障碍、发热、精神行为异常、睡眠障碍、癫痫、运动障碍、自主神经症状等。患儿对免疫治疗有较好的反应,早期诊断、早期治疗患儿预后良好。展开更多
The incidence of Japanese encephalitis(JE)has significantly decreased in China due to JE vaccines.In this study,we investigated the post-JE vaccination seroprevalence and protection provided by vaccinated sera against...The incidence of Japanese encephalitis(JE)has significantly decreased in China due to JE vaccines.In this study,we investigated the post-JE vaccination seroprevalence and protection provided by vaccinated sera against Japanese encephalitis virus(JEV)to elucidate the persistence and waning of antibodies to JEV among JE-SA14-14-2-vaccinated children.A total of 300 serum samples were collected from vaccinated children aged 3-10 years in Zhaotong,Yunnan,China.The seroprevalence of anti-JEV antibodies was determined by enzyme-linked immune sorbent assay and plaque reduction neutralization test.The highest seropositivity of 82%was observed in vaccinated children during the first 0.5-1.5 years after booster vaccination.Then,the seropositivity began to decline and remained lower than the original level observed in the 0.5-1.5-year group.An association was found between the waning of seroprevalence and elapsed time of the post-booster vaccination.Similarly,the neutralizing antibody(nAb)titres gradually decreased over time,and the levels showed a positive correlation with the protective efficacy in mice.This finding suggests that nAbs play an important role in the antiviral process and that the nAb titre is an adequately credible parameter for evaluating the protective efficacy induced by the JE vaccine.Our results provide data that clarify the persistence and waning of antibodies to JEV,which may help elucidate the pathogenesis of JE.展开更多
文摘BACKGROUND It is not uncommon to develop viral encephalitis.Epidemic Japanese B encephalitis infection combined with contactin-associated protein-like 2(CASPR-2)antibody-positive autoimmune encephalitis has not been reported at present.In clinical work,we need to consider more options.CASE SUMMARY A 32-year-old male worker presented with headache,fever and call-unresponsive presentation.Complete cranial magnetic resonance image showed symmetrical abnormal signals in bilateral medial temporal lobe,bilateral thalamus and basal ganglia.Improved lumbar puncture showed that cerebrospinal fluid protein and cell count increased significantly.Viral encephalitis was considered,and the patient's consciousness still increased rapidly after antiviral treatment.Further detection of Cerebrospinal fluid Japanese B encephalitis virus Polymerase Chain Reaction positive,serum autoimmune encephalitis antibody showed CASPR-2 antibody positive(1:320),the patient's condition gradually improved after plasma exchange treatment.3 mo later,the serum CASPR-2 antibody was negative and the patient's condition was stable.CONCLUSION This article reports the world’s first case of Epidemic Japanese B encephalitis infection combined with CASPR-2 antibody-positive autoimmune encephalitis,with a view to raising awareness.
文摘目的分析儿童抗接触蛋白相关蛋白-2(contactin-associated protein 2,Caspr2)抗体相关自身免疫性脑炎的临床特点、诊疗过程及预后情况,以期提高儿科医生对此病的认识。方法回顾性收集2019年6月至2022年6月山东大学附属儿童医院收治的抗Caspr2抗体相关脑炎患儿4例,分析其临床资料的特征并进行随访。结果男女患儿各2例,年龄为1.3~7.0岁。4例均呈亚急性发病,首发症状表现为发热、惊厥发作4例,表现为自主神经功能障碍2例、头痛1例、精神行为异常1例;主要临床表现为意识障碍3例,言语障碍、运动障碍各2例,睡眠增多、反复头痛各1例。4例患儿头颅MRI检查和脑电图检查结果均存在异常。3例脑脊液Caspr2抗体阳性,4例血清Caspr2抗体阳性(其中1例复发时呈阳性)。3例行糖皮质激素联合免疫球蛋白治疗,1例行支持治疗,出院时病情均好转。出院后18~28个月进行随访,1例出现复发,4例改良Rankin评分0~2分。结论儿童抗Caspr2抗体相关脑炎临床表现不典型,常表现为意识障碍、发热、精神行为异常、睡眠障碍、癫痫、运动障碍、自主神经症状等。患儿对免疫治疗有较好的反应,早期诊断、早期治疗患儿预后良好。
基金supported by grants from the National Natural Science Foundation of China (81471957, 81772172, 81671971, U1602223 and 81871641)a grant from the Open Research Projects of Key Laboratory of Beijing Ditan Hospital, Capital Medical University (DTKF201705)
文摘The incidence of Japanese encephalitis(JE)has significantly decreased in China due to JE vaccines.In this study,we investigated the post-JE vaccination seroprevalence and protection provided by vaccinated sera against Japanese encephalitis virus(JEV)to elucidate the persistence and waning of antibodies to JEV among JE-SA14-14-2-vaccinated children.A total of 300 serum samples were collected from vaccinated children aged 3-10 years in Zhaotong,Yunnan,China.The seroprevalence of anti-JEV antibodies was determined by enzyme-linked immune sorbent assay and plaque reduction neutralization test.The highest seropositivity of 82%was observed in vaccinated children during the first 0.5-1.5 years after booster vaccination.Then,the seropositivity began to decline and remained lower than the original level observed in the 0.5-1.5-year group.An association was found between the waning of seroprevalence and elapsed time of the post-booster vaccination.Similarly,the neutralizing antibody(nAb)titres gradually decreased over time,and the levels showed a positive correlation with the protective efficacy in mice.This finding suggests that nAbs play an important role in the antiviral process and that the nAb titre is an adequately credible parameter for evaluating the protective efficacy induced by the JE vaccine.Our results provide data that clarify the persistence and waning of antibodies to JEV,which may help elucidate the pathogenesis of JE.
