Neurosyphilis complicated by anti-γ-aminobutyric acid-B receptor encephalitis: A case report  

作　　者：Ya-Xiu Fang Xiao-Ming Zhou Dong Zheng Guang-Hui Liu Peng-Bo Gao Xiao-Zhen Huang Zhi-Cheng Chen Hui Zhang Lin Chen Ya-Fang Hu 

机构地区：[1]Department of Neurology,The Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510000,Guangdong Province,China [2]Department of Neurology,Nanfang Hospital,Southern Medical University,Guangzhou 510000,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2024年第11期1960-1966,共7页世界临床病例杂志

摘　　要：BACKGROUND Syphilis is an infectious disease caused by Treponema pallidum that can invade the central nervous system,causing encephalitis.Few cases of anti-N-methyl-Daspartate receptor autoimmune encephalitis(AE)secondary to neurosyphilis have been reported.We report a neurosyphilis patient with anti-γ-aminobutyric acid-B receptor(GABABR)AE.CASE SUMMARY A young man in his 30s who presented with acute epileptic status was admitted to a local hospital.He was diagnosed with neurosyphilis,according to serum and cerebrospinal fluid(CSF)tests for syphilis.After 14 d of antiepileptic treatment and anti-Treponema pallidum therapy with penicillin,epilepsy was controlled but serious cognitive impairment,behavioral,and serious psychiatric symptoms were observed.He was then transferred to our hospital.The Mini-Mental State Examination(MMSE)crude test results showed only 2 points.Cranial magnetic resonance imaging revealed significant cerebral atrophy and multiple fluidattenuated inversion recovery high signals in the white matter surrounding both lateral ventricles,left amygdala and bilateral thalami.Anti-GABABR antibodies were discovered in CSF(1:3.2)and serum(1:100).The patient was diagnosed with neurosyphilis complicated by anti-GABABR AE,and received methylprednisolone and penicillin.Following treatment,his mental symptoms were alleviated.Cognitive impairment was significantly improved,with a MMSE of 8 points.Serum anti-GABABR antibody titer decreased to 1:32.The patient received methylprednisolone and penicillin after discharge.Three months later,the patient’s condition was stable,but the serum anti-GABABR antibody titer was 1:100.CONCLUSION This patient with neurosyphilis combined with anti-GABABR encephalitis benefited from immunotherapy.

关 键 词：Anti-γ-aminobutyric acid-B receptor GABABR NEUROSYPHILIS Tissue-based assay Magnetic resonance imaging Mini-mental state examination Case report 

分 类 号：R759.1[医药卫生—皮肤病学与性病学] R742.9[医药卫生—临床医学]