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熊震.抗谷氨酸脱羧酶65抗体脑炎及相关自身免疫性多内分泌腺病综合征[J].内科急危重症杂志,2023,29(3):189-192
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| DOI：10.11768/nkjwzzzz20230304 |
| CN KeyWords: 抗谷氨酸脱羧酶抗体 自身免疫性脑炎 自身免疫性多内分泌腺病综合征 |
| EN KeyWords: |
| Fund Project:国家自然科学基金(No:82171465) |
| Author: |
| View Counts: 2934 |
| PDF Download Counts: 2544 |
| CN Abstract: |
| 摘要 抗谷氨酸脱羧酶65(GAD65)抗体脑炎是自身免疫性脑炎的一种亚型，常表现为僵人综合征、小脑性共济失调、颞叶癫痫等神经综合征，早期识别诊断并给予免疫治疗对于患者的预后有极大改善。目前对于抗GAD65抗体脑炎的诊断主要依赖于血清中检测出高滴度的GAD65抗体或脑脊液中GAD65抗体阳性，然而GAD65抗体与广泛的自身免疫性疾病相关，在非神经系统中可引起自身免疫疾病包括1型糖尿病和甲状腺炎等。因此，诊治抗GAD65抗体脑炎的过程中需要筛查潜在的内分泌腺体的变化，在多内分泌免疫环境下出现神经症状也需要考虑合并抗GAD65抗体脑炎的可能。 |
| EN Abstract: |
| Abstract Anti-glutamic acid decarboxylase 65 (GAD65) antibody-associated autoimmune encephalitis is a subtype of autoimmune encephalitis. It is often manifested as neurological syndromes such as stiff-person syndrome, cerebellar ataxia and temporal lobe epilepsy. Early diagnosis and immunotherapy can greatly improve the prognosis of patients with this disease. The current diagnosis of anti-GAD65 antibody-associated autoimmune encephalitis mainly relies on the detection of high titers of GAD65 antibodies in serum or positive GAD65 antibody in cerebrospinal fluid. However, GAD65 antibodies have been associated with a wide range of autoimmune diseases, including non-neurological autoimmune diseases type 1 diabetes and thyroiditis. Therefore, it is necessary to screen for changes in other endocrine glands during the diagnosis and treatment of anti-GAD65 antibody-associated autoimmune encephalitis, and the possibility of concomitant anti-GAD65 antibody-associated autoimmune encephalitis should also be considered for neurological symptoms that occur in a polyendocrine immune environment. |
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