Department of Clinical Neurology, IRCCS, National Neurological Institute C Mondino, Pavia, Italy.
Neurol Sci. 2011 Oct;32(5):915-7. doi: 10.1007/s10072-011-0510-y. Epub 2011 Mar 3.
Anti-Ma2/Ta antibodies are rare paraneoplastic antibodies, which are mostly associated with limbic encephalitis in male patients with testicular cancer. We report on a 50-year-old woman with a pure progressive spastic paraparesis. Next, she was diagnosed as having a Sjögren syndrome, with serological positivity for anti-SS-Ro antibodies. The patient's serum and cerebrospinal fluid samples were positive for anti-Ma2/Ta antibodies, which were also proved to be intrathecally produced. These findings, and the coexistence of systemic autoimmunity, led us to treat the patient with corticosteroids first, and then with plasma exchange. Neurological symptoms scarcely responded to both the therapies. The search for cancer was negative up to 4 years after the disease onset. Our case expands the spectrum of clinical syndromes associated with anti-Ma2/Ta antibodies.
抗 Ma2/Ta 抗体是罕见的副肿瘤性抗体，主要与睾丸癌男性患者的边缘性脑炎相关。我们报告了一例 50 岁女性，表现为单纯进行性痉挛性截瘫。随后，她被诊断为干燥综合征，血清抗 SS-Ro 抗体阳性。患者的血清和脑脊液样本均为抗 Ma2/Ta 抗体阳性，且证实为鞘内合成。这些发现，以及自身免疫的存在，使我们首先用皮质类固醇治疗患者，然后用血浆置换治疗。这两种治疗方法对神经系统症状的反应都很差。在发病 4 年后，癌症仍未被发现。我们的病例扩大了抗 Ma2/Ta 抗体相关临床综合征的范围。
