中风与神经疾病杂志2024，Vol.41Issue(12)：1106-1112,7.DOI:10.19845/j.cnki.zfysjjbzz.2024.0211
抗谷氨酸脱羧酶65抗体相关脑炎14例临床分析
Clinical features of 14 patients with anti-glutamic acid decarboxylase 65 encephalitis
摘要
Abstract
Objective To investigate the clinical characteristics and treatments of anti-glutamic acid decarboxylase 65(anti-GAD65)encephalitis.Methods The clinical data of 14 patients with anti-GAD65 encephalitis who were hospital-ized in the department of pediatrics or neurology in Guangxi Zhuang Autonomous Region from November 2020 to January 2024 were retrospectively analyzed for their clinical features.Results Of the 14 patients,5 were males and 9 were fe-males.The mean age of them was(33.80±19.83)years,and the mean age of onset was 1.5-71 years.The prodromal symptoms included fever,headache,diarrhea,fatigue,and sore throat.Cerebrospinal fluid and blood GAD65 antibody tests were performed in all these cases.Eleven patients were positive for serum GAD65 antibody,with titers ranging from 1∶10-1∶300;9 patients were positive for cerebrospinal fluid GAD65 antibody,with titers ranging from 1∶10-1∶100;the se-rum IgG index was>0.7 in 2 cases;the 24 h IgG synthesis rate was>10 mg/24 h in 6 cases;the cerebrospinal fluid albumin quotient was>7×10-3 in 1 case.Three patients had lesions in the frontal,parietal,and temporal lobes on MRI,showing high-signal patches on T2WI and T2 FLAIR sequences,some of which showed enhancement.Seven patients showed sharp waves and spike-and-slow waves on electroencephalography.Ten patients were treated with hormone pulse therapy,of whom 1 patient also received intravenous immunoglobulin treatment;one case was given rituximab;three cases were not treated with hormones or immunomodulators.Five patients had improvements within one month.Conclusion Patients with anti-GAD65 encephalitis can have heterogeneous clinical features,with certain response to glucocorticoid treatment in some cases.关键词
自身免疫性脑炎/抗谷氨酸脱羧酶65/临床特征Key words
Autoimmune encephalitis/Anti-glutamic acid decarboxylase 65/Clinical characteristics分类
医药卫生引用本文复制引用
李泰燕,周少旦,孔德燕,潘丽雅,刘倩倩,陈艳兰,黄文..抗谷氨酸脱羧酶65抗体相关脑炎14例临床分析[J].中风与神经疾病杂志,2024,41(12):1106-1112,7.基金项目
国家自然科学基金资助项目(82060236) （82060236）
