Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Department of Hematology, Graduate School of Medical Sciences, International University of Health and Welfare, Narita, Japan.
Int J Hematol. 2020 Aug;112(2):254-257. doi: 10.1007/s12185-020-02859-0. Epub 2020 Mar 21.
Various central nervous system (CNS) complications may occur after allogeneic hematopoietic stem cell transplantation (allo-HSCT), which can result in severe clinical problems. Diagnosis is often difficult, as distinctive clinical symptoms may be absent and different neurological disorders may exhibit similar symptoms. Despite the fact that antibodies responding to brain cell surface antigens have become well recognized in several CNS disorders, cases of autoimmune CNS disorders after allo-HSCT have rarely been reported. Here, we report on a patient who developed encephalitis associated with antibodies against N-methyl-D-aspartate (NMDA)-type glutamate receptor (GluR) after allo-HSCT. To the best of our knowledge, this is the first report of the involvement of antibodies against NMDA-type GluR in post-transplantation encephalitis. Autoimmunity to NMDA-type GluR may have contributed to neurological complications after transplantation in unresolved cases.
异基因造血干细胞移植（allo-HSCT）后可能会发生各种中枢神经系统（CNS）并发症，这可能导致严重的临床问题。由于缺乏独特的临床症状，不同的神经障碍可能表现出相似的症状，因此诊断通常较为困难。尽管针对脑细胞表面抗原的抗体已在几种 CNS 疾病中得到广泛认可，但 allo-HSCT 后自身免疫性 CNS 疾病的病例很少见。在这里，我们报告了一例 allo-HSCT 后发生与 N-甲基-D-天冬氨酸（NMDA）型谷氨酸受体（GluR）抗体相关的脑炎的患者。据我们所知，这是首例报道 NMDA 型 GluR 抗体参与移植后脑炎的病例。在未解决的情况下，针对 NMDA 型 GluR 的自身免疫可能导致移植后的神经并发症。
