抗谷氨酸脱羧酶抗体相关小脑共济失调临床特征与预后分析  

Clinical characteristics and prognosis of patients with anti‑glutamic acid decarboxylase antibody‑related cerebellar ataxia

作　　者：柏琳 蔡耘[2] 任海涛[1] 邸卫英[2] 刘曼歌 范思远[1] 关鸿志[1] Bai Lin;CaiYun;Ren Haitao;Di Weiying;Liu Mange;Fan Siyuan;Guan Hongzhi(Department of Neurology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Neurology,Affiliated Hospital of Hebei University,Baoding 071000,China)

机构地区：[1]中国医学科学院北京协和医院神经科,北京100730 [2]河北大学附属医院神经科,保定071000

出　　处：《中华医学杂志》2022年第25期1935-1937,共3页National Medical Journal of China

基　　金：中国医学科学院临床与转化医学研究基金(2020‑I2M‑C&T‑B‑012)。

摘　　要：回顾北京协和医院2015年至2021年11月收治的10例抗谷氨酸脱羧酶(GAD)抗体相关小脑共济失调患者的临床资料、诊疗方案和预后。女性8例,中位年龄55岁,主要表现为行走不稳(10/10),头晕(8/10),复视(6/10),构音障碍(5/10)。4例患者合并其他自身免疫性疾病,包括白癜风(3/4)、桥本甲状腺炎(1/4)、血小板减低症(1/4),1例患者合并小细胞肺癌。所有患者均接受免疫治疗,6例临床症状改善,5例功能预后良好。抗GAD抗体相关小脑共济失调可合并其他自身免疫性疾病,仅少数患者合并肿瘤。半数以上患者对免疫治疗有效,功能预后良好。The clinical data,diagnosis,treatment,and prognosis of 10 patients with anti-glutamic acid decarboxylase(GAD)antibody-related cerebellar ataxia in Department of Neurology,Peking Union Medical College Hospital,from May 2015 to November 2021 were retrospectively analyzed.There were 8 female patients with a median age of 55 years old.Patients mainly presented with gait ataxia(10/10),dizziness(8/10),diplopia(6/10),and dysarthria(5/10).Four of them were complicated with other autoimmune disease,including vitiligo(3/4),Hashimoto thyroiditis(1/4),thrombocytopenia(1/4),and small cell lung cancer(1/4).All patients received immunotherapy,6 out of 10 exhibited a good response,and half of them had satisfied functional prognosis.Patients of anti-GAD antibody-related cerebellar ataxia may be complicated with other autoimmune diseases,but underlying tumor is rare.More than half of patients have a good response to immunotherapy and satisfied prognosis.

关 键 词：小脑共济失调 谷氨酸脱羧酶 自身免疫 抗体 

分 类 号：R744.7[医药卫生—神经病学与精神病学]