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Teratoma-associated anti-N-methyl-D-aspartate receptor encephalitis: A case report and literature review.
Medicine (Baltimore). 2019 May; 98(21):e15765.M

Abstract

RATIONALE

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease associated with the NMDA receptor and has a good response to treatment. However, only few cases related to teratoma have been reported. Here, we report a case of teratoma-associated anti-NMDAR encephalitis.

PATIENT CONCERNS

A 25-year-old woman presenting with fever for 20 days and psychiatric symptoms for 9 days was admitted to the hospital. The patient progressed to a minimally conscious state consistent with encephalitis.

DIAGNOSIS

Considering the possibility of autoantibody-mediated encephalitis, laboratory tests were conducted to detect anti-NMDAR antibodies in cerebrospinal fluid and serum. Results confirmed the diagnosis of anti-NMDAR encephalitis. Furthermore, gynecological ultrasound investigation detected teratoma in the left ovary.

INTERVENTIONS

After resection of the teratoma with laparoscopic adnexectom, the patient was treatment with immunosuppressive therapy.

OUTCOMES

The patient recovered gradually and was discharged 2 months after the operation.

LESSONS

Anti-NMDAR encephalitis remains difficult to diagnose because of its vague manifestations, and no clinical practice guidelines for prevention and treatment of the disease have been established yet. The clinical data of a case of teratoma-related anti-NMDAR encephalitis were analyzed, and relevant studies were reviewed.

Links

Publisher Full Text
ncbi.nlm.nih.gov
dx.doi.org
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Aggregator Full Text

Authors+Show Affiliations

Yan B
Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Shanghai Key Laboratory of Gynecologic Oncology, Focus Construction Subject of Shanghai Education Department.
Wang Y
Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Shanghai Key Laboratory of Gynecologic Oncology, Focus Construction Subject of Shanghai Education Department.
Zhang Y
Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
Lou W
Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Shanghai Key Laboratory of Gynecologic Oncology, Focus Construction Subject of Shanghai Education Department.

MeSH

AdultAnti-N-Methyl-D-Aspartate Receptor EncephalitisAutoantibodiesFemaleHumansOvarian NeoplasmsReceptors, N-Methyl-D-AspartateTeratoma

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

31124965

Citation

Yan, Bin, et al. "Teratoma-associated anti-N-methyl-D-aspartate Receptor Encephalitis: a Case Report and Literature Review." Medicine, vol. 98, no. 21, 2019, pp. e15765.
Yan B, Wang Y, Zhang Y, et al. Teratoma-associated anti-N-methyl-D-aspartate receptor encephalitis: A case report and literature review. Medicine (Baltimore). 2019;98(21):e15765.
Yan, B., Wang, Y., Zhang, Y., & Lou, W. (2019). Teratoma-associated anti-N-methyl-D-aspartate receptor encephalitis: A case report and literature review. Medicine, 98(21), e15765. https://doi.org/10.1097/MD.0000000000015765
Yan B, et al. Teratoma-associated anti-N-methyl-D-aspartate Receptor Encephalitis: a Case Report and Literature Review. Medicine (Baltimore). 2019;98(21):e15765. PubMed PMID: 31124965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Teratoma-associated anti-N-methyl-D-aspartate receptor encephalitis: A case report and literature review. AU - Yan,Bin, AU - Wang,You, AU - Zhang,Ying, AU - Lou,Weihua, PY - 2019/5/25/entrez PY - 2019/5/28/pubmed PY - 2019/5/31/medline SP - e15765 EP - e15765 JF - Medicine JO - Medicine (Baltimore) VL - 98 IS - 21 N2 - RATIONALE: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease associated with the NMDA receptor and has a good response to treatment. However, only few cases related to teratoma have been reported. Here, we report a case of teratoma-associated anti-NMDAR encephalitis. PATIENT CONCERNS: A 25-year-old woman presenting with fever for 20 days and psychiatric symptoms for 9 days was admitted to the hospital. The patient progressed to a minimally conscious state consistent with encephalitis. DIAGNOSIS: Considering the possibility of autoantibody-mediated encephalitis, laboratory tests were conducted to detect anti-NMDAR antibodies in cerebrospinal fluid and serum. Results confirmed the diagnosis of anti-NMDAR encephalitis. Furthermore, gynecological ultrasound investigation detected teratoma in the left ovary. INTERVENTIONS: After resection of the teratoma with laparoscopic adnexectom, the patient was treatment with immunosuppressive therapy. OUTCOMES: The patient recovered gradually and was discharged 2 months after the operation. LESSONS: Anti-NMDAR encephalitis remains difficult to diagnose because of its vague manifestations, and no clinical practice guidelines for prevention and treatment of the disease have been established yet. The clinical data of a case of teratoma-related anti-NMDAR encephalitis were analyzed, and relevant studies were reviewed. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/31124965/Teratoma_associated_anti_N_methyl_D_aspartate_receptor_encephalitis:_A_case_report_and_literature_review_ L2 - http://dx.doi.org/10.1097/MD.0000000000015765 DB - PRIME DP - Unbound Medicine ER -