Gao, D.; Lv, X.; Shen, Z.; Wang, H.; Zhao, W.; Wang, H.; Jin, X.; Tan, L.; Yin, L.; Wang, J.; Yue, W.; Wang, H. Early Diagnosis of CNS Virus Infections from Neurological Autoimmune Diseases: A Cross-Sectional Study from China in ER Setting. Brain Sci.2024, 14, 888.
Gao, D.; Lv, X.; Shen, Z.; Wang, H.; Zhao, W.; Wang, H.; Jin, X.; Tan, L.; Yin, L.; Wang, J.; Yue, W.; Wang, H. Early Diagnosis of CNS Virus Infections from Neurological Autoimmune Diseases: A Cross-Sectional Study from China in ER Setting. Brain Sci. 2024, 14, 888.
Gao, D.; Lv, X.; Shen, Z.; Wang, H.; Zhao, W.; Wang, H.; Jin, X.; Tan, L.; Yin, L.; Wang, J.; Yue, W.; Wang, H. Early Diagnosis of CNS Virus Infections from Neurological Autoimmune Diseases: A Cross-Sectional Study from China in ER Setting. Brain Sci.2024, 14, 888.
Gao, D.; Lv, X.; Shen, Z.; Wang, H.; Zhao, W.; Wang, H.; Jin, X.; Tan, L.; Yin, L.; Wang, J.; Yue, W.; Wang, H. Early Diagnosis of CNS Virus Infections from Neurological Autoimmune Diseases: A Cross-Sectional Study from China in ER Setting. Brain Sci. 2024, 14, 888.
Abstract
It is challenging to differentiate central nervous system (CNS) virus infections and neurological autoimmune diseases in the emergency department. Considering their different pathogenesis, we assume they differ in neuropsychiatric symptoms and laboratory results. 80 patients were included, 50 with CNS virus infections and 30 with CNS autoimmune diseases, confirmed by polymerase chain reaction (PCR) of cerebrospinal fluid (CSF). A binary logistic regression model and receiver operating characteristic (ROC) curve were conducted to examine the discrimination between the two diseases based on neuropsychiatric symptoms and laboratory results. Compared to patients with neurological autoimmune diseases, patients with CNS virus infections had higher incidence of abnormal behavior (p=0.026) and abnormal sensation/thought (p=0.029), higher total (p = 0.005), direct (p = 0.004), and indirect bilirubin (p = 0.004), increased CSF cell (p = 0.01) and CSF white cell counts (p = 0.01). ROC analysis showed that patients with disturbance of consciousness and abnormal sensation/thought were 7.79-fold and 5.07-fold more likely to be diagnosed with CNS virus infections (OR = 7.79, p = 0.008; OR = 5.07, p = 0.032). Each unit increase in blood indirect bilirubin concentration and CSF white cell counts increased risk of developing CNS virus infections by 1.25-fold and 1.01-fold (OR = 1.25, p = 0.016; OR = 1.01, p = 0.011). Our study found that patients with CNS viral infections tend to have higher blood indirect bilirubin concentration, CSF leukocyte count, frequency of disorders of consciousness, and abnormal sensation and thought, which may help differentiate them from neurological autoimmune diseases.
Keywords
central nervous system; virus infections; neurological autoimmune diseases; differentiation
Subject
Medicine and Pharmacology, Neuroscience and Neurology
Copyright:
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