Clinical analysis of paraneoplastic encephalitis associated with ovarian teratoma
Clinical analysis of paraneoplastic encephalitis associated with ovarian teratoma
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DOI：
10.1007/s11060-007-9372-9
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发表时间：
2007-09-01
影响因子：
3.9
通讯作者：
Ueno, Satoshi
中科院分区：
文献类型：
--
作者：
Tonomura, Yasuyo;Kataoka, Hiroshi;Ueno, Satoshi
背景 最近，与卵巢畸胎瘤相关的副肿瘤性脑炎已被描述并与自身抗体相关。方法：我们描述了 4 名卵巢畸胎瘤相关脑炎 (OTE) 患者，并将他们的临床表现与之前报道的 17 名 OTE 患者进行了比较。结果：临床上，OTE 的特点是出现急性显着精神症状（21 名患者中的 20 名）、癫痫发作（21 名患者中的 15 名）和中枢性通气不足（21 名患者中的 13 名）。我们的患者患有流涎过多（三名患者）和心脏传导问题（所有患者）；一名患者出现体温过低。从 OTE 发生到肿瘤诊断的平均时间为 19.6 +/- 22.1 周。平均需要通气支持 54.9 +/- 25.4 天。脑脊液白细胞计数为55.1+/-61.2/mm(3)。 12 名患者的头颅 MRI 显示异常，涉及颞区（7 名患者）或脑干（4 名患者）等区域。除了肿瘤切除之外，17 名患者还接受了某种类型的免疫治疗：17 名患者接受皮质类固醇治疗，10 名患者接受静脉注射免疫球蛋白，2 名患者接受环磷酰胺，7 名患者接受血浆置换。 18 名 OTE 患者的神经功能得到改善，其中 11 名完全康复。结论：除了精神症状、癫痫发作和中枢性通气不足之外，OTE 还存在心脏传导问题和唾液过多。
Background Recently, paraneoplastic encephalitis associated with ovarian teratoma has been described and related to an autoantibody. Methods: We describe four patients with ovarian teratoma-associated encephalitis (OTE) and compared their clinical pictures with those of 17 previously reported patients with OTE. Results: Clinically, OTE was characterized by the development of acute prominent psychiatric symptoms (20 of 21 patients), seizures (15 of 21 patients), and central hypoventilation (13 of 21 patients). Our patients had hypersalivation (three patients) and cardiac conduction problems (all patients); hypothermia was present in one patient. The mean time from the onset of OTE to tumor diagnosis was 19.6 +/- 22.1 weeks. Ventilatory support was required for 54.9 +/- 25.4 days on average. The white blood cell count in cerebrospinal fluid was 55.1 +/- 61.2/mm(3). Twelve patients showed abnormalities on cranial MRI, involving areas such as the temporal regions (seven patients) or brainstem (four patients). In addition to tumor resection, 17 patients received some type of immunotherapy: 17 patients received corticosteroids, 10 received intravenous immunoglobulins, two received cyclophosphamide, seven received plasma exchange. Eighteen patients with OTE had neurological improvement, including 11 with full recovery. Conclusions: OTE presents with cardiac conduction problems and hypersalivation in addition to psychiatric symptoms, seizures, and central hypoventilation.