摘要
目的报道1例抗谷氨酸脱羧酶65抗体脑炎合并僵人综合征(SPS)及自身免疫性多内分泌腺病综合征Ⅱ型(APS-Ⅱ)的病例,以提高对该疾病的认识。方法回顾性分析2017年至2019年安徽医科大学第一附属医院收治的1例34岁女性抗谷氨酸脱羧酶65抗体脑炎合并SPS及APS-Ⅱ患者的临床资料并复习相关文献。结果患者2017年3月以近记忆缺损起病,脑脊液抗谷氨酸脱羧酶65抗体阳性,甲状腺抗体(抗甲状腺球蛋白抗体,甲状腺过氧化酶抗体)明显高于正常值;2018年10月出现肢体和躯干僵硬、活动受限;2019年7月发现血糖异常和甲状腺功能异常,糖尿病抗体(蛋白酪氨酸磷酸酶抗体,锌转运蛋白8抗体)阳性。诊断为抗谷氨酸脱羧酶65抗体脑炎、SPS、APS-Ⅱ(桥本甲状腺炎,1型糖尿病)。予以免疫治疗和对症治疗后,患者的症状稳定,未继续进展。结论抗谷氨酸脱羧酶65抗体脑炎合并SPS和APS-Ⅱ临床上较为罕见。抗谷氨酸脱羧酶65抗体或遗传易患性可能是该抗谷氨酸脱羧酶65抗体脑炎患者同时合并多种自身免疫疾病的原因。
Objective To report a case of anti-glutamate decarboxylase(GAD)65 antibody encephalitis with stiff-person syndrome(SPS)and autoimmune polyendocrinopathy syndrome typeⅡ(APS-Ⅱ)to improve the understanding of this disease.Methods Clinical data of a 34-year-old female patient who had anti-GAD65 antibody encephalitis with SPS and APS-Ⅱin the First Affiliated Hospital of Anhui Medical University during 2017 to 2019 were reported and analyzed.The relevant literature was reviewed.Results The patient started with short-term memory impairment in March 2017.The anti-GAD65 antibody in cerebrospinal fluid was positive and the levels of thyroid antibodies(anti-thyroglobulin antibody,thyroid peroxidase antibody)in serum were significantly higher than the normal value.In October 2018,her limbs and trunk were stiff and her movement was restricted.In July 2019,she was found with abnormal blood glucose and thyroid function,and diabetes antibodies(protein tyrosine phosphatase antibody,zinc transporter 8 antibody)were positive.Finally,the patient was diagnosed with anti-GAD65 antibody encephalitis,SPS and APS-Ⅱ(Hashimoto thyroiditis,type 1 diabetes).After immunotherapy and symptomatic treatments,her symptoms were controlled and did not progress.Conclusions It is extremely rare for a patient who suffered anti-GAD65 antibody encephalitis,SPS and APS-Ⅱ.The existence of anti-GAD65 antibody or genetic susceptibility may be the reason why the patient suffered three syndromes successively.
作者
侯强强
章娟娟
姬洋
郭媛媛
陈越
周农
汪凯
田仰华
Hou Qiangqiang;Zhang Juanjuan;Ji Yang;Guo Yuanyuan;Chen Yue;Zhou Nong;Wang Kai;Tian Yanghua(Department of Neurology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders,Hefei 230022,China)
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2021年第2期112-116,共5页
Chinese Journal of Neurology
基金
安徽省杰出青年科学基金(1808085J23)
安徽省高校自然科学研究项目(KJ2019A0243)。
