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抗谷氨酸脱羧酶抗体副肿瘤性边缘性脑炎伴急性髓系白血病。

Anti-glutamic acid decarboxylase antibody paraneoplastic limbic encephalitis associated with Acute Myeloid Leukemia.

机构信息

La Timone, Internal Medicine Department, University Hospital of Marseille, France.

La Timone, Internal Medicine Department, University Hospital of Marseille, France.

出版信息

Clin Neurol Neurosurg. 2020 Feb;189:105618. doi: 10.1016/j.clineuro.2019.105618. Epub 2019 Nov 25.

Abstract

A 75-year-old woman developed a frontal lobe disorder a few days after the diagnostic of an Acute Myeloid Leukemia secondary to a myelodysplastic syndrome. The patterns on the cerebral Magnetic Resonance Imaging and positron emission tomography and the find of antiglutamic acid decarboxylase antibody on cerebral spinal fluid were in favor of a paraneoplastic limbic encephalitis. In cerebral spinal fluid, there were no micro-organisms nor leukemic cells. We found no sign of cancer on full body computerized tomography-scan, on full-body PET and on rectosigmoidoscopy. The patient was treated by corticosteroid and intravenous immunoglobulins with success, but she died before receiving chemotherapy. It's known that anti- glutamic acid decarboxylase antibody is involved in paraneoplastic syndromes. Paraneoplastic limbic encephalitis is frequently associated with carcinoma or Hodgkin's lymphoma, but it was only reported associated with Acute Myeloid Leukemia in one case report. Even if Acute Myeloid Leukemia is not frequently associated with paraneoplastic limbic encephalitis, the clinicians must consider paraneoplastic limbic encephalitis as an etiology of unexplained neurological disorders.

摘要

一位 75 岁女性在诊断出骨髓增生异常综合征继发的急性髓系白血病几天后出现额叶紊乱。脑磁共振成像和正电子发射断层扫描的模式以及脑脊液中谷氨酸脱羧酶抗体的发现均支持副肿瘤性边缘叶脑炎。脑脊液中无微生物或白血病细胞。全身计算机断层扫描-扫描、全身正电子发射断层扫描和直肠乙状结肠镜检查均未发现癌症迹象。患者接受皮质类固醇和静脉注射免疫球蛋白治疗后成功,但在接受化疗之前死亡。已知抗谷氨酸脱羧酶抗体与副肿瘤综合征有关。副肿瘤性边缘叶脑炎常与癌或霍奇金淋巴瘤相关,但仅在一例病例报告中报道与急性髓系白血病相关。即使急性髓系白血病与副肿瘤性边缘叶脑炎不常相关,临床医生也必须将副肿瘤性边缘叶脑炎视为不明原因神经障碍的病因。

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