富亮氨酸胶质瘤失活蛋白1抗体相关性脑炎(附1例报告及文献复习)

Clinical Analysis of One Patient with Leucine-rich Glioma Inactivated-1 Protein Antibody Associated Encephalitis:A Case Report and Literature Review

目的总结富亮氨酸胶质瘤失活蛋白1(LGI-1)抗体相关性脑炎的临床特征、诊断及治疗,加强对该病的认识。方法收集1例LGI-1抗体相关性脑炎患者的临床和随访(近1年)资料,并结合文献分析该病的临床特征及诊治。结果患者为中年女性,亚急性起病,临床主要表现为认知功能障碍、癫、睡眠障碍,辅助检查血清及脑脊液LGI-1抗体阳性,MRI提示双侧海马病变,合并有低钠血症,未检出肿瘤性疾病,经激素与免疫球蛋白联合静脉注射治疗,随访1年临床明显好转。结论 LGI-1抗体相关性脑炎具有特征性临床表现,血清和(或)脑脊液LGI-1抗体阳性,对免疫抑制剂敏感,预后相对良好。

Aim To summarize the clinical characteristics,diagnosis and treatment of lencinerich glioma inactivated-1（LGI-1） protein antibody associated encephalitis,and improve the clinical recognition of the disease.Methods The clinical data and almost one year followed-up data of a patient who was diagnosed with LGI-1 antibody associated encephalitis were collected,and then its clinical features,diagnosis and therapies combined with some literature were analyzed.Results The patient was a middle aged female,suffering from subacute onset of cognitive impairment,epilepsy,sleep disorders,hyponatremia,anti-LGI-1 antibody was identified in serum and cerebrospinal fluid,T2 and FLAIR MRI scan showed hyperintensities within bilateral hippocampus,not detected any tumor,and achieved a good outcome with intravenous steroids and immunoglobulins.Conclusion LGI-1 antibody associated encephalitis has a specific clinical features,with LGI-1 antibody positive in serum and cerebrospinal fluid,sensitive to immunotherapy,and the prognosis is relatively good.