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卵巢畸胎瘤切除术治疗抗N-甲基-D-天冬氨酸受体脑炎:文献综述与两例病例报告

Treatment of Anti-NMDA Receptor Encephalitis with Ovarian Teratoma Removal: A Literature Review and Two Case Reports.

作者信息

Tu Nguyen Phuong, Nha Pham Ba, Hung Nguyen Duy, Minh Nguyen Hoang, Anh Hoang Ngoc, Dinh Thien Chu

机构信息

Obstetrics and Gynecology Department of Hanoi Medical University, Hanoi, Vietnam.

Obstetrics and Gynecology Department in Bach Mai Hospital, Hanoi, Vietnam.

出版信息

Open Access Maced J Med Sci. 2019 Dec 20;7(24):4378-4382. doi: 10.3889/oamjms.2019.839. eCollection 2019 Dec 30.

Abstract

BACKGROUND

N-methyl-d-aspartate receptor (NMDAR) antibody encephalitis appears common in the world, but the number of clinical cases in Vietnam which were recorded is rare.

CASE REPORT

We describe two new cases of disease in recent years with the aim of contributing to diagnosis and treatment experiences. These cases were noted over the past 3 years with the patients who have been treated at lower levels but have no results. They came to us when symptoms became worse and therefore required prolonged treatment with special intensive care facilities. The atypical and easily confused symptoms are the reasons that make the disease be detected late; leading to a much higher cost of treatment and the complication may appear in the patient. In the past, patients with these manifestations were diagnosed with unexplained encephalitis and severe sequelae or death. Autoimmune encephalitis has many types; NMDA encephalitis associated with ovarian teratoma is the most common autoimmune encephalitis in young women.

CONCLUSION

In conclusion, based on the case report, we hope to contribute some experiences on the diagnosis and the strategy in early treatment. With most female patients at very young age, early treatment to avoid complications will help patients have a quality life and maintain reproductive function.

摘要

背景

N-甲基-D-天冬氨酸受体(NMDAR)抗体脑炎在全球似乎较为常见,但越南记录的临床病例数量很少。

病例报告

我们描述了近年来的两例新病例,旨在积累诊断和治疗经验。这些病例是在过去3年中发现的,患者此前在基层接受治疗但未见成效。当症状加重时他们前来就诊,因此需要在特殊重症监护设施下接受长期治疗。非典型且易混淆的症状导致该病发现较晚,进而使治疗成本大幅增加,患者可能出现并发症。过去,有这些表现的患者被诊断为不明原因脑炎,出现严重后遗症或死亡。自身免疫性脑炎有多种类型;与卵巢畸胎瘤相关的NMDAR脑炎是年轻女性中最常见的自身免疫性脑炎。

结论

总之,基于该病例报告,我们希望能为诊断及早期治疗策略提供一些经验。对于大多数非常年轻的女性患者,早期治疗以避免并发症将有助于患者拥有高质量生活并维持生殖功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68db/7084035/0b5402fdc67a/OAMJMS-7-4378-g001.jpg

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