Data Sheet 1_Anti-metabotropic glutamate receptor 5 coexistent anti-N-methyl-D-aspartate receptor encephalitis: a case report and literature review.pdf

Metabotropic glutamate receptor 5 (mGluR5) antibody encephalitis is an infrequent clinical disorder, initially reported in 2011 among two patients presenting with limbic encephalitis and Hodgkin’s lymphoma. Mental and behavioral abnormalities are prevalent manifestations, accompanied by cognitive impairment, movement disorders, seizures, and other associated symptoms. In this report, we present the case of a young female patient who presented with abnormal mental behavior, seizures, and disturbances of consciousness. A cell-based assay (CBA) showed positive IgG metabotropic glutamate receptor 5 in both her serum and cerebrospinal fluid (CSF), as well as positive IgG N-methyl-D-aspartate receptor (NMDAR) in both her serum and CSF. She was diagnosed with mGluR5 overlapping NMDAR antibody encephalitis and received high-dose intravenous methylprednisolone pulse therapy and immunoglobulin therapy. Tumor screening suggested the presence of bilateral ovarian teratoma. However, unfortunately the prognosis was extremely poor. Clinical results suggested that patients with mGluR5-Abs mostly have good prognoses, excepting our case.

代谢型谷氨酸受体5（metabotropic glutamate receptor 5, mGluR5）抗体脑炎是一种罕见的临床病症，2011年首次被报道于两名同时表现为边缘性脑炎与霍奇金淋巴瘤的患者。精神行为异常是其常见临床表现，常伴随认知障碍、运动障碍、癫痫发作及其他相关症状。本病例报告报道了一例以精神行为异常、癫痫发作及意识障碍为主要表现的年轻女性患者。细胞分析检测法（cell-based assay, CBA）结果显示，其血清与脑脊液（cerebrospinal fluid, CSF）中代谢型谷氨酸受体5 IgG抗体呈阳性，同时血清及脑脊液中N-甲基-D-天冬氨酸受体（N-methyl-D-aspartate receptor, NMDAR）IgG抗体亦为阳性。患者被确诊为mGluR5重叠NMDAR抗体脑炎，并接受了大剂量静脉甲泼尼龙冲击疗法与免疫球蛋白治疗。肿瘤筛查提示存在双侧卵巢畸胎瘤，但遗憾的是患者预后极差。现有临床研究结果表明，绝大多数mGluR5抗体阳性患者的预后良好，本病例属于例外情况。