公共卫生 公共卫生
Glauco Kody Nagata1, Eduarda Rosa Fernandes1, Tatiane Morgana da Silva1
1Neurology Department, São Lucas Hospital of PUCRS, Porto Alegre, Rio Grande do Sul, Brazil.
一名66岁的妇女出现了神经症状,如动力衰竭和,后来被诊断为脑小变性. 这种罕见的疾病是由潜在的乳腺癌引起的,这突显了早期诊断和治疗癌症和神经问题的必要性.
科学领域:
- 神经学 神经学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 一名66岁的女性出现了亚急性和显著的体重减轻.
- 病史包括类风湿性关节炎,糖尿病,GERD,高血压,焦虑和抑郁症.
- 在初始评估后的六个月,她出现了克隆,舌头结,失衡,震,低听力和心动.
研究的目的:
- 在患有慢性病史的患者中调查持续的神经缺陷的原因.
- 为了确立对瘤神经综合征的诊断.
主要方法:
- 广泛的诊断工作包括MRI,CSF分析,CT和PET-CT扫描.
- 淋巴结活检的免疫组织化学分析.
- 用甲基prednisolone脉冲疗法进行治疗.
主要成果:
- 核磁共振扫描显示小脑缩;脑脊液显示有氧克隆带和升高的IgG指数.
- 胸部CT和乳房MRI发现了一个可疑的下淋巴结和乳房损伤.
- 活检证实了转移性乳腺癌,具有特定的免疫组织化学标志物 (CK7+,CK20-,GATA-3+,ER+,PR-,C-erbB-2不确定的,Ki-67 50%).
结论:
- 这名患者被诊断出患有乳腺癌继发的副发性大脑小脑变性.
- 麻性神经综合征可以在癌症诊断之前或之后出现,因此需要全面评估.
- 早期识别和治疗神经症状和潜在恶性瘤至关重要.
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