{"created":"2024-07-18T06:16:26.311539+00:00","id":2000437,"links":{},"metadata":{"_buckets":{"deposit":"8228ac34-4304-4d06-a03f-28ae7ab97fd4"},"_deposit":{"created_by":50,"id":"2000437","owner":"50","owners":[50],"pid":{"revision_id":0,"type":"depid","value":"2000437"},"status":"published"},"_oai":{"id":"oai:kagawa-u.repo.nii.ac.jp:02000437","sets":["2:1720746067615:1720752099702"]},"author_link":["1547","2006","4277","4274","4278","1061","4276","4275"],"control_number":"2000437","item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2011-09-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"48","bibliographicPageStart":"43","bibliographicVolumeNumber":"13","bibliographic_titles":[{"bibliographic_title":"香川産科婦人科雑誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kagawa journal of obstetrics and gynecology : official journal of the Kagawa Society of Obstetrics and Gynecology","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"卵巣成熟嚢胞性奇形腫に関連した自己免疫性辺縁系脳炎と考えられた一例を経験したので文献的考察を加えて報告する。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"症例は29歳、未妊婦。約1週間続く発熱、全身倦怠感のため、精査加療目的で当院呼吸器内科紹介入院となった。内科初診時頃からめまい、歩行時のふらつきといった下肢失調症状が出現した。髄液検査にて単核球優位の細胞数増加を認めたため、ウイルス性髄膜炎を疑い、輸液・安静で経過観察した。入院後3日目に発熱は改善したが、両手・顔の振るえ、ミオクローヌスを自覚するようになった。全身検索のため、腹部CT検査を施行したところ、径5cm大の左卵巣成熟奇形腫を認めたため、当科紹介予定となった。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"ところが、入院4日目排尿障害が出現し、一時的に軽度意識レベルが低下したため（JCS1）、産婦人科受診は延期され、入院10日目に神経内科受診した。不随意運動のミオクローヌスや、小脳障害時に見られる協調運動障害を認め、卵巣奇形腫を合併することから、卵巣奇形腫に伴う自己免疫性辺縁系脳炎との診断結果であった。卵巣奇形腫に伴う自己免疫性辺縁系脳炎に関与するとされる、グルタミン酸受容体に対する自己抗体の測定をしたところ、抗グルタミン酸受容体δ2抗体陽性と判明した。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"入院24日目に当科紹介となった。骨盤MRIでも左卵巣成熟奇形腫を認め、CA19-9が軽度高値を示した。腹腔鏡下左卵巣腫瘍摘出術を施行した。病理組織検査にて成熟嚢胞性奇形腫と診断された。術後、症状は軽快した。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"抗グルタミン酸受容体δ2抗体は小脳プルキンエ細胞に特異的に発現するグルタミン酸受容体δ型に対する抗体である。本症例で小脳半球障害の症状である協調運動障害が認められたことを考慮すると、この抗グルタミン酸受容体δ2抗体が本症例の病態に関与していると思われた。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"卵巣奇形腫を有する若年女性の場合、卵巣奇形腫に随伴する自己免疫性辺縁系脳炎について念頭に置き、診療する必要があると考えられた。","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_10001_heading_23":{"attribute_name":"見出し","attribute_value_mlt":[{"subitem_heading_banner_headline":"症例報告","subitem_heading_language":"ja"},{"subitem_heading_banner_headline":"[Case 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