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与抗mGluR5抗体相关的脑炎

Denison Alves Pedrosa¹, João Henrique Fregadolli Ferreira¹, Rene Gleizer¹

¹Hospital Israelita Albert Einstein, São Paulo, Brazil.

Practical neurology

|February 29, 2024

概括

这一案例突出显示了抗甲基酸盐受体5 (mGluR5) 脑炎,它超出了奥菲利亚综合征. 早期诊断需要先进的抗体测试,而不仅仅是商业测试,用于罕见的自身免疫性脑炎.

科学领域:

神经学神经学
免疫学免疫学免疫学
在瘤学瘤学.

背景情况:

自身免疫性脑炎呈现出各种神经系统症状.
抗甲基氨酸受体5 (mGluR5) 脑炎是一种罕见的神经疾病.
奥菲利亚综合征是先前描述的抗mGluR5脑炎的表现.

研究的目的:

描述一种具有非典型表现的抗mGluR5脑炎病例.
强调诊断挑战和特定抗体检测的重要性.
要突出自身免疫性脑炎和潜在的恶性瘤之间的关联.

主要方法:

一个有神经症状的30岁女性的临床病例介绍.
脑脊液 (CSF) 和血清分析,包括细胞计数,蛋白质和葡萄糖水平.
大脑的磁共振成像 (MRI).
免疫学测定:商用基于细胞的测定 (CBA),基于组织的测定,以及针对抗mGluR5抗体的特定CBA.

主要成果:

患者表现出视觉幻觉,阴影,记忆障碍和沉默症.
脑脊液分析显示了多细胞体和改变的葡萄糖水平.
大脑MRI成像显示了边缘,外边缘和脑干的参与.
基于组织的测定显示了神经染,血清和CSFCBA对抗mGluR5抗体呈阳性.
这名患者后来被诊断为霍奇金淋巴瘤.

结论:

抗mGluR5脑炎的临床范围比以前描述的更广泛.
商业的基于细胞的测试可能不足以诊断罕见的自身免疫性脑炎.
以组织为基础的测定,其次是血清和CSF抗体测试,对于准确的诊断至关重要.
自身免疫性脑炎可以是瘤性,与诸如霍奇金淋巴瘤之类的潜在癌症相关.

关键词:

幻觉是一种幻觉.图像分析图像分析神经免疫学神经免疫学这是一种PARANEOPLASTIC综合征.

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