Department of Neurology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan.
Front Immunol. 2022 Aug 19;13:952868. doi: 10.3389/fimmu.2022.952868. eCollection 2022.
Anti-N-methyl-D-aspartate receptor (NMDAR) antibody encephalitis is caused by a reversible inhibition of ion channel actions by autoantibodies and is associated with a relatively good prognosis. Pathological findings of NMDAR encephalitis usually do not show neurophagorous nodules, but rare or mild inflammatory infiltration. We report a patient of small cell lung cancer (SCLC)-related paraneoplastic encephalitis with NMDAR antibodies, a cytotoxic T-cell-mediated pathology of the brain, and a rapid clinical course. This case highlights that the neuropathological diversity of NMDAR encephalitis may be even broader than previously thought and that NMDAR antibodies may also be found in various pathological conditions with a vigorous immune response.
抗 N-甲基-D-天冬氨酸受体(NMDAR)抗体脑炎是由自身抗体对离子通道作用的可逆抑制引起的,与相对较好的预后相关。NMDAR 脑炎的病理发现通常不显示神经吞噬结节,但有罕见或轻度的炎症浸润。我们报告了一例小细胞肺癌(SCLC)相关副肿瘤性脑炎伴 NMDAR 抗体、脑细胞毒性 T 细胞介导的病理改变和快速临床病程。该病例提示 NMDAR 脑炎的神经病理学多样性可能比之前认为的更为广泛,并且在具有强烈免疫反应的各种病理情况下也可能发现 NMDAR 抗体。