Terada Atsumu, Tasaki Shingo, Tachibana Takashi, Sakamoto Yoshitaka, Yokomine Masato, Shimomura Takuya, Murakami Fumihiro
Department of Obstetrics and Gynecology, St. Mary's Hospital, Fukuoka, Japan.
Gynecol Minim Invasive Ther. 2017 Jan-Mar;6(1):34-37. doi: 10.1016/j.gmit.2016.06.004. Epub 2016 Jul 26.
Anti--methyl-D-aspartate (NMDA) receptor antibody encephalitis is an autoimmune form of limbic encephalitis. Eighty percent of patients with anti-NMDA receptor (NMDAR) encephalitis are women, and 39% of those women are reported to have an ovarian teratoma also. When a tumor is also present, prompt surgery can prevent the development of more severe symptoms or the prolongation of symptoms of encephalitis. The current authors encountered two cases in which anti-NMDAR encephalitis was suspected. In these cases, abdominal computed tomography (CT) revealed an ovarian teratoma and both patients underwent a laparoscopic salpingo-oophorectomy. Both patients underwent surgery before a definitive diagnosis was made. Findings in one case did not lead to a diagnosis of anti-NMDAR encephalitis, but symptoms rapidly improved after surgery in both cases. Laparoscopic surgery is minimally invasive, so this approach may be the first step in a treatment algorithm for treatment of a tumor in a patient with anti-NMDAR encephalitis.
抗N-甲基-D-天冬氨酸（NMDA）受体抗体脑炎是一种自身免疫性边缘叶脑炎。80%的抗NMDA受体（NMDAR）脑炎患者为女性，据报道其中39%的女性还患有卵巢畸胎瘤。当同时存在肿瘤时，及时手术可预防更严重症状的出现或脑炎症状的延长。本文作者遇到两例疑似抗NMDAR脑炎的病例。在这些病例中，腹部计算机断层扫描（CT）显示有卵巢畸胎瘤，两名患者均接受了腹腔镜输卵管卵巢切除术。两名患者均在确诊前接受了手术。其中一例的检查结果未导致抗NMDAR脑炎的诊断，但两例患者术后症状均迅速改善。腹腔镜手术创伤极小，因此这种方法可能是抗NMDAR脑炎患者肿瘤治疗算法中的第一步。
