Development of moyamoya disease after non-herpetic acute limbic encephalitis: A case report.
Development of moyamoya disease after non-herpetic acute limbic encephalitis: A case report.
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非疱疹性急性边缘脑炎后烟雾病的发展：病例报告。
DOI：
10.1016/j.jocn.2018.04.042
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Mikuni N.
中科院分区：
文献类型：
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作者：
Takahashi Y;Mikami T;Suzuki H;Komatsu K;Yamamoto D;Shimohama S;Houkin K;Sugita S;Hasegawa T;Mikuni N.
我们报告了一例烟雾病 (MMD)，该病是在与抗富含亮氨酸的神经胶质瘤失活 1 (LGI1) 抗体相关的非疱疹性急性边缘脑炎 (NHALE) 后发生的。患者母亲有MMD病史。 NHALE 时未发现血管病变。九年后，患者因记忆障碍和右肢反复短暂性脑缺血发作而来我院就诊。弥散加权磁共振成像显示分散的信号高信号区域，根据血管造影，患者最终被诊断为MMD。在左侧进行血运重建手术，在 123 I-N-异丙基对碘苯丙胺单光子发射计算机断层扫描中脑血流受损。术后，患者神经系统检查正常出院。与 LGI1 抗体相关的 NHALE 是一种自身免疫性疾病。尽管自身免疫性疾病是准MMD中除动脉粥样硬化之外最常见的发现，但这是首次报道NHALE与模拟准MMD的抗LGI1抗体相关。除了遗传背景外，炎症和血管生成也可能导致 MMD 的发生。
We report a case of moyamoya disease (MMD), which developed after non-herpetic acute limbic encephalitis (NHALE) associated with anti-leucine-rich glioma-inactivated 1 (LGI1) antibody. The patient’s mother had a history of MMD. No vascular lesions were identified at the time of the NHALE. Nine years later, the patient visited our hospital due to memory disturbances and repeated transient ischemic attacks affecting the right limb. Diffusion-weighted magnetic resonance imaging revealed scattered areas of signal hyperintensity, and the patient was ultimately diagnosed with MMD based on angiography. Revascularization surgery was performed on the left side, where cerebral blood flow was impaired on123I-N-isopropyl-p-iodoamphetamine single photon emission computed tomography. Postoperatively, the patient was discharged with a normal neurological examination. NHALE associated with LGI1 antibodies is an autoimmune disease. Although autoimmune disease is the most frequent finding other than atherosclerosis in quasi-MMD, this is the first report of NHALE associated with anti-LGI1 antibodies mimicking quasi-MMD. Inflammation and angiogenesis may contribute to the development of MMD, in addition to genetic background.