A case report of mGluR1 antibody related encephalitis and literature review
Objective To explore the clinical manifestations,treatment and prognosis of encephalitis with metabotropic glutamate receptors 1(mGluR1)antibody in order to improve clinicians'understanding of this disease.Methods The clinical data of a patient with mGluR1 antibody was reported,and a retrospective analysis was carried out based on 34 patients with mGluR1 antibody in the literature.Results A 38-year-old man mainly manifested as dizzy and ataxia for about 2 months.The cerebrospinal fluid(CSF)protein and IgG index were slightly elevated,while head MRI scan and enhanced examination showed no criminal lesions.The serum and CSF mGluR1 IgG titers were both 1∶100.Diagnosis was made as anti-mGluR1 antibody related encephalitis.Symptoms were significantly relieved after methylprednisolone pulse,intravenous immunoglobulin and rituximab therapy.Including our case,35 cases have been reported.The average age of these patients was(48.3+20.3)years old.The main clinical symptoms included ataxia(33 cases)and decreased cognitive function(11 cases).Eight patients(22.9％)were concomitant with tumor,and all patients'serum and/or cerebrospinal fluid anti-mGluR1 antibodies was positive.85.7％(30/35)of the patients received immunotherapy,of which 11 patients received 2 immunotherapies,and 11 patients received 3 or more immunotherapies.At the end of follow-up,21 patients(60.0％)improved,4 patients(11.4％)relapsed,7 patients(20.0％)remained stable,1 patient(5.7％)remained unchanged and 1 patient(2.9％)died.Conclusions Anti-mGluR1antibody related encephalitis mainly manifests cerebellar ataxia.Serum or CSF anti-mGluR1 antibody testing is helpful for diagnosis.Most patients improve after treated with glucocorticoids combined with immunosuppressants or rituximab,while a small number of patients have recurrence and poor prognosis.
万方数据
维普
