抗富亮氨酸胶质瘤失活1蛋白和抗髓鞘少突胶质细胞糖蛋白双抗体阳性的边缘叶脑炎1例  

A case of limbic encephalitis with positive anti-leucine-rich glioma inactivated 1 protein antibody and anti-myelin oligodendrocyte glycoprotein antibody

作　　者：董晓娇[1] 杨昊翔[1] 尹立勇[1] 刘宏丽[1] Dong Xiaojiao;Yang Haoxiang;Yin Liyong;Liu Hongli(Department of Neurology,First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院神经内科,秦皇岛066000

出　　处：《中华神经科杂志》2022年第5期501-506,共6页Chinese Journal of Neurology

摘　　要：介绍1例抗富亮氨酸胶质瘤失活1蛋白(LGI1)和抗髓鞘少突胶质细胞糖蛋白(MOG)双抗体阳性的边缘叶脑炎患者。患者为中年男性,既往有视网膜静脉阻塞病史,本次发病主要症状为颞叶癫痫、面臂肌张力障碍、自主神经功能障碍等;头颅磁共振成像示右侧海马长T2信号、无强化、灌注正常;脑电图示发作间期阵发性慢波、尖慢波;血抗MOG抗体、血和脑脊液抗LGI1抗体双阳性,主要诊断为边缘叶脑炎,给予激素和丙种球蛋白治疗后症状好转,复查双抗体均转阴。该抗LGI1/MOG双阳性病例较罕见,且临床症状和影像学表现并非与单一抗体阳性患者完全一致,有其不同特点。文中对该病例临床资料进行报道以期进一步加深临床医师对该病的认识。A case of limbic encephalitis with positive anti-leucine-rich glioma inactivated 1 protein(LGI1)antibody and anti-myelin oligodendrocyte glycoprotein(MOG)antibody was reported.The patient was a middle-aged male with a history of retinal vein occlusion.The main symptoms were temporal lobe epilepsy,facial arm dystonia,autonomic nerve dysfunction.Magnetic resonance imaging showed long T2 signal in the right hippocampus without enhancement and normal perfusion.Electroencephalogram showed paroxysmal slow wave and sharp slow wave in interictal period.Blood anti-MOG antibody,blood and cerebrospinal fluid anti-LGI1 antibody were double positive.The main diagnosis was limbic encephalitis.After treatment with hormone and gamma globulin,the symptoms were improved and double antibodies were turned negative.Anti-LGI1/MOG double positive cases are rare,and the clinical manifestations and imaging manifestations of double positive antibody cases are not completely consistent with those with each single antibody,with different characteristics.This report can help clinicians enhance awareness.

关 键 词：边缘叶脑炎 富亮氨酸胶质瘤失活1蛋白抗体 髓鞘少突胶质细胞糖蛋白抗体 

分 类 号：R742.9[医药卫生—神经病学与精神病学]