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[卵巢畸胎瘤合并抗N-甲基-D-天冬氨酸受体脑炎:5例报告并文献复习]

[Ovarian teratoma associated with anti-N-methyl-D-aspartate receptor encephalitis: a report of 5 cases and review of the literature].

作者信息

Zhou Xingnan, Sun Dawei, Feng Limin, Guo Lei, Ren Haitao, Xue Xiaowei, Liu Zhufeng, Leng Jinhua, Zhu Lan, Lang Jinghe

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital,Beijing 100730, China.

Email:

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2014 Apr;49(4):281-6.

Abstract

OBJECTIVE

To report the clinical features of ovarian teratoma in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

METHODS

The clinical information of five female patients with ovarian teratoma and anti-NMDAR encephalitis in Peking Union Medical College Hospital and Beijing Tiantan Hospital affiliated to Capital Medical University from June 2011 to May 2013 were obtained. Relevant literatures were reviewed.

RESULTS

The initial symptoms varied from respiratory prodromes or emotional incentives before the onset of psychiatric symptoms. Patients always presented with psychosis, bizarre dyskinesia and seizures. Antibodies to NMDAR in serum and cerebrospinal fluid (CSF) were positive; The psychiatric symptoms were dramatically relieved by tumor reception and immunotherapy which occurred in inverse order of symptom development. No evidence of tumor recurrence was observed during a short-time follow-up after the surgery.

CONCLUSIONS

Ovarian teratoma with anti-NMDAR encephalitis always presents with psychiatric symptoms which could be misdiagnosed as psychiatric diseases. Patients respond to tumor resection and immunotherapy.

摘要

目的

报告抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎患者合并卵巢畸胎瘤的临床特征。

方法

获取2011年6月至2013年5月在北京协和医院及首都医科大学附属北京天坛医院就诊的5例合并卵巢畸胎瘤及抗NMDAR脑炎的女性患者的临床资料,并复习相关文献。

结果

初始症状在精神症状发作前表现为呼吸道前驱症状或情绪诱因。患者常出现精神病性症状、怪异的运动障碍及癫痫发作。血清和脑脊液(CSF)中的NMDAR抗体呈阳性;肿瘤切除及免疫治疗后精神症状显著缓解,且症状缓解顺序与症状出现顺序相反。术后短期随访未观察到肿瘤复发迹象。

结论

合并抗NMDAR脑炎的卵巢畸胎瘤常表现为精神症状,易被误诊为精神疾病。患者对肿瘤切除及免疫治疗有效。

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