目的:报道1例胶质母细胞瘤合并自身免疫性脑炎,提高对该疾病的认识和诊断。

方法:对1例胶质母细胞瘤合并自身免疫性脑炎患者的诊疗经过进行了详细的描述,讨论了疾病的临床表现和诊治思路。

结果:1 例患者以头晕、双下肢乏力、行走不稳,伴言语含糊以及偶有饮水呛咳为主要临床表现。入院后完善相关检查,头颅 MRI 可见多发异常信号影,血清抗 N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor,NMDAR)抗体效价为1:32，血清抗胶质纤维酸性蛋白(alial fibrilary acidic protein,GFAP)抗体效价为1:10,脑脊液抗 NMDAR 抗体效价为 1∶1。颅内病灶病理活检提示“IDH1 野生型，胶质母细胞瘤，中枢神经系统(central nervoussystem,CNS )WHO 4级”。最终诊断为胶质母细胞瘤合并自身免疫性脑炎。

结论:胶质母细胞瘤可与自身免疫性脑炎同时存在,2者的临床及影像学表现类似,临床上易漏诊及误诊,所以应注意疾病诊断的多元性及全面性。同时,机体的免疫反应性可作为潜在的生物标志物早期识别胶质母细胞瘤,以期尽早给予有效的于预措施并改善预后。

Objective: A case of glioblastoma associated with autoimmune encephalitis is reported to improve the understanding and diagnosis of this disease.

Methods: The diagnosis and treatment of a case of glioblastoma associated with autoimmune encephalitis were described in detail, and the clinical manifestations and treatment ideas of the disease were discussed.

Results: A patient presented dizziness, fatigue of both lower limbs, unstable gait.vagueness speech, and occasional dysphagia as the main clinical manifestations. Relevant examinations had been taken in hospital. Multiple abnormal signal images were observedon MRl. The serum N-methyl-D-Aspartate receptor (NMDAR) antibody lgG titer was 1:32.The serum anti-glial fbrillary acidic protein (GFAP) antibody titer was 1:10, and the cerebrospinal fluid anti-NMDAR antibody titer was 1:1. The pathological biopsy of intracranial lesion indicated “lDH1 wild type, glioblastoma, central nervous system (CNSWHO grade 4". This patient was diagnosed with glioblastoma associated with autoimmune encephalitis finally.

Conclusion: Glioblastoma could coexist with autoimmune encephalitis. These two diseases have similar clinical and imaging manifestations and it is prone to missed diagnosis and misdiagnosis in clinical practice. Therefore, attention should be paid to the diversity and comprehensiveness of disease diagnosis, At the same time, the immune reactivity of thebody can be used as a potential biomarker for early recognition of glioblastoma, and to provide effective intervention and improve the prognosis as soon as possible.