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Ovarian Teratoma Associated with Coexisting Anti-N-Methyl-D-Aspartate Receptor and Glial Fibrillary Acidic Protein Autoimmune Meningoencephalitis in an Adolescent Girl: A Case Report.
J Pediatr Adolesc Gynecol. 2018 Jun; 31(3):321-324.JP

Abstract

BACKGROUND

Ovarian teratomas are rarely associated with paraneoplastic autoimmune meningoencephalitis. In addition to the well known N-methyl-D-aspartate receptor (NMDA-R) antibody, the glial fibrillary acidic protein (GFAP) antibody is a novel biomarker of autoimmune meningoencephalitis that might be seen in patients with ovarian teratoma.

CASE

A 13-year-old girl with acute-onset meningoencephalitis and incidental finding of ovarian teratoma was found to have coexisting anti-NMDA-R and GFAP antibodies present in her cerebrospinal fluid.

SUMMARY AND CONCLUSION

NMDA-R and GFAP autoimmune encephalitis should be considered in adolescent patients with neurologic or psychiatric symptoms and an ovarian teratoma. Prompt diagnosis and surgical resection increase the likelihood of full neurologic recovery.

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Authors+Show Affiliations

Martin AL
Department of Obstetrics, Gynecology and Women's Health, University of Louisville School of Medicine, Louisville, Kentucky. Electronic address: almart15@louisville.edu.
Jolliffe E
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Hertweck SP
Department of Pediatric and Adolescent Gynecology, Norton Children's Hospital, Louisville, Kentucky.

MeSH

AdolescentAnti-N-Methyl-D-Aspartate Receptor EncephalitisBiomarkersFemaleGlial Fibrillary Acidic ProteinHumansLaparoscopyMeningoencephalitisOvarian NeoplasmsOvaryReceptors, N-Methyl-D-AspartateTeratomaUltrasonography

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

29294378

Citation

Martin, Alexandra L., et al. "Ovarian Teratoma Associated With Coexisting Anti-N-Methyl-D-Aspartate Receptor and Glial Fibrillary Acidic Protein Autoimmune Meningoencephalitis in an Adolescent Girl: a Case Report." Journal of Pediatric and Adolescent Gynecology, vol. 31, no. 3, 2018, pp. 321-324.
Martin AL, Jolliffe E, Hertweck SP. Ovarian Teratoma Associated with Coexisting Anti-N-Methyl-D-Aspartate Receptor and Glial Fibrillary Acidic Protein Autoimmune Meningoencephalitis in an Adolescent Girl: A Case Report. J Pediatr Adolesc Gynecol. 2018;31(3):321-324.
Martin, A. L., Jolliffe, E., & Hertweck, S. P. (2018). Ovarian Teratoma Associated with Coexisting Anti-N-Methyl-D-Aspartate Receptor and Glial Fibrillary Acidic Protein Autoimmune Meningoencephalitis in an Adolescent Girl: A Case Report. Journal of Pediatric and Adolescent Gynecology, 31(3), 321-324. https://doi.org/10.1016/j.jpag.2017.12.009
Martin AL, Jolliffe E, Hertweck SP. Ovarian Teratoma Associated With Coexisting Anti-N-Methyl-D-Aspartate Receptor and Glial Fibrillary Acidic Protein Autoimmune Meningoencephalitis in an Adolescent Girl: a Case Report. J Pediatr Adolesc Gynecol. 2018;31(3):321-324. PubMed PMID: 29294378.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ovarian Teratoma Associated with Coexisting Anti-N-Methyl-D-Aspartate Receptor and Glial Fibrillary Acidic Protein Autoimmune Meningoencephalitis in an Adolescent Girl: A Case Report. AU - Martin,Alexandra L, AU - Jolliffe,Evan, AU - Hertweck,S Paige, Y1 - 2017/12/30/ PY - 2017/11/27/received PY - 2017/12/21/accepted PY - 2018/1/3/pubmed PY - 2018/9/25/medline PY - 2018/1/3/entrez KW - Anti-NMDA receptor encephalitis KW - Autoimmune meningoencephalitis KW - Glial fibrillary acidic protein (GFAP) meningoencephalitis KW - Ovarian teratoma SP - 321 EP - 324 JF - Journal of pediatric and adolescent gynecology JO - J Pediatr Adolesc Gynecol VL - 31 IS - 3 N2 - BACKGROUND: Ovarian teratomas are rarely associated with paraneoplastic autoimmune meningoencephalitis. In addition to the well known N-methyl-D-aspartate receptor (NMDA-R) antibody, the glial fibrillary acidic protein (GFAP) antibody is a novel biomarker of autoimmune meningoencephalitis that might be seen in patients with ovarian teratoma. CASE: A 13-year-old girl with acute-onset meningoencephalitis and incidental finding of ovarian teratoma was found to have coexisting anti-NMDA-R and GFAP antibodies present in her cerebrospinal fluid. SUMMARY AND CONCLUSION: NMDA-R and GFAP autoimmune encephalitis should be considered in adolescent patients with neurologic or psychiatric symptoms and an ovarian teratoma. Prompt diagnosis and surgical resection increase the likelihood of full neurologic recovery. SN - 1873-4332 UR - https://www.unboundmedicine.com/medline/citation/29294378/Ovarian_Teratoma_Associated_with_Coexisting_Anti_N_Methyl_D_Aspartate_Receptor_and_Glial_Fibrillary_Acidic_Protein_Autoimmune_Meningoencephalitis_in_an_Adolescent_Girl:_A_Case_Report_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-3188(17)30540-5 DB - PRIME DP - Unbound Medicine ER -