GAD65-IgG相关神经系统疾病重症肌无力的治疗策略1例

IF 2.5 4区医学 Q3 IMMUNOLOGY

Journal of neuroimmunology Pub Date : 2025-08-31 DOI:10.1016/j.jneuroim.2025.578741

Xiao-Na Xu , Wen-Jun Luo , Hui-Ning Li , Xin Li , Jun-Ping Wang , Wei Jiang , Shu Yang , Chun-Sheng Yang

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引用次数: 0

摘要

我们报告一例具有临床指导意义的50岁女性乙酰胆碱受体（AChR）抗体阳性的广泛性重症肌无力（MG），随后发展为谷氨酸脱羧酶65 （GAD65）抗体相关的神经系统疾病，并伴有B2型胸腺瘤。这种罕见的共存突出了胸腺瘤引起的深刻的免疫失调，其中自我耐受性的丧失出现了多种并发的自身免疫现象。患者对多模式免疫治疗（包括依加替莫德、大剂量皮质类固醇和利妥昔单抗）的良好反应强调了在这种复杂的神经免疫综合征中进行早期靶向免疫调节的治疗必要性。由于目前还没有针对MG合并gad65 - igg相关神经系统疾病的标准化治疗方法，该病例为这种复杂疾病的诊断和治疗方法提供了重要的临床见解。

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Treatment strategy for myasthenia gravis with GAD65-IgG associated neurological disorders: A case report

We present a clinically instructive case of a 50-year-old woman with acetylcholine receptor (AChR) antibody-positive generalized myasthenia gravis (MG) who subsequently developed glutamic acid decarboxylase 65 (GAD65) antibody-associated neurological disorders alongside a type B2 thymoma. This rare coexistence highlights the profound immune dysregulation induced by thymomas, wherein loss of self-tolerance emergence multiple concurrent autoimmune phenomena. The patient's favorable response to multimodal immunotherapy—including efgartigimod, high-dose corticosteroids, and rituximab—underscores the therapeutic imperative for early, targeted immunomodulation in such complex neuroimmunological syndromes. As no standardized treatment currently exists for MG with GAD65-IgG-associated neurological disorders, this case provides critical clinical insights into both the diagnostic and therapeutic approach for this complex disease.

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来源期刊

Journal of neuroimmunology 医学-免疫学

CiteScore

6.10

自引率

3.00%

发文量

154

审稿时长

37 days

期刊介绍： The Journal of Neuroimmunology affords a forum for the publication of works applying immunologic methodology to the furtherance of the neurological sciences. Studies on all branches of the neurosciences, particularly fundamental and applied neurobiology, neurology, neuropathology, neurochemistry, neurovirology, neuroendocrinology, neuromuscular research, neuropharmacology and psychology, which involve either immunologic methodology (e.g. immunocytochemistry) or fundamental immunology (e.g. antibody and lymphocyte assays), are considered for publication.