ENCEFALITES AUTOIMUNES – ABORDAGEM PRÁTICA PARA SITUAÇÕES DE RECURSOS LIMITADOS

Christian Pereira Gregory, Adaucto Wanderley Nóbrega Jr, Katia Lin

Resumo


As encefalites autoimunes são um grupo de doenças causadas por autoanticorpos contra antígenos neuronais. Nos últimos dez anos, surgiram várias publicações que possibilitaram classificar e tratar pacientes com quadros de encefalites que antes eram irreconhecíveis e fatais. Estima-se que as causas autoimunes são responsáveis por 20% de todas as encefalites. Pelo fato de o diagnóstico ser bastante dependente de testes imunológicos de difícil acesso no SUS, este trabalho apresenta uma revisão não sistemática, com o enfoque em uma abordagem clínica dessas doenças, de modo prático, que agilize o diagnóstico destas emergências neurológicas, mesmo em locais de recursos limitados. A pesquisa da literatura foi baseada na base de dados do PubMed, Medline.


Palavras-chave


encefalite; encefalite autoimune; autoimunidade

Texto completo:

PDF

Referências


Lancaster E, Dalmau J. Neuronal autoantigens-pathogenesis, associated disorders and antibody testing. Nat Rev Neurol. 2012;8(7):380–90.

Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016;15(4):391–404.

Granerod J, Ambrose HE, Davies NWS, Clewley JP, Walsh AL, Morgan D, et al. Causes of encephalitis and differences in their clinical presentations in England: A multicentre, population-based prospective study. Lancet Infect Dis. 2010;10(12):835–44.

Dutra LA, Abrantes F, Toso FF, Pedroso JL, Barsottini OGP, Hoftberger R. Autoimmune encephalitis: a review of diagnosis and treatment. Arq Neuropsiquiatr. 2018;76(1):41–9.

Gaieski DF, O’Brien NF, Hernandez R. Emergency Neurologic Life Support: Meningitis and Encephalitis. Neurocrit Care. 2017;27:124–33.

Ankersmit HJ, Felipe A De, Saiz A. Encephalitis and GABA B receptor antibodies. Neurology. 2013;81:1–7.

Van Coevorden-Hameete MH, de Graaff E, Titulaer MJ, Hoogenraad CC, Sillevis Smitt PAE. Molecular and cellular mechanisms underlying anti-neuronal antibody mediated disorders of the central nervous system. Autoimmun Rev. 2014;13(3):299–312.

Linnoila JJ, Binnicker MJ, Majed M, Klein CJ, McKeon A. CSF herpes virus and autoantibody profiles in the evaluation of encephalitis. Neurol - Neuroimmunol Neuroinflammation. 2016;3(4):e245.

Frank Leypoldt , Klaus-Peter Wandinger, Christian G Bien and JD. Autoimmune Encephalitis HHS. Eur Neurol Rev. 2013;8(1):31–7.

Dalmau J, Rosenfeld MR, DeAngelis LM, Eichler AF. Paraneoplastic and autoimmune encephalitis. Uptodate. 2017;(December):1–22.

Davis R, Dalmau J. Autoimmunity, seizures, and status epilepticus. Epilepsia. 2013;54(SUPPL. 6):46–9.

Nóbrega-Jr AW, Gregory CP, Schlindwein-Zanini R, Neves F de S, Wolf P, Walz R, et al. Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal autoantibodies. Epilepsia. 2018;59(9):e152–6.

Kayser MS, Dalmau J. Anti-NMDA receptor encephalitis, autoimmunity, and psychosis. Schizophr Res. 2016;176(1):36–40.

Titulaer MJ, McCracken L, Gabilondo I, Armangué T, Glaser C, Iizuka T, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: An observational cohort study. Lancet Neurol. 2013;12(2):157–65.

Gresa-Arribas N, Planagumà J, Petit-Pedrol M, Kawachi I, Katada S, Glaser CA, et al. Human neurexin-3α antibodies associate with encephalitis and alter synapse development. Neurology. 2016;86(24):2235–42.

Dale RC, Merheb V, Pillai S, Wang D, Cantrill L, Murphy TK, et al. Antibodies to surface dopamine-2 receptor in autoimmune movement and psychiatric disorders. Brain. 2012;135(11):3453–68.

Fang B, McKeon A, Hinson SR, Kryzer TJ, Pittock SJ, Aksamit AJ, et al. Autoimmune glial fibrillary acidic protein astrocytopathy: A novel meningoencephalomyelitis. JAMA Neurol. 2016;73(11):1297–307.

Kelley BP, Patel SC, Marin HL, Corrigan JJ, Mitsias PD, Griffith B. Autoimmune encephalitis: Pathophysiology and imaging review of an overlooked diagnosis. Am J Neuroradiol. 2017;38(6):1070–8.

Schmitt SE, Pargeon K, Frechette ES, Hirsch LJ. Extreme delta brush receptor encephalitis. Neurology. 2012;79:1094–100.

Lizcano A, Carriço L, Barbosa P, Carvalho MI, Yasuda C, Montenegro MA, et al. EEG and magnetic resonance imaging abnormalities in patients with acute limbic encephalitis. J Epilepsy Clin Neurophysiol. 2011;17(4):133–9.

Dubey D, Blackburn K, Greenberg B, Stuve O, Vernino S. Diagnostic and therapeutic strategies for management of autoimmune encephalopathies. Expert Rev Neurother. 2016;16(8):937–49.

Forsström B, Bisławska Axnäs B, Rockberg J, Danielsson H, Bohlin A, Uhlen M. Dissecting antibodies with regards to linear and conformational epitopes. PLoS One. 2015;10(3):1–11.

Vincent A, Bien CG, Irani SR, Waters P. Autoantibodies associated with diseases of the CNS: New developments and future challenges. Lancet Neurol. 2011;10(8):759–72.

Dahm L, Ott C, Steiner J, Stepniak B. Seroprevalence of autoantibodies against brain antigens in health and disease. :1–23.

Petit-Pedrol M, Armangue T, Peng X, Bataller L, Cellucci T, Davis R, et al. Encephalitis with refractory seizures, status epilepticus, and antibodies to the GABAAreceptor: A case series, characterisation of the antigen, and analysis of the effects of antibodies. Lancet Neurol. 2014;13(3):276–86.

Payer J, Petrovic T, Lisy L, Langer P. Hashimoto encephalopathy: A rare intricate syndrome. Int J Endocrinol Metab. 2012;10(2):506–14.

Titulaer MJ, Soffietti R, Dalmau J, Gilhus NE, Giometto B, Graus F, et al. Screening for tumours in paraneoplastic syndromes: Report of an EFNS Task Force. Eur J Neurol. 2011;18(1):19–27.

Marshall GA, Doyle JJ. Long-Term Treatment of Hashimoto’s Encephalopathy. J Neuropsychiatry Clin Neurosci. 2006;18(1):14–20.

Prüss H, Dalmau J, Harms L, Höltje M, Ahnert-Hilger G, Borowski K, et al. Retrospective analysis of NMDA receptor antibodies in encephalitis of unknown origin. Neurology. 2010;75(19):1735–9.

Bale JF. Virus and Immune-Mediated Encephalitides: Epidemiology, Diagnosis, Treatment, and Prevention. Pediatr Neurol. 2015;53(1):3–12.




DOI: https://doi.org/10.32963/bcmufsc.v5i2.3488

Apontamentos

  • Não há apontamentos.


Direitos autorais 2019 Christian Pereira Gregory

URL da licença: https://creativecommons.org/licenses/by/3.0/