Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Ann Neurol. 2023 Sep;94(3):502-507. doi: 10.1002/ana.26730. Epub 2023 Jul 14.
Autoimmune movement disorders are increasingly recognized, but isolated tremor is extremely rare. We describe a 70-year-old male with rapidly progressive, severe postural and intention tremor and weight loss. His cerebrospinal fluid was inflammatory and harbored a neural tissue-restricted antibody. The autoantigen was identified by immunoprecipitation and mass spectrometry and confirmed by antigen-specific assays to be specific for tenascin-R. He was investigated for cancer and diagnosed with follicular lymphoma that expressed tenascin-R suggesting a paraneoplastic origin; cancer treatment and immunotherapy led to complete recovery. With this individualized patient approach and antibody discovery, we expand the spectrum of antibodies accompanying autoimmune hyperkinetic movement disorders. ANN NEUROL 2023;94:502-507.
自身免疫性运动障碍日益受到重视，但孤立性震颤极为罕见。我们描述了一名 70 岁男性，表现为进行性加重的严重姿势性和意向性震颤及体重减轻。他的脑脊液呈炎症性，携带一种神经组织受限抗体。该自身抗原通过免疫沉淀和质谱分析鉴定，并通过抗原特异性检测证实其特异性针对 tenascin-R。他因癌症接受了检查，并被诊断为表达 tenascin-R 的滤泡性淋巴瘤，提示为副肿瘤性起源；癌症治疗和免疫治疗导致完全康复。通过这种个体化的患者治疗方法和抗体发现，我们扩展了伴随自身免疫性运动障碍的抗体谱。ANN NEUROL 2023;94:502-507.
