title: [A Patient with Probable Dementia with Lewy Bodies and Positive Autoantibodies against the Anti-NH2-terminal of α-Enolase].
abstract: Dementia with Lewy bodies (DLB) is clinically characterized by progressive dementia that is frequently accompanied by neurological and psychiatric manifestations. Hashimoto's encephalopathy (HE) is a rare autoimmune disease with neurological and psychiatric manifestations that is not well understood. However, this disease has attracted growing attention as a treatable dementia. Although autoimmune mechanisms are thought to play a pathogenic role in HE, the etiology of the disease remains unclear. Recently, it was reported that the serum in patients with HE is frequency positive for autoantibodies against the anti-NH2-terminal of α-enolase (anti-NAE), indicating a useful serological diagnostic marker for HE. We report the case of an 81-year-old Japanese woman with probable DLB and hypothyroidism. In her serum, elevated anti-thyroid antibodies and positive autoantibodies against anti-NAE were observed. Elevated levels of anti-glutamate receptor ε2 subunit (GluRε2) antibodies were also detected in her cerebrospinal fluid. Because her clinical condition became stable after treatment with cholinesterase inhibitor, levodopa, and levothyroxine, immunotherapy was not performed. Although the relationship between autoimmunity and cognitive decline in this patient was unclear, the present observations suggest the coexistence of neurodegeneration and autoimmunity as the underlying pathogenic mechanism.
authors.affiliation: Department of Psychiatry, Yokohama City University School of Medicine.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ikura
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Fujishiro
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Yoneda
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Saito
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Chiba
authors.forename: Ayuko
authors.initials: A
authors.lastname: Kamada
authors.forename: Omi
authors.initials: O
authors.lastname: Katsuse
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hirayasu
mesh_terms: D000369:Aged, 80 and over; D001323:Autoantibodies / Q000276:immunology*; D001927:Brain Diseases / Q000175:diagnosis / Q000276:immunology*; D003937:Diagnosis, Differential; D004660:Encephalitis; D005260:Female; D050031:Hashimoto Disease / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis / Q000201:enzymology / Q000276:immunology*; D008279:Magnetic Resonance Imaging; D010751:Phosphopyruvate Hydratase / Q000276:immunology*; D017470:Receptors, Glutamate / Q000276:immunology
chemical_list: D001323:Autoantibodies; D017470:Receptors, Glutamate; D010751:Phosphopyruvate Hydratase