Early pathologic findings and long-term improvement in anti-Ma2-associated encephalitis.
A 67-year-old man sequentially developed anti-Ma2-associated paraneoplastic encephalitis (PNE) and contralateral herpes simplex encephalitis (HSE). Brain biopsy 1 month before HSE revealed extensive infiltrates of T cells, B cells, and plasma cells. Most T cells expressed the cytotoxic granule-associated protein TIA-1 and the membranolytic protein granzyme-B. Although recovery was thought to be unlikely, treatment of the PNE with corticosteroids and resection of the associated lung cancer resulted in dramatic improvement for 21 months.
Blumenthal
D T
DT
Department of Neurology, Oncology Huntsman Cancer Institute, University of Utah, Salt Lake City, USA.
Salzman
K L
KL
Digre
K B
KB
Jensen
R L
RL
Dunson
W A
WA
Dalmau
J
J
D000368:Aged; D000906:Antibodies / Q000097:blood; D015703:Antigens, CD / Q000378:metabolism; D000951:Antigens, Neoplasm / Q000276:immunology*; D001921:Brain / Q000378:metabolism / Q000473:pathology; D004660:Encephalitis / Q000276:immunology* / Q000473:pathology*; D020803:Encephalitis, Herpes Simplex / Q000276:immunology / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009419:Nerve Tissue Proteins / Q000276:immunology*; D039102:Poly(A)-Binding Proteins / Q000378:metabolism; D000074019:T-Cell Intracellular Antigen-1
D000906:Antibodies; D015703:Antigens, CD; D000951:Antigens, Neoplasm; C119249:Ma2 antigen; D009419:Nerve Tissue Proteins; D039102:Poly(A)-Binding Proteins; D000074019:T-Cell Intracellular Antigen-1; C071558:TIA1 protein, human