布罗利祖马布诱导的反约抗体阳性脑炎:一个病例报告
Takafumi Yamano1, Toshihide Yokoyama1, Tadashi Ishida1
1Department of Respiratory Medicine Kurashiki Central Hospital Okayama Japan.
Respirology case reports
|March 25, 2025
概括
我们描述了一个罕见的免疫检查点抑制剂相关的大脑炎的病例,该病例在患有肺腺癌的患者中具有抗Yo抗体. 静脉注射免疫球蛋白疗法有效地解决了神经症状,强调了抗体检测的重要性.
科学领域:
- 神经瘤学神经瘤学
- 免疫学 免疫学 免疫学
- 神经学 神经学
背景情况:
- 肺腺癌是一种常见的恶性瘤.
- 免疫检查点抑制剂 (ICI),如 pembrolizumab,用于癌症治疗.
- 通过ICI可以出现神经系统的副作用.
研究的目的:
- 报告一种罕见的ICI诱导的大脑炎与抗Yo抗体的病例.
- 突出ICI相关神经系统疾病的诊断挑战.
- 讨论这种情况的治疗策略.
主要方法:
- 一名患有第四阶段肺腺癌的患者的病例报告,接受了 pembrolizumab 的治疗.
- 临床评估包括神经学检查,MRI和脑脊液分析.
- 血清检测对瘤性抗体 (anti-Yo) 的测试.
主要成果:
- 在 pembrolizumab 治疗后,患者出现了阴囊和动力衰竭.
- 大脑脊髓液显示了淋巴细胞主导的高细胞性,蛋白质增加和基克隆带.
- 通过阳性anti-Yo抗体确认ICI相关大脑炎的诊断,排除其他原因.
结论:
- 这是ICI相关的大脑炎与肺腺癌中抗Yo抗体的首例报告.
- 瘤性抗体测试对于诊断ICI相关脑炎至关重要,特别是正常的MRI.
- 静脉注射免疫球蛋白治疗在缓解症状方面是有效的.
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