Abstract:
A 30-year-old woman presented with rapidly progressive dementia 1 month after the coronavirus disease 2019 infection. Repeated CSF analysis showed extreme hypoglycorrhachia, while cultures, metagenomic next-generation sequencing, and cytopathology testing of CSF were negative. Laboratory investigations for possible etiologies revealed elevated blood ammonia and cancer antigen 125. Brain MRI demonstrated bilateral symmetric diffuse cortical lesions with mild hyperintensity on T1-weighted image and postcontrast enhancement. A more thorough history and specific examinations subsequently indicated an underlying etiology. This case provides an approach for evaluating young patients with rapidly progressive dementia, extreme hypoglycorrhachia, and diffuse CNS lesions, highlighting the importance of considering a broad differential diagnosis.
摘要:
一名30岁的女性在2019年冠状病毒感染后1个月出现快速进行性痴呆。反复的脑脊液分析显示极度低血糖,而文化,宏基因组下一代测序,和脑脊液的细胞病理学检查均为阴性。对可能病因的实验室研究显示血氨和癌症抗原125升高。脑MRI显示双侧对称弥漫性皮质病变,T1加权图像和造影后增强显示轻度高强度。随后,更彻底的病史和具体的检查表明了潜在的病因。该病例提供了一种评估快速进行性痴呆的年轻患者的方法,极度低血糖,和弥漫性中枢神经系统病变,强调考虑广泛鉴别诊断的重要性。