Novoselova Victoria, Kumar Vikas, Singh Niranjan N, Lacasse Alexandre
Department of Internal Medicine, SSM St. Mary's Hospital-St. Louis, St. Louis, MO, USA.
SSM Neurosciences Institute, SSM St. Mary's Hospital-St. Louis, St.Louis, MO, USA.
J Community Hosp Intern Med Perspect. 2020 Oct 29;10(6):591-593. doi: 10.1080/20009666.2020.1811068.
Anti-voltage-gated potassium channel (anti-VGKC) antibody encephalitis is a common form of autoimmune encephalitis (AE). AE is usually associated with autoimmune diseases or paraneoplastic phenomena such as seen in small cell lung cancer. Clinical presentation can include memory impairment, seizures, and psychiatric symptoms. We report a case of a 72-year-old male with non-small lung cancer in remission who presented with erosive gastritis and acute severe encephalopathy. Anti-VGKC antibody limbic encephalitis was diagnosed. Spontaneous resolution of encephalitis-associated changes on brain Magnetic Resonance (MR) with concomitant decreased circulating antibody levels were observed despite lack of overall cognitive improvement.
AE: autoimmune encephalitis; AMPAR: antibody limbic encephalitis - anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor encephalitis; Anti-VGKC encephalitis: anti-Voltage-gated potassium channel antibody encephalitis; CRP: c-reactive protein; CT: computed tomography; EEG: electroencephalography; ESR: erythrocyte sedimentation rate; GCS: Glasgow Coma Scale; MRImaging: Magnetic resonance imaging; NMDA-R encephalitis: Anti-N-methyl D-aspartate receptor encephalitis; PCR: polymerase chain reaction.
抗电压门控钾通道（anti-VGKC）抗体性脑炎是自身免疫性脑炎（AE）的一种常见形式。AE通常与自身免疫性疾病或副肿瘤现象相关，如在小细胞肺癌中所见。临床表现可包括记忆障碍、癫痫发作和精神症状。我们报告一例72岁男性，非小细胞肺癌处于缓解期，出现糜烂性胃炎和急性重症脑病。诊断为抗VGKC抗体边缘性脑炎。尽管总体认知功能未改善，但观察到脑磁共振成像（MR）上与脑炎相关的改变自发消退，同时循环抗体水平下降。
AE：自身免疫性脑炎；AMPAR：抗体边缘性脑炎 - 抗α-氨基-3-羟基-5-甲基-4-异恶唑丙酸受体脑炎；抗VGKC脑炎：抗电压门控钾通道抗体性脑炎；CRP：C反应蛋白；CT：计算机断层扫描；EEG：脑电图；ESR：红细胞沉降率；GCS：格拉斯哥昏迷量表；MR成像：磁共振成像；NMDA-R脑炎：抗N-甲基-D-天冬氨酸受体脑炎；PCR：聚合酶链反应。
