{"title":"畸胎瘤相关抗nmdar脑炎1例","authors":"Wei-Hua Lou, Bin Yan, You Wang, W. Di","doi":"10.18314/cogo.v1i1.1270","DOIUrl":null,"url":null,"abstract":"Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune encephalitis that is associated with the NMDA receptor and has a good response to treatment. However, only a small number of cases related teratoma has been reported in literature. Here we report a case of teratoma-associated anti-NMDAR encephalitis. A 25-year-old woman with the presentation of fever for 20 days and psychiatric symptoms for 9 days was admitted to the hospital. This patient progressed to a minimally conscious state consistent with encephalitis. Considering the possibility of autoantibody-mediated encephalitis, laboratory tests were undertaken to observe the anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum, which confirmed the diagnosis of anti-NMDAR encephalitis. Furthermore, gynecological ultrasound investigation detected teratoma in the left ovary. After resection of the teratoma with Laparoscopic adnexectom and treatment with immunosuppressive therapy, the patient recovered gradually and was discharged one month after the operation. Due to the lack of clinical practice guidelines for the prevention and treatment of anti-NMDAR encephalitis, the disease is still difficult to diagnose because of its vague manifestations. For the further study, the clinic data of one case of teratoma-related anti-NMDAR encephalitis was analyzed and the relevant literatures were reviewed.","PeriodicalId":92345,"journal":{"name":"Current opinion in gynecology and obstetrics","volume":"101 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Case of Teratoma-Associated Anti-NMDAR Encephalitis\",\"authors\":\"Wei-Hua Lou, Bin Yan, You Wang, W. Di\",\"doi\":\"10.18314/cogo.v1i1.1270\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune encephalitis that is associated with the NMDA receptor and has a good response to treatment. However, only a small number of cases related teratoma has been reported in literature. Here we report a case of teratoma-associated anti-NMDAR encephalitis. A 25-year-old woman with the presentation of fever for 20 days and psychiatric symptoms for 9 days was admitted to the hospital. This patient progressed to a minimally conscious state consistent with encephalitis. Considering the possibility of autoantibody-mediated encephalitis, laboratory tests were undertaken to observe the anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum, which confirmed the diagnosis of anti-NMDAR encephalitis. Furthermore, gynecological ultrasound investigation detected teratoma in the left ovary. After resection of the teratoma with Laparoscopic adnexectom and treatment with immunosuppressive therapy, the patient recovered gradually and was discharged one month after the operation. Due to the lack of clinical practice guidelines for the prevention and treatment of anti-NMDAR encephalitis, the disease is still difficult to diagnose because of its vague manifestations. For the further study, the clinic data of one case of teratoma-related anti-NMDAR encephalitis was analyzed and the relevant literatures were reviewed.\",\"PeriodicalId\":92345,\"journal\":{\"name\":\"Current opinion in gynecology and obstetrics\",\"volume\":\"101 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2018-12-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current opinion in gynecology and obstetrics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18314/cogo.v1i1.1270\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current opinion in gynecology and obstetrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18314/cogo.v1i1.1270","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
抗n -甲基- d -天冬氨酸受体(anti-NMDAR)脑炎是一种与NMDA受体相关的自身免疫性脑炎,治疗效果良好。然而,文献中仅报道了少数与畸胎瘤相关的病例。我们在此报告一例畸胎瘤相关的抗nmdar脑炎。一名25岁女子因发烧20天并出现精神症状9天而入院。该患者发展到符合脑炎的最低意识状态。考虑到自身抗体介导的脑炎的可能性,实验室检测脑脊液和血清中抗nmdar抗体,证实了抗nmdar脑炎的诊断。此外,妇科超声检查发现左侧卵巢畸胎瘤。经腹腔镜附件切除术及免疫抑制治疗后,患儿病情逐渐恢复,术后1个月出院。由于缺乏预防和治疗抗nmdar脑炎的临床实践指南,该疾病由于其表现模糊,仍然难以诊断。为了进一步研究,我们分析了1例畸胎瘤相关抗nmdar脑炎的临床资料,并复习了相关文献。
A Case of Teratoma-Associated Anti-NMDAR Encephalitis
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune encephalitis that is associated with the NMDA receptor and has a good response to treatment. However, only a small number of cases related teratoma has been reported in literature. Here we report a case of teratoma-associated anti-NMDAR encephalitis. A 25-year-old woman with the presentation of fever for 20 days and psychiatric symptoms for 9 days was admitted to the hospital. This patient progressed to a minimally conscious state consistent with encephalitis. Considering the possibility of autoantibody-mediated encephalitis, laboratory tests were undertaken to observe the anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum, which confirmed the diagnosis of anti-NMDAR encephalitis. Furthermore, gynecological ultrasound investigation detected teratoma in the left ovary. After resection of the teratoma with Laparoscopic adnexectom and treatment with immunosuppressive therapy, the patient recovered gradually and was discharged one month after the operation. Due to the lack of clinical practice guidelines for the prevention and treatment of anti-NMDAR encephalitis, the disease is still difficult to diagnose because of its vague manifestations. For the further study, the clinic data of one case of teratoma-related anti-NMDAR encephalitis was analyzed and the relevant literatures were reviewed.