CAJ | 학술논문

目的：总结卵巢畸胎瘤合并抗N-甲基-D-天冬氨酸受体（ NMDAR）脑炎患者的临床特征。方法收集北京协和医院和北京天坛医院2011年6月至2013年5月收治的5例卵巢畸胎瘤合并抗NMDAR脑炎患者的临床资料，对其临床表现、治疗及预后进行分析。结果5例患者发病前均有上呼吸道感染的前驱症状或其他情绪诱因。临床多表现为典型精神或神经症状、运动障碍和痫性发作。血清和脑脊液中抗NMDAR抗体检查结果均呈阳性。经过卵巢畸胎瘤切除及免疫治疗，所有患者神经及精神症状均得到明显缓解。随访期间均未出现肿瘤复发。结论卵巢畸胎瘤合并抗NMDAR脑炎常以神经及精神症状起病，容易被误诊为精神心理疾病，癫痫等；手术切除卵巢畸胎瘤结合免疫治疗预后良好。
목적：총결란소기태류합병항N-갑기-D-천동안산수체（ NMDAR）뇌염환자적림상특정。방법수집북경협화의원화북경천단의원2011년6월지2013년5월수치적5례란소기태류합병항NMDAR뇌염환자적림상자료，대기림상표현、치료급예후진행분석。결과5례환자발병전균유상호흡도감염적전구증상혹기타정서유인。림상다표현위전형정신혹신경증상、운동장애화간성발작。혈청화뇌척액중항NMDAR항체검사결과균정양성。경과란소기태류절제급면역치료，소유환자신경급정신증상균득도명현완해。수방기간균미출현종류복발。결론란소기태류합병항NMDAR뇌염상이신경급정신증상기병，용역피오진위정신심리질병，전간등；수술절제란소기태류결합면역치료예후량호。
Objective To report the clinical features of ovarian teratoma in patients with anti-N-methyl-D-aspartate receptor ( NMDAR ) encephalitis .Methods The clinical information of five female patientswith ovarian teratoma and anti-NMDAR encephalitis in Peking Union Medical College Hospital and Beijing Tiantan Hospital affiliated to Capital Medical University from June 2011 to May 2013 were obtained . Relevant literatures were reviewed .Results The initial symptoms varied from respiratory prodromes or emotional incentives before the onset of psychiatric symptoms .Patients always presented with psychosis , bizarre dyskinesia and seizures . Antibodies to NMDAR in serum and cerebrospinal fluid ( CSF ) were positive;The psychiatric symptoms were dramatically relieved by tumor reception and immunotherapy which occured in inverse order of symptom development .No evidence of tumor recurrence was observed during a short-time follow-up after the surgery .Conclusions Ovarian teratoma with anti-NMDAR encephalitis always presents with psychiatric symptoms which could be misdiagnosed as psychiatric diseases .Patients respond to <br> tumor resection and immunotherapy .