在一个青少年患者中,反复出现的抗NMDAR脑炎需要卵巢切除:一个病例报告
Shadowen Caroline1, Agrawal Nidhi2, Fugina Alexa3
1Department of Obstetrics & Gynecology, Virginia Commonwealth University Hospital System, 1250 East Marshall Street, Richmond, Virginia 23298, USA.
Case reports in obstetrics and gynecology
|October 24, 2024
概括
抗NMDA受体 (A-NMDAR) 脑炎,通常与卵巢瘤有关,即使在手术后也可能复发. 这一案例突显了在复发性A-NMDAR脑炎的诊断挑战,当瘤在成像上看不到时.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 妇科 妇科 妇科 妇科
背景情况:
- 抗NMDA受体 (A-NMDAR) 脑炎是一种罕见的自身免疫性疾病.
- 它经常与卵巢瘤有关,手术切除通常会导致恢复.
- 复发是不常见的,这使得这个案子特别值得注意.
研究的目的:
- 报告一个独特的反复反NMDA受体脑炎的案例.
- 为了突出诊断挑战,在复发期间在成像上缺乏可识别的瘤所带来的挑战.
- 强调需要对替代诊断方法进行进一步研究.
主要方法:
- 病例报告详细介绍了一名14岁的女性初发性和复发性A-NMDAR脑炎.
- 诊断工作包括临床评估,成像 (超声波,MRI) 和手术干预.
- 治疗包括手术切除双侧卵巢瘤,随后进行左卵巢切除术.
主要成果:
- 患者经历了双边卵巢囊切除术后的初步康复.
- 一年后,她出现了复发性A-NMDAR脑炎,尽管最初的影像检测结果对瘤是负面的.
- 重复成像最终确定了可疑的瘤,导致了沙卵巢切除术和完全康复.
结论:
- 这种病例表现出A-NMDAR脑炎的非典型特征,包括神经精神病发作,双边瘤和严重复发.
- 在复发期间在成像上缺乏可识别的瘤,造成了诊断困境.
- 需要进一步研究A-NMDAR脑炎的诊断方式,在成像上没有明显的瘤,特别是在女性患者中.
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