scholarly journals Recurrent anti-NMDAR encephalitis during pregnancy combined with two antibodies positive

2021 ◽  
Author(s):  
Hong Liu ◽  
Xiu Chen
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Young Women ◽  
Psychiatric Symptoms ◽  
Review Of The Literature ◽  
Double Antibody ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Surface Antibody

AbstractAnti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune synaptic encephalitis likely mediated by neuronal surface antibody. Clinically, it is characterized by a variety of neurological and psychiatric symptoms, predominantly affecting young women. Recurrent anti-NMDAR cases combined with double-antibody positive during pregnancy have not been reported. We report a 19-year-old pregnant woman with recurrent anti-NMDAR encephalitis and double-antibody positive. Through our case report and a review of the literature, we hope to heighten an awareness of anti-NMDAR encephalitis, particularly in a pregnant setting.

scholarly journals Ovarian Teratoma as an Uncommon Cause of Encephalitis: Anti-Nmdar Syndrome, A Case Report

2020 ◽  
pp. 1-4
Author(s):  
Lourdes Sala Climent ◽  
Ana R. Calvo Redol ◽  
F. Xavier González Tallada ◽  
Javier Medrano Juárez ◽  
Lourdes Sala Climent ◽  
...  
Keyword(s):  
Case Report ◽  
Young Women ◽  
Psychiatric Symptoms ◽  
Mature Teratoma ◽  
Epileptiform Activity ◽  
Cognitive Status ◽  
Whole Body ◽  
Ovarian Teratoma ◽  
Nmdar Encephalitis ◽  
Adnexal Tumor

Objective: Anti-N-methyl D-aspartate receptor (NMDAR) encephalitis is a paraneoplastic, immunemediated encephalopathy with a known association with ovarian tumors, more frequently with mature teratoma. Case Report: We present the case of a 20-year-old patient presenting with fever for 3 weeks and an acute onset of cognitive disturbances. The initial suspicion was that of an infective encephalopathy; however, the lumbar puncture results were negative. Electroencephalography reported epileptiform activity in anterior horns, supporting a diagnosis of encephalopathy. Extensive autoimmune screening was done and found to be positive for anti-NMDAR antibodies. A whole body-TC found a right adnexal tumor compatible with ovarian teratoma. At laparoscopy, the right adnexal tumor was excised, preserving most of the ovarian parenchyma; and histology confirmed a mature teratoma with neural tissue. There were no postoperative complications. The patient recovered normal speech and her former cognitive status, within 40 days from the day after surgery. Conclusion: The association ovarian teratoma-anti-NMDAR encephalitis is a serious and potentially fatal pathology occurring in young women and under-recognized in many countries and among gynaecologists. Given the recent discovery, special attention should be given to possible behavioural changes and psychiatric symptoms that may occur in young women with apparently unknown cause. It is also very important the diagnostic confirmation through the positivity of the anti-NMDAR antibodies, the diagnosis of the underlying tumour and the early tumour excision; since, the earlier the treatment is, the greater is the rate of success and the clinical remission.

Isolated Psychiatric Presentation of Anti N-Methyl-D-Aspartate Receptor Encephalitis: A Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S524-S524
Author(s):  
P. Azevedo ◽  
F. Monteiro ◽  
A.P. Correia ◽  
A. Norton ◽  
A.M. Moreira
Keyword(s):  
Case Report ◽  
Psychiatric Symptoms ◽  
Brain Mri ◽  
Autoimmune Disorder ◽  
Oligoclonal Bands ◽  
Neurological Involvement ◽  
Sleep Cycle ◽  
Psychotic Episode ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis

IntroductionAnti N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an autoimmune disorder with a presentation that includes acute behavioral changes, psychosis, cognitive impairment and autonomic instability. In some cases, there are isolated psychiatric symptoms without neurological involvement.AimsTo raise awareness of the disorder among psychiatrists, considering it a differential diagnosis in a first psychotic episode since a prompt diagnosis and treatment can dramatically affect the outcome.ObjectivesTo summarize the latest literature about this field and to present a case report.MethodsA brief review of the latest literature was performed on PubMed using the keywords “anti N-methyl-D-aspartate receptor encephalitis”, “anti-NMDA encephalitis”, “psychiatric symptoms”.ResultsA 20-year-old male was admitted to our inpatient unit with bizarre delusions of grandious and religious content, somatic hallucinations, sleep cycle inversion and strange behaviour. These symptoms had been present for 1 week and remitted after 10 days of treatment with risperidone. On follow-up, he developed anhedonia, apathy and blunt affect. Brain MRI showed multiple hyperintense changes in T2 and T2-FLAIR, highly suggestive of demyelinating lesions. The cerebrospinal fluid showed mild lymphocytic pleocytosis, mildly increased proteins, oligoclonal bands and anti-NMDAR antibodies of intrathecal production. He was treated with corticoids and the antipsychotic was discontinued. No neurologic symptoms were ever present.ConclusionThis is an atypical case of anti-NMDAR encephalitis because of its isolated psychiatric presentation. Most patients develop neurological symptoms 2 to 3 weeks after onset of psychiatric symptoms. Monosymptomatic syndromes arise in less than 5% of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Lethal Vertebral Artery Dissection in Pregnancy: A Case Report and Review of the Literature

2006 ◽  
Vol 130 (4) ◽  
pp. 533-535 ◽  
Author(s):  
Madalina Tuluc ◽  
Daniel Brown ◽  
Bruce Goldman
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Subarachnoid Hemorrhage ◽  
Vertebral Artery ◽  
Fatal Outcome ◽  
Vertebral Artery Dissection ◽  
Rare Event ◽  
Artery Dissection ◽  
Review Of The Literature ◽  
In Pregnancy

Abstract Subarachnoid hemorrhage represents a rare event in pregnancy with a high mortality rate. We present the case of a 39-year-old pregnant woman who developed right vertebral artery dissection with subsequent massive subarachnoid hemorrhage with fatal outcome. The macroscopic and microscopic autopsy findings are described. A review of the literature with a discussion of the varied predisposing factors for vertebral artery dissection and subarachnoid hemorrhage and the rarity of these events in pregnancy is provided.

Use of an Impedance Threshold Device to Treat Severe Hypotension in a Pregnant Woman: Case Report and Review of the Literature

2013 ◽  
Vol 45 (4) ◽  
pp. e113-e115 ◽  
Author(s):  
Nicolas Segal ◽  
David I. Page ◽  
Charles J. Lick ◽  
Daryl D. Doering ◽  
Demetris Yannopoulos
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Review Of The Literature ◽  
Severe Hypotension ◽  
Threshold Device ◽  
Impedance Threshold Device

scholarly journals Lyme Disease and Associated NMDAR Encephalitis: A Case Report and Literature Review

2021 ◽  
Vol 13 (4) ◽  
pp. 487-496
Author(s):  
Natalja Predkele ◽  
Jānis Mednieks
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Marked Improvement ◽  
Clinical Signs ◽  
Antibacterial Treatment ◽  
Speech Impairments ◽  
Igg Antibodies ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Csf Findings

We present a case of a patient with positive N-methyl-D-aspartate receptor (NMDAR) IgG antibodies in their serum and cerebrospinal fluid (CSF) associated with neuroborreliosis. Clinically, the patient presented with symptoms of confusion, as well as behavioral and speech impairments. Regardless of antibacterial treatment, no significant improvement was achieved. Methylprednisolone provided a marked improvement in the patient’s clinical signs and CSF findings. The screening did not reveal any underlying neoplasm. Taking into account the marked clinical improvement after treatment with glucocorticosteroids, we suggest that NMDAR encephalitis is a possible autoimmune complication in neuroborreliosis patients requiring additional immunotherapy.

scholarly journals Renal impairment in Alport syndrome pregnant woman: Case report and review of the literature

2020 ◽  
Vol 8 (12) ◽  
pp. 3003-3007
Author(s):  
Franco Pepe ◽  
Federica Di Guardo ◽  
Elisa Zambrotta ◽  
Luisa Maria Di Gregorio ◽  
Giulio Insalaco ◽  
...  
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Renal Impairment ◽  
Alport Syndrome ◽  
Review Of The Literature
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