自己免疫性脳症の新展開  [in Japanese] A paradigm shift in autoimmune encephalopathy  [in Japanese]

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Author(s)

    • 犬塚 貴 Inuzuka Takashi
    • 岐阜大学大学院医学系研究科神経内科・老年学分野 Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine
    • 木村 暁夫 Kimura Akio
    • 岐阜大学大学院医学系研究科神経内科・老年学分野 Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine
    • 林 祐一 Hayashi Yuichi
    • 岐阜大学大学院医学系研究科神経内科・老年学分野 Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine

Abstract

<p>Several autoantibodies are associated with autoimmune encephalitis. Some of these antibodies are directed against intracellular neuronal antigens such as Hu and Ma2, which are strongly associated with paraneoplatic syndrome. In the past 10 years, various antibodies were identified that recognize neuronal cell–surface or synaptic proteins in patients associated with or without malignancy. Some of these antibodies are able to directly access receptors of neurotransmitters or channels and are responsible for causing neurological syndromes. Autoimmune encephalopathy with these antibodies generally responds to immunotherapies, such as steroids, plasmapheresis, and intravenous immunoglobulin as well as immunosuppressant and anti–cancer treatments in cases of paraneoplastic syndrome.</p><p>Patients with N–methyl–D–aspartate (NMDA) receptor antibodies, which are the most common in autoimmune encephalopathy, often cause psychiatric manifestation, memory impairment, seizures, dyskinesia, catatonia, autonomic instability and respiratory failures. Although 86% of patients become worse at the stage of mRS5, almost 80% of all patients recover to the stage of less than mRS2 with immunomodulatory therapy and careful management for their general condition. Detection of those antibodies in both serum and CSF using cell–based assays is important for definite diagnosis. Availability of screening systems of antibodies and covering health insurance for immunomodulatory therapy for autoimmune encephalitis are highly expected.</p>

Journal

  • Neurological Therapeutics

    Neurological Therapeutics 33(2), 94-98, 2016

    Japanese Society of Neurological Therapeutics

Codes

  • NII Article ID (NAID)
    130005256771
  • Text Lang
    JPN
  • ISSN
    0916-8443
  • Data Source
    J-STAGE 
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