양극성장애로 오인된 LGI1 자가면역성뇌염
Anti-LGI1 Antibody Encephalitis
1
조회
0
다운로드
1
인용
0
참고문헌
초록
Leucine rich glioma inactivated (LGI1) encephalitis is an uncommon neurological disorder rarely encountered in clinical practice. However, it is a potentially fatal autoimmune syndrome that can decrease the level of consciousness, possibly progressing to coma. Additionally, unless diagnosed and promptly treated, it can cause permanent cognitive impairment. Since LGI1 encephalitis can initially present with psychiatric symptoms, there can be delays in reaching a proper diagnosis. This report describes a case of a 47-yearold woman with LGI1 antibodies-associated limbic encephalitis who initially presented with psychosis. Her blood tests were normal and no MRI and EEG abnormalities were found. Cerebrospinal fluid analysis was negative for other possible infectious causes. Three months after admission, she was found to be LGI1 antibody positive. LGI1 encephalitis should be suspected in patients with symptoms such as memory loss, confusion, seizures, and psychiatric symptoms. Prompt diagnosis and treatment of LGI1 encephalitis are warranted because prognosis becomes worse when such actions are delayed.
Abstract
Leucine rich glioma inactivated (LGI1) encephalitis is an uncommon neurological disorder rarely encountered in clinical practice. However, it is a potentially fatal autoimmune syndrome that can decrease the level of consciousness, possibly progressing to coma. Additionally, unless diagnosed and promptly treated, it can cause permanent cognitive impairment. Since LGI1 encephalitis can initially present with psychiatric symptoms, there can be delays in reaching a proper diagnosis. This report describes a case of a 47-yearold woman with LGI1 antibodies-associated limbic encephalitis who initially presented with psychosis. Her blood tests were normal and no MRI and EEG abnormalities were found. Cerebrospinal fluid analysis was negative for other possible infectious causes. Three months after admission, she was found to be LGI1 antibody positive. LGI1 encephalitis should be suspected in patients with symptoms such as memory loss, confusion, seizures, and psychiatric symptoms. Prompt diagnosis and treatment of LGI1 encephalitis are warranted because prognosis becomes worse when such actions are delayed.
참고문헌 (18)
- Tüzün E, "Limbic encephalitis and variants : classification, diagnosis and treatment", Neurologist, 13, pp.261~271 (2007)
- Brierley JB, "Subacute encephalitis of later adult life. Mainly affecting the limbic areas", Brain, 83, pp.357~368 (1960)
- Ramanathan S, "Autoimmune encephalitis : recent updates and emerging challenges", J Clin Neurosci, 21, pp.722~730 (2014)
- Shin YW, "VGKCcomplex", LGI1-antibody encephalitis: clinical manifestations and response to immunotherapy, 2013, pp.265, 75~81
- Anderson NE, "Limbic encephalitis-a review", J Clin Neurosci, 15, pp.961~971 (2008)
- Florance NR, "Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis in children and adolescents", Ann Neurol, 66, pp.11~18 (2009)
- Dubey D, "Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis", Ann Neurol, 83, pp.166~177 (2018)
- 김현진, "안면상완근긴장발작으로 발현한 항LGI1항체 자가면역뇌염", 대한신경과학회지, 32(1), pp.22~25 (2014), 대한신경과학회
- 박인우, "단순헤르페스뇌염 후 발생한항N-methyl-D-aspartate 수용체 뇌염", 대한신경과학회지, 36(2), pp.93~96 (2018), 대한신경과학회[DOI]
- 선우준상, "자가면역 뇌염에서 코르티코스테로이드 치료", Journal of Neurocritical Care, 10(2), pp.60~68 (2017), 대한신경집중치료학회[DOI]
- Jang Y, "Psychiatric symptoms delay the diagnosis of anti-LGI1 encephalitis", J Neuroimmunol, 317, pp.8~14 (2018)
- Kayser MS, "Frequency and characteristics of isolated psychiatric episodes in anti–N-methyl-daspartate receptor encephalitis", JAMA Neurol, 70, pp.1133~1139 (2013)
- Wang D, "LGI1 antibody encephalitisdetailed clinical, laboratory and radiological description of 13 cases in China", Compr Psychiatry, 81, pp.18~21 (2018)
- Venkatesan A, "Case definitions, diagnostic algorithms, and priorities in encephalitis : consensus statement of the international encephalitis consortium", Clin Infect Dis, 57, pp.1114~1128 (2013)
- Eric Lancaster, "Te Diagnosis and Treatment of Autoimmune Encephalitis", Journal of Clinical Neurology, 12(1), pp.1~13 (2016), 대한신경과학회[DOI]
- Zuliani L, "Central nervous system neuronal surface antibody associated syndromes : review and guidelines for recognition", J Neurol Neurosurg Psychiatry, 83, pp.638~645 (2012)
- Chapman MR, "Anti-NMDA receptor encephalitis : diagnosis, psychiatric presentation, and treatment", Am J Psychiatry, 168, pp.245~251 (2011)
- Zandi MS, "Disease-relevant autoantibodies in first episode schizophrenia", J Neurol, 258, pp.686~688 (2011)