[求救] paraneoplastic syndrome的antibody
板上先進好
我是臨床醫師，現手上有一位患者疑似paraneoplastic syndrome 引起的
encephalitis
病史：34 y/o, women, choriocarcinoma with multiple metastasis(liver, spleen, lung, brain) since
2006 post chemotherapy+radiotherapy with complete remission in 2008.
EMA-CO regimen
EMA-EP regimen
最近remove venous port 後，返家當天開始發燒，意識不清 aphasia等症狀
入院後兩次lumbar puncture結果WBC, protein, glucose都在正常範圍
lactate 2~3mg/dl
血液中WBC, lactate, Beta-HCG皆在正常範圍
兩次brain MRI第一次無明顯異常，第二次左側大腦似乎較為腫脹加上多處
DWI訊號增強(都小於2mm，但散布整個左大腦cortex)
EEG:兩次左側呈現慢波，第三次檢測時患者出現右臉抽搐予意識障礙，懷疑
complex partial seizure, suspect status epilepticus (without regaining
consciousness between seizures for greater than 5 minutes)，EEG 呈現
slow wave 與 PLED交錯
SPECT呈現：左大腦activity 與blood flow增加
綜合結果考慮為 paraneoplastic encephalomyelitis 或Cerebral venous
sinus thrombosis (影像證據不像)
因此向各位先進請教是否知道台灣哪一家醫院或lab可代驗
paraneoplastic syndrome相關Ab
anti-Ma Ab, anti-Hu, anti-Yo, anti-Ri, antiamphiphysin, anti-CV2, anti-Ma2 等
如能有 Anti-NMDA-R, anti-GABA-R, Ephrin-B2等surface protein更佳
先謝謝各位的幫忙
另，回覆時請一併寄一份到 youcheng00@gmail.com謝謝，因職務關係不一定每天
上PTT
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