与抗mGluR5抗体相关的脑炎。

IF 2.4 Q2 CLINICAL NEUROLOGY
Denison Alves Pedrosa, João Henrique Fregadolli Ferreira, Rene Gleizer, Rafael Bernhart Carra, Rachel Marin de Carvalho, Verena Endmayr, Romana Hoftberger, Lívia Almeida Dutra
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引用次数: 0

摘要

一名 30 岁的女性出现视幻觉、眼球震颤、记忆障碍和缄默症 5 天。经检查,她神志不清,注意力下降,凝视诱发眼球震颤,肌张力减退,额叶反射异常。脑脊液(CSF)显示有80个细胞,蛋白质0.41克/升,葡萄糖3.2毫摩尔/升(血浆葡萄糖5.0毫摩尔/升)。脑部磁共振扫描显示边缘区、边缘外区和脑干受累。商用细胞检测呈阴性,但组织检测显示神经髓染色,血清和脑脊液中抗代谢谷氨酸受体5(mGluR5)抗体呈阳性。六个月后,她被诊断为霍奇金淋巴瘤。该病例强调了抗 mGluR5 脑炎更广泛的临床范围,对最初将其定性为奥菲莉亚综合征提出了质疑。它强调了解释基于细胞的商业检测方法的重要性,并提倡在诊断罕见自身免疫性脑炎时,先进行基于组织的检测,然后再进行基于血清和脑脊液的细胞检测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Encephalitis associated with anti-mGluR5 antibodies.

A 30-year-old woman had 5 days of visual hallucinations, nystagmus, memory impairment and mutism. On examination, she was disorientated with reduced attention span, gaze-evoked nystagmus, paratonia and abnormal frontal reflexes. Cerebrospinal fluid (CSF) showed 80 cells, protein 0.41 g/L and glucose 3.2 mmol/L (plasma glucose 5.0 mmol/L). MR scan of the brain showed involvement of limbic and extra-limbic regions and brainstem. Commercial cell-based assays were negative, but tissue-based assays showed neuropil staining, and cell-based assays for anti-metabotropic glutamate receptor 5 (mGluR5) antibodies were positive in serum and CSF. Six months later, she was diagnosed with Hodgkin's lymphoma. This case emphasises the broader clinical spectrum of anti-mGluR5 encephalitis, challenging its initial characterisation as Ophelia syndrome. It underscores the significance of interpreting commercial cell-based assays and advocates for tissue-based assay testing followed by cell-based assay testing in serum and CSF for diagnosing rare autoimmune encephalitis.

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来源期刊
PRACTICAL NEUROLOGY
PRACTICAL NEUROLOGY Medicine-Neurology (clinical)
CiteScore
3.70
自引率
3.60%
发文量
113
期刊介绍: The essential point of Practical Neurology is that it is practical in the sense of being useful for everyone who sees neurological patients and who wants to keep up to date, and safe, in managing them. In other words this is a journal for jobbing neurologists - which most of us are for at least part of our time - who plough through the tension headaches and funny turns week in and week out. Primary research literature potentially relevant to routine clinical practice is far too much for any neurologist to read, let alone understand, critically appraise and assimilate. Therefore, if research is to influence clinical practice appropriately and quickly it has to be digested and provided to neurologists in an informative and convenient way.
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