抗N-甲基-D-天冬氨酸受体脑炎合并纵隔畸胎瘤1例报告及文献复习  

Anti-N-methyl-D-aspartate receptor encephalitis combined with mediastinal teratoma:a case report and literature review

作　　者：汤瑶 王欢 黄凤琴 罗兴梅 TANG Yao;WANG Huan;HUANG Fengqin;LUO Xingmei(Graduate School,Guizhou Medical University,Guizhou Province,Guiyang 550000,China;Integrated Ward,Affiliated Hospital of Guizhou Medical University,Guizhou Province,Guiyang 550000,China)

机构地区：[1]贵州医科大学研究生院,贵州贵阳550000 [2]贵州医科大学附属医院综合病房,贵州贵阳550000

出　　处：《中国医药导报》2023年第18期169-173,共5页China Medical Herald

基　　金：贵州省卫生健康委员会科学技术基金项目(gzwjkj2020-1-019)。

摘　　要：抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎是一种复杂的自身免疫性神经精神综合征,既往文献报道了抗NMDAR脑炎与女性卵巢畸胎瘤相关,但抗NMDAR脑炎联合纵隔畸胎瘤较为罕见,临床特点不明确,治疗存在一定局限性。本文介绍了1例抗NMDAR脑炎合并纵隔畸胎瘤14岁男性患者,病程中持续存在四肢抽搐及口周不自主运动,先后予以激素冲击治疗、血浆置换、丙球蛋白、利妥昔单抗及多种抗癫痫药物合并使用,效果不佳,切除纵隔畸胎瘤,病情好转后出院。本文结合病历及文献资料综述了抗NMDAR脑炎合并畸胎瘤的发病机制、临床表现及治疗等,以期提高临床医师对该疾病的认知度。Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis is a complex autoimmune neuropsychiatric syndrome.Previous literature has reported that anti-NMDAR encephalitis is associated with female ovarian teratoma,however,anti-NMDAR encephalitis combined with mediastinal teratoma is rare.The clinical characteristics are not clear,and the treatment has certain limitations.This article present a 14-year-old male patient with anti-NMDAR encephalitis and mediastinal teratoma.During the course of the disease,there were persistent convulsions of the limbs and involuntary movements around the mouth.Hormone shock therapy,plasma exchange,proglobulin,rituximab,and a variety of antiepileptic drugs were used in combination,poor effect.Resection of mediastinal teratoma,condition improved after discharge.In this paper,the pathogenesis,clinical manifestations,and treatment of anti-NMDAR encephalitis complicated with teratoma were reviewed based on medical records and literature,in order to improve clinicians’awareness of this disease.

关 键 词：自身免疫性脑炎 抗N-甲基-D-天冬氨酸受体 纵隔畸胎瘤 超难治性癫痫持续状态 

分 类 号：R74[医药卫生—神经病学与精神病学]