Omi Tsubasa, Kinoshita Makoto, Nishikawa Akira, Tomioka Takahito, Ohmori Kenichi, Fukada Kei, Matsunaga Hidenori
Department of Psychiatry, Osaka General Medical Center, Japan.
Department of Neurology, Osaka General Medical Center, Japan.
Intern Med. 2018 Apr 1;57(7):1011-1013. doi: 10.2169/internalmedicine.9682-17. Epub 2017 Dec 8.
We report a rare case of anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) encephalitis presenting clinical relapse in association with recurrence of thymoma. Anti-AMPAR encephalitis is an autoimmune-mediated neurological disease, frequently accompanied by the presence of neoplasms, thus comprising the spectrum of paraneoplastic syndrome. A patient had been in remission for 34 months showed clinical relapse 3 months after the detection of recurrent thymoma. Clinical relapse of anti-AMPAR encephalitis after the recurrence of an initially detected neoplasm has not been previously reported. Our case therefore highlights the pathogenic relevance of specific tumor antigens as a trigger of anti-AMPAR antibody production and induction of the disease.
我们报告了一例罕见的抗α-氨基-3-羟基-5-甲基-4-异恶唑丙酸受体(AMPAR)脑炎,其临床复发与胸腺瘤复发相关。抗AMPAR脑炎是一种自身免疫介导的神经疾病,常伴有肿瘤存在,因此属于副肿瘤综合征范畴。一名已缓解34个月的患者在检测到复发性胸腺瘤3个月后出现临床复发。先前尚未报道过最初检测到的肿瘤复发后抗AMPAR脑炎的临床复发情况。因此,我们的病例突出了特定肿瘤抗原作为抗AMPAR抗体产生和疾病诱导触发因素的致病相关性。