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Ovarian teratoma associated with anti-NMDA (N-methyl D-aspartate) receptor encephalitis.
BMJ Case Rep. 2018 Mar 13; 2018BC

Abstract

Anti-N-methyl D-aspartate receptor (NMDAR) encephalitis is a paraneoplastic, immune-mediated encephalopathy with a known association with ovarian teratomas. We present the first case in the UK of a 7-year-old patient presenting with this condition. Having been previously fit and healthy, the patient presented with an acute onset of cognitive disturbances. The initial suspicion was that of an infective encephalopathy; however, the lumbar puncture results were negative. Electroencephalography reported diffuse background slowing, supporting a diagnosis of encephalopathy. Extensive autoimmune screening was done and found to be positive for anti-NMDAR antibodies. A whole body MRI found a right adnexal lesion consistent with ovarian teratoma. At laparoscopy, the right ovary was excised and histology confirmed a mature cystic teratoma with neural tissue. There were no postoperative complications with the patient's neurology recovering progressively at follow-up.

Authors+Show Affiliations

Department of Paediatric Surgery, Guy's and St Thomas's NHS Foundation Trust, London, UK.Department of Paediatric Surgery, Guy's and St Thomas's NHS Foundation Trust, London, UK.Paediatric Surgery, Evelina Children's Hospital, London, UK.Department of Paediatric Surgery, Guy's and St Thomas's NHS Foundation Trust, London, UK. Evelina London Children's Hospital, Guy's and St Thomas NHS foundation Trust, London, UK.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

29535092

Citation

Leel, Nellihela, et al. "Ovarian Teratoma Associated With anti-NMDA (N-methyl D-aspartate) Receptor Encephalitis." BMJ Case Reports, vol. 2018, 2018.
Leel N, Thakkar HS, Drake D, et al. Ovarian teratoma associated with anti-NMDA (N-methyl D-aspartate) receptor encephalitis. BMJ Case Rep. 2018;2018.
Leel, N., Thakkar, H. S., Drake, D., & Bouhadiba, N. (2018). Ovarian teratoma associated with anti-NMDA (N-methyl D-aspartate) receptor encephalitis. BMJ Case Reports, 2018. https://doi.org/10.1136/bcr-2017-220333
Leel N, et al. Ovarian Teratoma Associated With anti-NMDA (N-methyl D-aspartate) Receptor Encephalitis. BMJ Case Rep. 2018 Mar 13;2018 PubMed PMID: 29535092.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ovarian teratoma associated with anti-NMDA (N-methyl D-aspartate) receptor encephalitis. AU - Leel,Nellihela, AU - Thakkar,Hemanshoo S, AU - Drake,David, AU - Bouhadiba,Nordeen, Y1 - 2018/03/13/ PY - 2018/3/15/entrez PY - 2018/3/15/pubmed PY - 2018/9/27/medline KW - neurology (drugs and medicines) KW - obstetrics, gynaecology and fertility KW - paediatric surgery JF - BMJ case reports JO - BMJ Case Rep VL - 2018 N2 - Anti-N-methyl D-aspartate receptor (NMDAR) encephalitis is a paraneoplastic, immune-mediated encephalopathy with a known association with ovarian teratomas. We present the first case in the UK of a 7-year-old patient presenting with this condition. Having been previously fit and healthy, the patient presented with an acute onset of cognitive disturbances. The initial suspicion was that of an infective encephalopathy; however, the lumbar puncture results were negative. Electroencephalography reported diffuse background slowing, supporting a diagnosis of encephalopathy. Extensive autoimmune screening was done and found to be positive for anti-NMDAR antibodies. A whole body MRI found a right adnexal lesion consistent with ovarian teratoma. At laparoscopy, the right ovary was excised and histology confirmed a mature cystic teratoma with neural tissue. There were no postoperative complications with the patient's neurology recovering progressively at follow-up. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/29535092/Ovarian_teratoma_associated_with_anti_NMDA__N_methyl_D_aspartate__receptor_encephalitis_ L2 - https://casereports.bmj.com/cgi/pmidlookup?view=long&pmid=29535092 DB - PRIME DP - Unbound Medicine ER -