血浆置换治疗抗GAD抗体相关神经系统综合征一例报道  

Plasma exchange therapy in neurological syndromes associated with anti-GAD antibodies:a case report

作　　者：耿介立[1] 曹雯炜[1] 周夏俊 王亦舒 蒋仙国[1] 张瑛[1] GENG Jieli;CAO Wenwei;ZHOU Xiajun;WANG Yishu;JIANG Xianguo;ZHANG Ying(Department of Neurology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院神经内科,上海200127

出　　处：《神经病学与神经康复学杂志》2024年第2期72-76,共5页Journal of Neurology and Neurorehabilitation

摘　　要：目的:提高对谷氨酸脱羧酶(glutamic acid decarboxylase,GAD)抗体相关神经系统自身免疫病的临床表现的认识,从而避免临床漏诊和误诊。方法:报道1例以僵人综合征为主要症状的患者临床资料,结合文献复习疾病的临床表现、发病机制、诊断和治疗。结果:抗GAD抗体相关神经系统综合征的患者临床症状多样,影像无特异性。GAD抗体对于诊断有重要意义。本例患者通过血浆置换治疗,症状有好转,续贯免疫治疗,症状平稳。结论:僵人综合征是抗GAD抗体相关神经系统综合征的常见表现,鞘内合成GAD抗体是诊断强有力的证据,免疫调节治疗对疾病治疗有效。Objective:Enhance understanding of neuroautoimmune disorders associated with glutamic acid decarboxylase(GAD)antibodies to prevent misdiagnoses.Methods:The clinical data of a patient primarily exhibiting stiff person syndrome was reported,reviewing symptomatology,pathogenesis,diagnostic processes,and treatment modalities based on existing literature.Results:Symptoms in patients with GAD antibody-associated neurological syndrome vary and imaging results are often non-specific.The presence of GAD antibodies is crucial for accurate diagnosis.In this reported case,the patient showed improvement following plasma exchange therapy and maintained symptom stability with ongoing immunotherapy.Conclusion:Stiff person syndrome frequently manifests in anti-GAD antibody associated neurological syndromes.The intrathecal synthesis of GAD antibodies strongly supports diagnosis.Immunomodulatory therapy has proven effective in treating this condition.

关 键 词：谷氨酸脱羧酶抗体 僵人综合征 血浆置换 

分 类 号：R741[医药卫生—神经病学与精神病学]