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五例卵巢畸胎瘤合并抗N-甲基-D-天冬氨酸受体脑炎病例报告的临床分析

Clinical analysis of five case reports of ovarian teratoma withanti-N-methyl-D-aspartate receptor encephalitis.

作者信息

Li Chanyuan, Meng Fanliang, Gong Shipeng

机构信息

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Gynecology and Obstetrics, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

出版信息

Ann Palliat Med. 2021 Apr;10(4):4950-4954. doi: 10.21037/apm-19-693. Epub 2021 Jan 5.

Abstract

We have collected the data of five patients with ovarian teratoma and anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis admitted to the Southern Hospital of Southern Medical University from June 2014 to December 2017, we found that all of them started with psychiatric symptoms, four had autonomic nervous system dysfunction, while all of them exposed to abnormal brain and pelvic imaging, four patients required mechanical ventilation to assist breathing during the hospital stay. The serum anti-NMDAR antibodies were positive in five patients. After immunotherapy and surgery, all patients showed favorable prognosis. Pathology: four mature teratomas and one immature teratoma. In conclusion, patients with ovarian teratoma with anti-NMDAR encephalitis often begins with neurological and psychiatric symptoms, it is easy to be misdiagnosed due to the lack of overt symptoms, while the early detection and tumor resection combined with immunotherapy will win favorable prognosis.

摘要

我们收集了2014年6月至2017年12月在南方医科大学南方医院收治的5例卵巢畸胎瘤合并抗N-甲基-D-天冬氨酸受体(抗NMDAR)脑炎患者的数据,我们发现所有患者均以精神症状起病,4例有自主神经系统功能障碍,而所有患者均有脑部及盆腔影像学异常,4例患者住院期间需要机械通气辅助呼吸。5例患者血清抗NMDAR抗体均为阳性。经过免疫治疗及手术治疗后,所有患者预后良好。病理结果:4例成熟畸胎瘤,1例未成熟畸胎瘤。综上所述,卵巢畸胎瘤合并抗NMDAR脑炎患者常以神经精神症状起病,因缺乏明显症状易被误诊,而早期发现并切除肿瘤联合免疫治疗可获得良好预后。

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