肾细胞癌患者中抗谷氨酸脱羧酶抗体阳性的副肿瘤性僵人综合征

GAD antibody positive paraneoplastic stiff person syndrome in a patient with renal cell carcinoma.

作者信息

McHugh John C, Murray Brian, Renganathan Radhakrishnan, Connolly Sean, Lynch Tim

机构信息

Department of Neurology, Mater Misericordiae University Hospital, Dublin, Ireland.

出版信息

Mov Disord. 2007 Jul 15;22(9):1343-6. doi: 10.1002/mds.21374.

DOI:10.1002/mds.21374

PMID:17486640

Abstract

Stiff person syndrome (SPS) is an unusual cause of muscle rigidity and spasms. It is believed to have an autoimmune pathogenesis and is associated with autoantibodies to glutamic acid decarboxylase (GAD). Paraneoplastic SPS (PSPS) has been described mainly in relation to breast cancer and is associated with antibodies to amphiphysin. Few reports of PSPS document the finding of GAD autoantibodies. We present the first reported case of anti-GAD positive PSPS in a 53-year-old male with occult renal carcinoma. Clinical benefit was marked following nephrectomy and intravenous immunoglobulin treatment. Renal carcinoma should be considered in patients with SPS.

摘要

僵人综合征（SPS）是肌肉僵硬和痉挛的一种罕见病因。据信其发病机制为自身免疫性，与谷氨酸脱羧酶（GAD）自身抗体有关。副肿瘤性僵人综合征（PSPS）主要与乳腺癌相关，且与抗 amphiphysin 抗体有关。关于 PSPS 的报道很少记录到 GAD 自身抗体的发现。我们报告首例 53 岁隐匿性肾癌男性患者的抗 GAD 阳性 PSPS 病例。肾切除及静脉注射免疫球蛋白治疗后临床获益显著。僵人综合征患者应考虑肾癌的可能。