Co-existence of anti-glutamic acid decarboxylase-65 and anti-sry-like high-mobility group box receptor antibody-associated autoimmune encephalitis: A rare case report

IF 1.8 Q3 CLINICAL NEUROLOGY Epilepsy and Behavior Reports Pub Date : 2024-01-01 DOI:10.1016/j.ebr.2024.100648

Raneem H. Alghamdi, Daad Alsowat, Suad Alyamani, Haya Alfaris, Amal Mokeem

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Abstract

Autoimmune encephalitis (AE) has been increasingly recognized in children. An 11-year-old Saudi boy presented with prodromal symptoms of fever and headache followed by behavioral changes, cognitive impairment, and focal seizures. Cerebrospinal fluid (CSF) analysis showed pleocytosis. Brain magnetic resonance imaging showed T2/fluid-attenuated inversion recovery hyperintensities involving the temporal, parietal and frontal lobes. Electroencephalography revealed diffuse encephalopathy and electrographic seizures. AE was suspected; intravenous methylprednisolone and immunoglobulin were administered. Autoantibodies against glutamic acid decarboxylase-65 were detected in his serum and CSF and against Sry-like high- mobility group box 1 in his serum only. The patient was diagnosed with seropositive AE and favorably responded to intensive immunosuppressive therapy.

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抗谷氨酸脱羧酶-65和抗sry样高迁移率基团盒受体抗体并存的自身免疫性脑炎：罕见病例报告

越来越多的儿童患上了自身免疫性脑炎（AE）。一名 11 岁的沙特男孩出现发热和头痛的前驱症状，随后出现行为改变、认知障碍和局灶性癫痫发作。脑脊液（CSF）分析显示多细胞。脑磁共振成像显示，颞叶、顶叶和额叶出现T2/流体增强反转恢复高密度。脑电图显示弥漫性脑病和电图癫痫发作。医生怀疑患者出现了AE，于是静脉注射了甲基强的松龙和免疫球蛋白。在他的血清和脑脊液中检测到针对谷氨酸脱羧酶-65的自身抗体，仅在血清中检测到针对Sry样高迁移率组盒1的自身抗体。患者被诊断为血清阳性 AE，并对强化免疫抑制治疗产生了良好反应。

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