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Nervenheilkunde 2018; 37(03): 167-175
DOI: 10.1055/s-0038-1642091
Seltene Erkrankungen
Schattauer GmbH

Seltene neuroimmunologische Syndrome mit Autoantikörpern gegen ZNS-Antigene

Rare neuroimmunological syndromes with autoantibodies against CNS antigens
B. Balint
1   Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
2   Department of Neurology, University Hospital Heidelberg, Germany
3   Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
,
H. Lerche
4   Department of Neurology and Epileptology, Hertie Institute of Clinical Brain Research, University of Tübingen, Germany
,
F. Leypoldt
5   Department of Neurology, Christian-Albrechts-University Kiel, Germany
6   Neuroimmunology section, Institute of Clinical Chemistry, University Hospital Schleswig-Holstein Kiel/Lübeck, Germany
› Institutsangaben
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Publikationsverlauf

eingegangen am: 20. November 2017

angenommen am: 28. November 2017

Publikationsdatum:
02. April 2018 (online)

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Zusammenfassung

Das klinische Spektrum von Erkrankungen mit Antikörpern gegen ZNS-Antigene expandiert rasch und umfasst sowohl neurologische als auch psychiatrische Manifestationsformen. Insbesondere autoimmune Syndrome assoziiert mit neu entdeckten Antikörpern gegen Oberflächenantigene auf Neuronen, wie z. B. Rezeptoren oder rezeptorassoziierte Proteine, erlangen zunehmend an Bedeutung, da die Antikörper pathogenetisch relevant sind und in ihrer Gesamtheit eine neue Gruppe von Erkrankungen definieren, die meist gut auf immunmodulierende Therapien ansprechen. Auch wenn diese Erkrankungen insgesamt als selten gelten, verdienen sie besondere Beachtung, da eine frühzeitige Therapie ein entscheidender prognostischer Faktor ist. Dementsprechend wichtig ist die Erkennung und Diagnosestellung.

In diesem Übersichtsartikel behandeln wir das klinische Spektrum der Syndrome mit antineuronalen und -glialen Autoantikörpern, und beleuchten insbesondere charakteristische Präsentationen hinsichtlich Symptomatik und Altersgruppe, und gewisse Warnzeichen („red flags“), die entscheidende Hinweise auf die Diagnose darstellen.

Summary

The clinical spectrum associated with antibodies against central nervous system antigens is rapidly expanding and comprises both neurological and psychiatric manifestations.

The more recently discovered antibodies against neuronal surface antigens, such as receptors or receptor associated proteins, are of particular interest as these antibodies are pathogenic and define a group of disorders which is typically well responding to immunotherapy. Although these disorders are generally considered rare they should not be missed, as early treatment initiation is an important prognostic factor. In this review, we discuss the clinical spectrum of the new neuronal and glial surface antibodies, highlighting characteristic clinical presentations regarding symptoms and patient age group and emphasising red flags which can give the clue to diagnosis.

Schlüsselwörter

Antikörper - neuroimmunologische Syndrome - klinisches Spektrum

Keywords

Antibodies - neuroimmunological syndromes - clinical spectrum
 

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