Anti-Ma2-associated encephalitis with normal FDG-PET: a case of pseudo-Whipple's disease

被引：35
作者：
Castle, James
Sakonju, Ai
Dalmau, Josep
Newman-Toker, David E.
机构：
[1] Johns Hopkins Univ, Sch Med, Dept Neurol, Baltimore, MD 21287 USA
[2] Stanford Univ, Stanford, CA 94305 USA
[3] Univ Penn, Philadelphia, PA 19104 USA
来源：
NATURE CLINICAL PRACTICE NEUROLOGY | 2006年 / 2卷 / 10期
关键词：
diagnosis; Ma2; antigen; opsoclonus; paraneoplastic syndromes; Whipple's disease;
D O I：
10.1038/ncpneuro0287
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
Background A 39-year-old man presented with a history of several months of progressive personality changes, social withdrawal, bradykinesia, mutism, dysphagia, worsening gait, and difficulty with daily living activities. Examination revealed an atypical parkinsonian appearance with incomplete supranuclear ophthalmoplegia and an unusual oculomotor disorder characterized by both low-amplitude, intermittent opsoclonus, and slow, nystagmoid intrusions. Investigations Routine laboratory testing, autoimmune and infectious serologies, brain MRI, lumbar puncture, electroencephalogram, whole-body CT scan, paraneoplastic serologies, small bowel biopsy, F-18-fluorodeoxyglucose positron emission tomography CT scan, brain biopsy, and testicular ultrasound. Diagnosis Anti-Ma2 paraneoplastic encephalitis in association with metastatic testicular cancer; initially misdiagnosed as CNS Whipple's disease. Management Corticosteroids, intravenous immunoglobulins, orchiectomy, muscle relaxants, mycophenolate mofetil, plasmapheresis, and bleomycin, etoposide and platinum chemotherapy.
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页码：566 / 572
页数：7
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