Ovarectomy despite Negative Imaging in Anti-NMDA Receptor Encephalitis: Effective Even Late.
Ovarectomy despite Negative Imaging in Anti-NMDA Receptor Encephalitis: Effective Even Late.
复制标题
卵巢切除术尽管在抗NMDA受体脑炎中进行了阴性成像：甚至迟到。
DOI：
10.1155/2013/843192
复制
发表时间：
2013
影响因子：
0.9
通讯作者：
Stangel M
中科院分区：
文献类型：
--
作者：
Boeck AL;Logemann F;Krauß T;Hussein K;Bültmann E;Trebst C;Stangel M
抗nmda受体（NMDAR）脑炎是一种自身免疫抗体介导的神经精神疾病。这种疾病已知与卵巢畸胎瘤有关，主要影响年轻女性。在这里，我们报告一例34岁的女性抗nmdar脑炎，其中详细的调查没有明确提示卵巢畸胎瘤。尽管如此，由于持续严重的临床综合征，进行了卵巢切除术，组织学检查显示为隐匿畸胎瘤。即使经过11个月的长期重症监护治疗，卵巢切除术也取得了显著的改善。从这个具有指导意义的病例中，最重要的教训是，即使没有任何检查表明卵巢畸胎瘤，包括探查性腹腔镜活检，仍然可能存在隐性卵巢畸胎瘤。这表明肿瘤搜索和诊断在抗nmdar脑炎患者中是极其重要的，因此剖腹手术和卵巢切除术是合理的。此外，切除畸胎瘤即使在非常严重的过程11个月后仍然是有效的治疗。
Anti-NMDA receptor (NMDAR) encephalitis is an autoimmune antibody-mediated neuropsychiatric disorder. The disorder is known to be associated with ovarian teratoma and predominantly affects young women. Here, we report the case of a 34-year-old woman with anti-NMDAR encephalitis, in which detailed investigations gave no specific hint for an ovarian teratoma. Despite this, and due to a continuous severe clinical syndrome, an ovarectomy was performed and histological examination revealed an occult teratoma. The ovarectomy led to a remarkable improvement even with a long term intensive care treatment for 11 months. The most important lesson to be learned from this instructive case is that even though none of the investigations was indicative for an ovarian teratoma, including an explorative laparoscopy with biopsy, there still may be an occult ovarian teratoma. This shows that tumour search and diagnosis are extremely important in patients presenting with anti-NMDAR encephalitis, and a laparotomy and ovarectomy is justified. Furthermore, removal of the teratoma even 11 months after a very severe course is still therapeutically effective.