Doden Tadashi, Sekijima Yoshiki, Ikeda Junji, Ozawa Kazuki, Ohashi Nobuhiko, Kodaira Minori, Hineno Akiyo, Tachibana Naoko, Ikeda Shu-Ichi
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan.
Intern Med. 2017;56(3):357-362. doi: 10.2169/internalmedicine.56.7442. Epub 2017 Feb 1.
We describe a 24-year-old woman with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis that developed 3 weeks after normal delivery. She was treated with methylprednisolone, intravenous immunoglobulin, and plasmapheresis, in addition to teratoma excision. However, her recovery was slow, and dysmnesia and mental juvenility persisted even two years after onset. To date, five patients with postpartum anti-NMDAR encephalitis have been reported. All of those patients showed psychotic symptoms and were suspected of having postpartum psychosis in the early period of the encephalitis. Changes in hormonal factors, modification of immune tolerance, or retrograde infection of the ovary may be contributing factors for postpartum anti-NMDAR encephalitis.
我们描述了一名24岁的女性，她在正常分娩3周后患上了抗N-甲基-D-天冬氨酸受体（抗NMDAR）脑炎。除了切除畸胎瘤外，她还接受了甲泼尼龙、静脉注射免疫球蛋白和血浆置换治疗。然而，她的恢复缓慢，甚至在发病两年后仍存在记忆障碍和智力幼稚。迄今为止，已有5例产后抗NMDAR脑炎患者被报道。所有这些患者均表现出精神症状，在脑炎早期被怀疑患有产后精神病。激素因素的变化、免疫耐受的改变或卵巢的逆行感染可能是产后抗NMDAR脑炎的促成因素。
