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Anti-N-methyl-D-aspartate receptor encephalitis induced by bilateral ovarian teratomas with distinct histopathologic types: A case report and brief literature review.
Medicine (Baltimore). 2019 Nov; 98(48):e18148.M

Abstract

RATIONALE

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder that is most frequently induced by ovarian teratoma in young females. The condition can be controlled and reversed via ovarian tumor resection and immunotherapy. However, anti-NMDAR encephalitis induced by bilateral ovarian teratomas with distinct histopathologic types is rarely reported in the literature.

PATIENT CONCERNS

A 23-year-old woman presented with seizures.

DIAGNOSES

The diagnosis was anti-NMDAR encephalitis associated with ovarian teratomas based on positive anti-NMDAR antibody tests in both the cerebrospinal fluid and serum, and the detection of bilateral ovarian lesions on pelvic computed tomography. The postoperative histopathologic examination confirmed that the left lesion was an immature teratoma, and the right lesion was a mature teratoma.

INTERVENTIONS

We performed surgical resection of the ovarian teratomas and administered immunotherapy for the control of anti-NMDAR encephalitis. Chemotherapy was administered for the immature teratoma.

OUTCOMES

The patient recovered without any postoperative complications. She has been confirmed to be in complete clinical remission, and has not had a recurrence during 18 months of follow-up.

LESSONS

Anti-NMDAR encephalitis induced by bilateral ovarian teratomas of differing histopathologic types (1 immature and 1 mature) is rare. Early diagnosis and treatment with tumor resection, immunotherapy, and chemotherapy are critical for a good prognosis.

Authors+Show Affiliations

Department of Neurotrauma.Department of Urology.Department of Radiology.Department of Library.Department of Outpatient, The First Hospital of Jilin University, Changchun, Jilin, China.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31770255

Citation

Li, Wenchen, et al. "Anti-N-methyl-D-aspartate Receptor Encephalitis Induced By Bilateral Ovarian Teratomas With Distinct Histopathologic Types: a Case Report and Brief Literature Review." Medicine, vol. 98, no. 48, 2019, pp. e18148.
Li W, Jia D, Tong L, et al. Anti-N-methyl-D-aspartate receptor encephalitis induced by bilateral ovarian teratomas with distinct histopathologic types: A case report and brief literature review. Medicine (Baltimore). 2019;98(48):e18148.
Li, W., Jia, D., Tong, L., Lun, Z., & Li, H. (2019). Anti-N-methyl-D-aspartate receptor encephalitis induced by bilateral ovarian teratomas with distinct histopathologic types: A case report and brief literature review. Medicine, 98(48), e18148. https://doi.org/10.1097/MD.0000000000018148
Li W, et al. Anti-N-methyl-D-aspartate Receptor Encephalitis Induced By Bilateral Ovarian Teratomas With Distinct Histopathologic Types: a Case Report and Brief Literature Review. Medicine (Baltimore). 2019;98(48):e18148. PubMed PMID: 31770255.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anti-N-methyl-D-aspartate receptor encephalitis induced by bilateral ovarian teratomas with distinct histopathologic types: A case report and brief literature review. AU - Li,Wenchen, AU - Jia,Dan, AU - Tong,Lan, AU - Lun,Zhijun, AU - Li,Hailiang, PY - 2019/11/27/entrez PY - 2019/11/27/pubmed PY - 2019/12/18/medline SP - e18148 EP - e18148 JF - Medicine JO - Medicine (Baltimore) VL - 98 IS - 48 N2 - RATIONALE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder that is most frequently induced by ovarian teratoma in young females. The condition can be controlled and reversed via ovarian tumor resection and immunotherapy. However, anti-NMDAR encephalitis induced by bilateral ovarian teratomas with distinct histopathologic types is rarely reported in the literature. PATIENT CONCERNS: A 23-year-old woman presented with seizures. DIAGNOSES: The diagnosis was anti-NMDAR encephalitis associated with ovarian teratomas based on positive anti-NMDAR antibody tests in both the cerebrospinal fluid and serum, and the detection of bilateral ovarian lesions on pelvic computed tomography. The postoperative histopathologic examination confirmed that the left lesion was an immature teratoma, and the right lesion was a mature teratoma. INTERVENTIONS: We performed surgical resection of the ovarian teratomas and administered immunotherapy for the control of anti-NMDAR encephalitis. Chemotherapy was administered for the immature teratoma. OUTCOMES: The patient recovered without any postoperative complications. She has been confirmed to be in complete clinical remission, and has not had a recurrence during 18 months of follow-up. LESSONS: Anti-NMDAR encephalitis induced by bilateral ovarian teratomas of differing histopathologic types (1 immature and 1 mature) is rare. Early diagnosis and treatment with tumor resection, immunotherapy, and chemotherapy are critical for a good prognosis. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/31770255/Anti_N_methyl_D_aspartate_receptor_encephalitis_induced_by_bilateral_ovarian_teratomas_with_distinct_histopathologic_types:_A_case_report_and_brief_literature_review_ L2 - https://doi.org/10.1097/MD.0000000000018148 DB - PRIME DP - Unbound Medicine ER -