Martin Alexandra L, Jolliffe Evan, Hertweck S Paige
Department of Obstetrics, Gynecology and Women's Health, University of Louisville School of Medicine, Louisville, Kentucky.
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
J Pediatr Adolesc Gynecol. 2018 Jun;31(3):321-324. doi: 10.1016/j.jpag.2017.12.009. Epub 2017 Dec 30.
Ovarian teratomas are rarely associated with paraneoplastic autoimmune meningoencephalitis. In addition to the well known N-methyl-D-aspartate receptor (NMDA-R) antibody, the glial fibrillary acidic protein (GFAP) antibody is a novel biomarker of autoimmune meningoencephalitis that might be seen in patients with ovarian teratoma.
A 13-year-old girl with acute-onset meningoencephalitis and incidental finding of ovarian teratoma was found to have coexisting anti-NMDA-R and GFAP antibodies present in her cerebrospinal fluid.
NMDA-R and GFAP autoimmune encephalitis should be considered in adolescent patients with neurologic or psychiatric symptoms and an ovarian teratoma. Prompt diagnosis and surgical resection increase the likelihood of full neurologic recovery.
卵巢畸胎瘤很少与副肿瘤性自身免疫性脑膜脑炎相关。除了众所周知的N-甲基-D-天冬氨酸受体(NMDA-R)抗体外,胶质纤维酸性蛋白(GFAP)抗体是自身免疫性脑膜脑炎的一种新型生物标志物,可能见于卵巢畸胎瘤患者。
一名13岁急性起病的脑膜脑炎女孩,偶然发现卵巢畸胎瘤,其脑脊液中同时存在抗NMDA-R和GFAP抗体。
对于有神经或精神症状且患有卵巢畸胎瘤的青少年患者,应考虑NMDA-R和GFAP自身免疫性脑炎。及时诊断和手术切除可增加完全神经恢复的可能性。