{"title":"抗n -甲基- d -天冬氨酸受体脑炎抗甲状腺抗体阳性与阴性的临床特点比较","authors":"Shuang Zhang, Lulu Yan, Xiaoxue Huang, Yao-Mao Tang","doi":"10.3760/CMA.J.ISSN.1671-8925.2020.02.009","DOIUrl":null,"url":null,"abstract":"Objective \nTo summarize and compare the clinical characteristics of anti N-methyl-D-aspartate (NMDA) receptor encephalitis with positive and negative anti-thyroid antibodies (ATAbs), and explore the clinical characteristics and possible mechanism of anti-NMDA receptor encephalitis with positive ATAbs. \n \n \nMethods \nThe clinical data of 53 patients with definitely diagnosed anti-NMDA receptor encephalitis, admitted to our hospital from January 2016 to April 2019, were collected. The patients were divided into two groups according to positive and negative ATAbs, and the clinical characteristics, experimental results and prognoses of the two groups were compared. \n \n \nResults \nAmong the 53 patients, 16 were combined with positive ATAbs, of which 11 were female (68.8%); 37 were combined with negative ATAbs, of which 11 were female (29.7%); number of female patients in the positive ATAbs group was significantly larger than that in the negative ATAbs group (P 0.05). There were no significant differences in prodromal manifestations, first symptoms (abnormal mental behavior or cognitive impairment, and epilepsy), main clinical manifestations, and incidence of complications between the two groups (P>0.05). As compared with the negative ATAbs group, positive ATAbs group had significantly higher maximum modified Rankin scale scores (4[4, 5] vs. 3[2, 5]), abnormal rate of rheumatic immunity antibodies (50.0% vs. 13.6%), and rate of adopting two or more immunotherapy measures (93.7% vs. 51.4%; P<0.05). \n \n \nConclusion \nThe clinical manifestations of anti-NMDA receptor encephalitis in the positive ATAbs patients are similar to those in the negative ATAbs patients, but the illness is more serious; moreover, the positive ATAbs patients are mostly combined with multiple antibody abnormalities, which may require more active immunotherapy. \n \n \nKey words: \nEncephalitis; Anti-thyroid antibody; Hashimoto's encephalopathy; Autoantibody","PeriodicalId":10104,"journal":{"name":"中华神经医学杂志","volume":"110 1","pages":"164-169"},"PeriodicalIF":0.0000,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of clinical characteristics of anti-N-methyl-D-aspartate receptor encephalitis with positive and negative anti-thyroid antibodies\",\"authors\":\"Shuang Zhang, Lulu Yan, Xiaoxue Huang, Yao-Mao Tang\",\"doi\":\"10.3760/CMA.J.ISSN.1671-8925.2020.02.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo summarize and compare the clinical characteristics of anti N-methyl-D-aspartate (NMDA) receptor encephalitis with positive and negative anti-thyroid antibodies (ATAbs), and explore the clinical characteristics and possible mechanism of anti-NMDA receptor encephalitis with positive ATAbs. \\n \\n \\nMethods \\nThe clinical data of 53 patients with definitely diagnosed anti-NMDA receptor encephalitis, admitted to our hospital from January 2016 to April 2019, were collected. The patients were divided into two groups according to positive and negative ATAbs, and the clinical characteristics, experimental results and prognoses of the two groups were compared. \\n \\n \\nResults \\nAmong the 53 patients, 16 were combined with positive ATAbs, of which 11 were female (68.8%); 37 were combined with negative ATAbs, of which 11 were female (29.7%); number of female patients in the positive ATAbs group was significantly larger than that in the negative ATAbs group (P 0.05). There were no significant differences in prodromal manifestations, first symptoms (abnormal mental behavior or cognitive impairment, and epilepsy), main clinical manifestations, and incidence of complications between the two groups (P>0.05). As compared with the negative ATAbs group, positive ATAbs group had significantly higher maximum modified Rankin scale scores (4[4, 5] vs. 3[2, 5]), abnormal rate of rheumatic immunity antibodies (50.0% vs. 13.6%), and rate of adopting two or more immunotherapy measures (93.7% vs. 51.4%; P<0.05). \\n \\n \\nConclusion \\nThe clinical manifestations of anti-NMDA receptor encephalitis in the positive ATAbs patients are similar to those in the negative ATAbs patients, but the illness is more serious; moreover, the positive ATAbs patients are mostly combined with multiple antibody abnormalities, which may require more active immunotherapy. \\n \\n \\nKey words: \\nEncephalitis; Anti-thyroid antibody; Hashimoto's encephalopathy; Autoantibody\",\"PeriodicalId\":10104,\"journal\":{\"name\":\"中华神经医学杂志\",\"volume\":\"110 1\",\"pages\":\"164-169\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-02-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华神经医学杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1671-8925.2020.02.009\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华神经医学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1671-8925.2020.02.009","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的总结和比较抗甲状腺抗体(ATAbs)阳性和阴性的抗n -甲基- d -天冬氨酸(NMDA)受体脑炎的临床特点,探讨ATAbs阳性的抗NMDA受体脑炎的临床特点及可能的发病机制。方法收集2016年1月至2019年4月我院收治的确诊抗nmda受体脑炎患者53例的临床资料。根据ATAbs阳性和阴性情况将患者分为两组,比较两组患者的临床特点、实验结果及预后。结果53例患者中合并ATAbs阳性16例,其中女性11例(68.8%);合并阴性抗体37例,其中女性11例(29.7%);ATAbs阳性组女性患者人数明显多于ATAbs阴性组(p0.05)。两组患者的前驱症状、首发症状(精神行为异常或认知障碍、癫痫)、主要临床表现、并发症发生率比较,差异均无统计学意义(P>0.05)。与ATAbs阴性组相比,ATAbs阳性组的最大改良Rankin评分(4[4,5]比3[2,5])、风湿病免疫抗体异常率(50.0%比13.6%)和采用两种或两种以上免疫治疗措施的比率(93.7%比51.4%;P < 0.05)。结论ATAbs阳性患者抗nmda受体脑炎的临床表现与ATAbs阴性患者相似,但病情更为严重;此外,ATAbs阳性患者多合并多种抗体异常,可能需要更积极的免疫治疗。关键词:脑炎;甲状腺抗体;桥本脑病;自身抗体
Comparison of clinical characteristics of anti-N-methyl-D-aspartate receptor encephalitis with positive and negative anti-thyroid antibodies
Objective
To summarize and compare the clinical characteristics of anti N-methyl-D-aspartate (NMDA) receptor encephalitis with positive and negative anti-thyroid antibodies (ATAbs), and explore the clinical characteristics and possible mechanism of anti-NMDA receptor encephalitis with positive ATAbs.
Methods
The clinical data of 53 patients with definitely diagnosed anti-NMDA receptor encephalitis, admitted to our hospital from January 2016 to April 2019, were collected. The patients were divided into two groups according to positive and negative ATAbs, and the clinical characteristics, experimental results and prognoses of the two groups were compared.
Results
Among the 53 patients, 16 were combined with positive ATAbs, of which 11 were female (68.8%); 37 were combined with negative ATAbs, of which 11 were female (29.7%); number of female patients in the positive ATAbs group was significantly larger than that in the negative ATAbs group (P 0.05). There were no significant differences in prodromal manifestations, first symptoms (abnormal mental behavior or cognitive impairment, and epilepsy), main clinical manifestations, and incidence of complications between the two groups (P>0.05). As compared with the negative ATAbs group, positive ATAbs group had significantly higher maximum modified Rankin scale scores (4[4, 5] vs. 3[2, 5]), abnormal rate of rheumatic immunity antibodies (50.0% vs. 13.6%), and rate of adopting two or more immunotherapy measures (93.7% vs. 51.4%; P<0.05).
Conclusion
The clinical manifestations of anti-NMDA receptor encephalitis in the positive ATAbs patients are similar to those in the negative ATAbs patients, but the illness is more serious; moreover, the positive ATAbs patients are mostly combined with multiple antibody abnormalities, which may require more active immunotherapy.
Key words:
Encephalitis; Anti-thyroid antibody; Hashimoto's encephalopathy; Autoantibody