血浆置换在一名伴有眼阵挛和谷氨酸受体δ2自身抗体患者治疗中的成功应用
The Successful Application of Plasmapheresis in the Treatment of a Patient with Opsoclonus and Autoantibodies to Glutamate Receptor δ2.
作者信息
Nakamagoe Kiyotaka, Nohara Seitaro, Takahashi Yukitoshi, Takiguchi Mao, Kawakami Rio, Koganezawa Tadachika, Tamaoka Akira
机构信息
Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan.
National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan.
出版信息
Intern Med. 2017 Oct 15;56(20):2773-2778. doi: 10.2169/internalmedicine.6771-15. Epub 2017 Sep 15.
Glutamate receptor δ2 (GluRδ2) is expressed in the neuronal postsynaptic densities at the junctions between the Purkinje cells and the parallel fibers. Recent reports have described patients with opsoclonus who possess anti-GluRδ2 antibodies. We report the case of a 53-year-old man with opsoclonus whose cerebrospinal fluid was positive for anti-GluRδ2 antibodies. Electronystagmography revealed abnormal sinusoidal eye movements, which were definitively identified as opsoclonus. The frequency and amplitude of saccadic oscillations diminished after plasmapheresis (PE). The patient's opsoclonus was altered after PE, suggesting that anti-GluRδ2 antibodies may act on the saccade generator in the brainstem via the cerebellum and that they may be involved in the onset of opsoclonus.
谷氨酸受体δ2（GluRδ2）表达于浦肯野细胞与平行纤维之间连接处的神经元突触后致密区。最近的报告描述了患有眼阵挛的患者体内存在抗GluRδ2抗体。我们报告了一例53岁患有眼阵挛的男性病例，其脑脊液抗GluRδ2抗体呈阳性。眼震电图显示异常的正弦形眼球运动，明确诊断为眼阵挛。血浆置换（PE）后，扫视振荡的频率和幅度降低。患者的眼阵挛在血浆置换后有所改善，提示抗GluRδ2抗体可能通过小脑作用于脑干中的扫视发生器，并且可能参与了眼阵挛的发病过程。
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