抗锌指蛋白4抗体、抗Hu抗体双阳性的边缘性脑炎一例  

A case of limbic encephalitis with positive anti-zinc finger protein 4 antibody and anti-Hu antibody

作　　者：徐广印[1] 任海涛[2] Xu Guangyin;Ren Haitao(Department of Neurology,Linyi People′s Hospital,Linyi,Shandong 276000,China;Department of Neurology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]临沂市人民医院神经内科,276000 [2]中国医学科学院北京协和医院神经科,100730

出　　处：《中华神经科杂志》2021年第7期700-704,共5页Chinese Journal of Neurology

摘　　要：报道1例抗锌指蛋白4(ZIC4)抗体、抗Hu抗体双重阳性的边缘性脑炎,患者中年女性,因记忆力下降、行走不稳、下肢麻木2个月余入院,临床主要表现为认知下降、共济失调、双下肢感觉障碍,磁共振示双侧颞叶、海马异常信号,肌电图示感觉神经损害,查血和脑脊液抗ZIC4抗体、抗Hu抗体双重阳性,其他各项检查未发现肿瘤。主要诊断为边缘性脑炎合并亚急性小脑变性、亚急性感觉神经元病,副肿瘤神经综合征。考虑存在潜在的肿瘤风险,需要长期随访。类似病例国内较少报道,以期引起临床医师的重视。A case of limbic encephalitis with positive anti-zinc finger protein 4(ZIC4)antibody and anti-Hu antibody was reported.A middle-aged female was admitted to hospital for two months because of memory loss and unstable walking.The main manifestations were cognitive decline,ataxia and sensory disturbance of both lower extremities.The main diagnosis was limbic encephalitis,complicated with subacute cerebellar degeneration and subacute sensory neuron disease,which was consistent with paraneoplastic nervous system syndrome.Magnetic resonance imaging showed abnormal signals in bilateral temporal lobe and hippocampus,electromyography showed sensory nerve damage,blood and cerebrospinal fluid anti-ZIC4 antibody and Hu antibody were both positive,and no tumor was found.It is speculated that there may be potential tumors and need to be followed up and monitored.This rare case is reported to attract the attention of clinicians.

关 键 词：自身免疫性脑炎 边缘叶脑炎 抗ZIC4抗体 抗Hu抗体 

分 类 号：R742.9[医药卫生—神经病学与精神病学]