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master's thesis
Autoimuni encefalitis u bolesnika s anti Caspr2 (contactin associated protein-like) encefalitisom
Zagreb: University of Zagreb, School of Medicine, 2017. urn:nbn:hr:105:225309
Simeunović, Stefan
University of Zagreb
School of Medicine
Department of Infectious Diseases

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

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Simeunović, S. (2017). Autoimuni encefalitis u bolesnika s anti Caspr2 (contactin associated protein-like) encefalitisom (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:225309

Simeunović, Stefan. "Autoimuni encefalitis u bolesnika s anti Caspr2 (contactin associated protein-like) encefalitisom." Master's thesis, University of Zagreb, School of Medicine, 2017. https://urn.nsk.hr/urn:nbn:hr:105:225309

Simeunović, Stefan. "Autoimuni encefalitis u bolesnika s anti Caspr2 (contactin associated protein-like) encefalitisom." Master's thesis, University of Zagreb, School of Medicine, 2017. https://urn.nsk.hr/urn:nbn:hr:105:225309

Simeunović, S. (2017). 'Autoimuni encefalitis u bolesnika s anti Caspr2 (contactin associated protein-like) encefalitisom', Master's thesis, University of Zagreb, School of Medicine, accessed 24 December 2024, https://urn.nsk.hr/urn:nbn:hr:105:225309

Simeunović S. Autoimuni encefalitis u bolesnika s anti Caspr2 (contactin associated protein-like) encefalitisom [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2017 [cited 2024 December 24] Available at: https://urn.nsk.hr/urn:nbn:hr:105:225309

S. Simeunović, "Autoimuni encefalitis u bolesnika s anti Caspr2 (contactin associated protein-like) encefalitisom", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2017. Available at: https://urn.nsk.hr/urn:nbn:hr:105:225309

Metadata
TitleAutoimuni encefalitis u bolesnika s anti Caspr2 (contactin associated protein-like) encefalitisom
Title (english)Autoimmune encephalitis in patients with anti-Caspr2 (contactin-associated protein-like) encephalitis
AuthorStefan Simeunović
MentorMarija Santini (mentor)
Committee memberDalibor Vukelić (predsjednik povjerenstva)
Committee memberGoran Tešović (član povjerenstva)
Committee memberMarija Santini (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Infectious Diseases)
Zagreb
Defense date and country2017-07-14, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Infectology
Abstract
Uvod: Autoimuni encefalitisi neurološke su bolesti koje su uzrokovane stvaranjem protutijela na intracelularne ili sinaptičke antigene neurona. Anti Caspr2 encefalitis autoimuni je encefalitis u čijoj genezi kljucnu ulogu imaju protutijela na contactin associated protein-like 2 (Caspr2), koji je kao protein membrane živčanih stanica bitan za funkciju voltažnih kalijevih kanala. Caspr2 encefalitis nerijetko se javlja kao paraneoplastični proces kod malignih bolesti prije svega timoma i sitnostaničnog karcinoma pluća. ----- Prikaz slučaja: Prikazan je slučaj pedesetšestogodišnjeg pacijenta koji iznenadno bez prodromalnih simptoma gubi svijest na radnom mjestu. Inicijalnom internističkom i neurološkom obradom nije bilo moguće ustvrditi siguran uzrok gubitka svijesti. U narednom periodu stanje pacijenta se pogoršava s izraženim neurološkim simptomima ponajprije mnestičkim deficitima, poteškoćama usnivanja te gubitkom na tjelesnoj težini. U sklopu daljnje dijagnostičke obrade učinjen je EEG koji pokazuje disritmičke promjene obostrano temporoparijetalno, a potom i MR koji pokazuje promjene asocirane uz limbički encefalitis. Analiza cerebrospinalnog likvora pokazala je da je riječ o encefalitisu autoimune etiologije, uzrokovan stvaranjem protutijela na Caspr2 protein. Opsežna klinička obrada isključila je tumorski proces kao mogući uzrok autoimunog encefalitisa. Terapija kortikosteroidima te intravenoznim imunoglobulinima rezultirala je značajnim poboljšanjem neuroloških simptoma, a u kontrolnom MR, četiri mjeseca od početka terapije dokumentirana je regresija limbičkog encefalitisa. ----- Zaključak: Autoimuni encefalitis je rijetka, ali potencijalno vrlo opasna bolest. Kod pacijenata koji se prezentiraju poremećajem svijesti, konvulzijama, poremećajem kognitivnih funkcija prije svega pamćenja, poremećajem usnivanja i gubitkom tjelesne težine u diferencijalnoj dijagnozi treba razmotriti i mogućnost limbičkog encefalitisa autoimune etiologije. Za konačnu dijagnozu bolesti potrebna je analiza seruma i cerebrospinalnog likvora. U slučaju pozitivnog nalaza autoimunih protutijela treba isključiti tumorski proces koji često može biti u pozadini autoimung encefalitisa. Terapija autoimunog enecefalitisa bazira se na kortikosteroidima i imunomodulacijskoj terapiji.
Abstract (english)
Introduction: Autoimmune encephalitides are neurologic disorders associated with antibodies against intracellular or synaptic proteins. Anti-Caspr2 encephalitis is an autoimmune encephalitis associated with antibodies against contactin associated protein-like 2 (Caspr2). Caspr2 is a membrane protein expressed in the neurons and it is important for proper function of voltage-gated potassium channels. Caspr2 antibodies can often occur as paraneoplastic process especially in patients with thymoma and small cell lung cancer. ----- Case presentation: A 56-year-old man presented with sudden loss of consciousness on his work. Initial internal and neurological diagnostic procedures did not find the cause of loss of consciousness. In the following period he noticed that he had become forgetful and that he could not remember some events. He also reported difficulties falling asleep and weight lost. After two months of having these symptoms he underwent EEG which showed dysrhythmia bilateral in temporoparietal region and MRI which revealed changes that pointed to the limbic encephalitis. Following diagnostic procedures found Caspr2 antibodies that cause limbic encephalitis. Patient also underwent diagnostic procedures to exclude tumor process as possible cause of autoimmune encephalitis. Treatment started with administering corticosteroids and IVIg and response to that therapy was good. Four months after treatment had started, his memory recovered and repeated MRI of brain revealed regression of limbic encephalitis. ----- Conclusion: Autoimmune encephalitis is a relatively rare but potentially dangerous condition. In patients with seizures, cognitive disturbance especially short term memory loss, sleep dysfunction and weight loss autoimmune limbic encephalitis needs to be considered as a possible diagnose. Analysis of serum and cerebrospinal fluid is necessary to detect cause of limbic encephalitis. In patients with positive autoimmune antibodies it is necessary to exclude tumor and start treatment with immunotherapy.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:225309
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2017-11-14 10:55:05