scholarly journals Anti-NMDA-Receptor Encephalitis in a Patient with Ovarian Teratoma, Harboring Brain Histology of Varying Developmental Stages and Regions with Chronic Inflammation

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S80-S81
Author(s):  
S Fatemi ◽  
E Qu ◽  
J Fullmer
Keyword(s):  
Case Report ◽  
Nmda Receptor ◽  
Developmental Stages ◽  
Clinical Symptoms ◽  
Cystic Teratoma ◽  
Imaging Study ◽  
Ovarian Teratoma ◽  
Laboratory Findings ◽  
Nmda Receptor Encephalitis ◽  
Nmdar Encephalitis

Abstract Introduction/Objective Anti-NMDA-receptor encephalitis is a subacute, autoimmune disorder thought to be caused by autoantibodies directed against the N-methyl-D-aspartate (NMDA) receptor. Clinical symptoms of anti-NMDAR encephalitis may mimic schizophrenia and psychotic spectrum disorders or substance-induced psychosis. Although initially described in association with ovarian teratomas in women, anti-NMDAR encephalitis has been reported in individuals without paraneoplastic association, as well as in males. Herein, we report a case of a 29-year-old woman with suicidal ideation and other neuropsychiatric manifestations who was found to have a right ovarian cystic mass by imaging study. Microscopically, the resected ovarian mass is composed of mature skin, fat, cartilage and neural tissues. Nerve, ganglions and multiple brain tissues are present. Cerebellum including external granular cell layer (normally only seen in infants), cerebrum-like, choroid plexus and other neural elements are present. There is peripheral lymphoplasmacytic infiltrates around and within the neuroglial matrix. Cerebral spinal fluid was concurrently tested positive for Anti-NMDAR. The combined clinical, histological, and laboratory findings confirmed the above diagnosis. Although Anti-NMDAR encephalitis is a familiar entity to many clinical psychiatrist and neurologists, it is less commonly reported in the pathology literature. Its resultant relationship to cystic teratoma warrants awareness of this condition by pathologists. Methods/Case Report Case Report Results (if a Case Study enter NA) NA Conclusion Anti-NMDA-receptor encephalitis is related to cystic teratoma, therefore pathologists need to be aware of this condition.

Management And Psychiatric Manifestations Of Anti-NMDA Receptor Encephalitis, A Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S525-S526
Author(s):  
R. Gallego ◽  
A. Flores
Keyword(s):  
Case Report ◽  
Nmda Receptor ◽  
Psychiatric Symptoms ◽  
Multidisciplinary Treatment ◽  
Autoimmune Disorder ◽  
Clonic Seizure ◽  
Nmda Receptor Encephalitis ◽  
Abnormal Movements ◽  
Nmdar Encephalitis ◽  
Psychiatric Manifestations

IntroductionAnti-NMDA receptor (NMDAR) encephalitis, formally recognized in 2007 by Dalmau et al, is an autoimmune disorder with a complex presentation that includes psychiatric symptoms, memory deficits, and autonomic instability. The exact incidence is unknown but age, gender, and ethnicity may all play a role. Presence of antibodies against the GluN1 subunit of the NMDAR in the CSF and serum confirm the diagnosis of NMDAR encephalitis.Case reportWe report the case of a previously healthy, 19-year-old woman, 6 weeks pregnant. She had a generalized tonic-clonic seizure followed by psychiatric symptoms, including insomnia, emotional lability, delusions, and disorganized behavior. During the course of the disease, she demonstrated speech impairments and catatonic features associated with abnormal movements.She was provided lorazepam 1 mg twice a day to treat her catatonic symptoms, her insomnia and her speech improved. Olanzapine was introduced, reaching a dose of 20 mg/day for managing psychosis and agitation.DiscussionNMDA-R encephalitis is a novel disorder with prominent psychiatric manifestations that is widely underdiagnosed. Neuroleptics may be helpful for managing psychosis and agitation, but may exacerbate movement abnormalities. Benzodiazepines are helpful for agitation, insomnia and catatonia associated with this condition.ConclusionEarlier recognition of this illness is crucial as prompt diagnosis and multidisciplinary treatment, can potentially improve prognosis. There is an increasing need for psychiatrists to become aware of the disorder and consider it in their differential diagnosis, specially in patients with new onset psychosis, history of encephalitis or subtle neurological symptoms. Careful selection of psychopharmacological interventions may reduce suffering.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Case report: meningitis as a presenting feature of anti-NMDA receptor encephalitis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Maria Stavrou ◽  
Jing Ming Yeo ◽  
Alexander David Slater ◽  
Oliver Koch ◽  
Sarosh Irani ◽  
...  
Keyword(s):  
Case Report ◽  
Nmda Receptor ◽  
Rapid Development ◽  
Clonic Seizure ◽  
Ovarian Teratoma ◽  
Caucasian Woman ◽  
Case Presentation ◽  
Nmda Receptor Encephalitis ◽  
Autonomic Instability ◽  
Lymphocytic Meningitis

Abstract Background Meningitis is a very rare atypical presenting feature of anti-NMDA receptor encephalitis. In our case report, we describe an unusual clinical presentation of anti-NMDA receptor encephalitis with a biphasic pattern of meningitis followed by encephalitis and discuss potential mechanisms underlying this presentation. We aim to widen the differential diagnosis to be considered in a patient presenting with clinical meningitis and pyrexia. Case presentation This is a case of a 33-year old Caucasian woman who initially presented with a lymphocytic meningitis attributed to a viral infection. She subsequently developed fluctuating consciousness, agitation, visual hallucinations, dyskinetic movements, a generalized tonic-clonic seizure, and autonomic instability. Investigations revealed a diagnosis of anti-NMDA receptor encephalitis secondary to a previously unidentified ovarian teratoma. She made an excellent recovery with immunotherapy and removal of the teratoma. Conclusion Clinicians should consider autoimmune encephalitides in individuals with meningitis, particularly where extensive investigations fail to identify a causative pathogen and there is rapid development of an encephalitic phenotype.

Anti-NMDA Receptor Encephalitis Associated With an Ovarian Teratoma Presenting as First-episode Psychosis: A Case Report

2022 ◽  
Vol 28 (1) ◽  
pp. 84-88
Author(s):  
Pedro Câmara-Pestana ◽  
Andreia D. Magalhães ◽  
Tiago Mendes ◽  
Pedro Levy ◽  
Ricardo Coentre
Keyword(s):  
Case Report ◽  
Nmda Receptor ◽  
First Episode Psychosis ◽  
Ovarian Teratoma ◽  
First Episode ◽  
Nmda Receptor Encephalitis ◽  
Episode Psychosis

scholarly journals Case Report: Anti-NMDA Receptor Encephalitis With Bilateral Hearing Loss as the Initial Symptom

2021 ◽  
Vol 12 ◽  
Author(s):  
Hongjiang Cheng ◽  
Fengbing Yang ◽  
Jing Zhang ◽  
Lina Xu ◽  
Longbin Jia ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Nmda Receptor ◽  
Combined Treatment ◽  
Ovarian Teratoma ◽  
Surgical Removal ◽  
Convulsive Status Epilepticus ◽  
Initial Symptom ◽  
Bilateral Hearing Loss ◽  
Nmdar Encephalitis

Introduction: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease associated with the NMDA receptor. This paper describes a patient who presented with bilateral hearing loss as the initial symptom of anti-NMDAR encephalitis.Case Report: We describe a 31-year-old young female with anti-NMDAR encephalitis who presented with bilateral severe hearing loss after brief loss of consciousness and then accompanied by other symptoms, such as generalized tonic–clonic seizures, manic episodes, excessive salivation, severe cognitive impairment, and complex non-convulsive status epilepticus. Great improvement was achieved by a combined treatment of steroid, IVIG, and plasmapheresis, especially after surgical removal of the ovarian teratoma. When she was discharged on hospital day 43, her hearing loss obtained a significant improvement.Conclusion: This case study and literature review investigated the impairment of hearing loss and its subsequent treatment in patients with anti-NMDAR encephalitis.

scholarly journals Anti-NMDA receptor encephalitis in a patient with ovarian teratoma – case report

2017 ◽  
Vol 26 (4) ◽  
pp. 246-254
Author(s):  
Anna Jasińska-Mikołajczyk ◽  
Przemysław Osip ◽  
Agnieszka Osip-Permoda ◽  
Filip Rybakowski
Keyword(s):  
Case Report ◽  
Nmda Receptor ◽  
Ovarian Teratoma ◽  
Nmda Receptor Encephalitis

scholarly journals Ovarectomy despite Negative Imaging in Anti-NMDA Receptor Encephalitis: Effective Even Late

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Anna-Lena Boeck ◽  
Frank Logemann ◽  
Terence Krauß ◽  
Kais Hussein ◽  
Eva Bültmann ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Clinical Syndrome ◽  
Ovarian Teratoma ◽  
Intensive Care Treatment ◽  
Important Lesson ◽  
Nmda Receptor Encephalitis ◽  
Nmdar Encephalitis ◽  
Negative Imaging ◽  
Instructive Case

Anti-NMDA receptor (NMDAR) encephalitis is an autoimmune antibody-mediated neuropsychiatric disorder. The disorder is known to be associated with ovarian teratoma and predominantly affects young women. Here, we report the case of a 34-year-old woman with anti-NMDAR encephalitis, in which detailed investigations gave no specific hint for an ovarian teratoma. Despite this, and due to a continuous severe clinical syndrome, an ovarectomy was performed and histological examination revealed an occult teratoma. The ovarectomy led to a remarkable improvement even with a long term intensive care treatment for 11 months. The most important lesson to be learned from this instructive case is that even though none of the investigations was indicative for an ovarian teratoma, including an explorative laparoscopy with biopsy, there still may be an occult ovarian teratoma. This shows that tumour search and diagnosis are extremely important in patients presenting with anti-NMDAR encephalitis, and a laparotomy and ovarectomy is justified. Furthermore, removal of the teratoma even 11 months after a very severe course is still therapeutically effective.

Poster 326 Paraneoplastic Ovarian Teratoma Anti-NMDA Receptor Encephalitis: A Case Report

PM&R ◽  
2016 ◽  
Vol 8 (9) ◽  
pp. S267
Author(s):  
Lauren A. Kremm ◽  
Qianna Armstrong ◽  
Mary H. Lawler
Keyword(s):  
Case Report ◽  
Nmda Receptor ◽  
Ovarian Teratoma ◽  
Nmda Receptor Encephalitis

scholarly journals Phylogenetic Analysis to Explore the Association Between Anti-NMDA Receptor Encephalitis and Tumors Based on microRNA Biomarkers

Biomolecules ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. 572 ◽  
Author(s):  
Wang
Keyword(s):  
Phylogenetic Analysis ◽  
Nmda Receptor ◽  
Phylogenetic Trees ◽  
Tumor Resection ◽  
Autoimmune Disorder ◽  
Control Of Gene Expression ◽  
Nmda Receptor Encephalitis ◽  
Nmdar Encephalitis ◽  
Non Coding Rna ◽  
The Relationship

MicroRNA (miRNA) is a small non-coding RNA that functions in the epigenetics control of gene expression, which can be used as a useful biomarker for diseases. Anti-NMDA receptor (anti-NMDAR) encephalitis is an acute autoimmune disorder. Some patients have been found to have tumors, specifically teratomas. This disease occurs more often in females than in males. Most of them have a significant recovery after tumor resection, which shows that the tumor may induce anti-NMDAR encephalitis. In this study, I review microRNA (miRNA) biomarkers that are associated with anti-NMDAR encephalitis and related tumors, respectively. To the best of my knowledge, there has not been any research in the literature investigating the relationship between anti-NMDAR encephalitis and tumors through their miRNA biomarkers. I adopt a phylogenetic analysis to plot the phylogenetic trees of their miRNA biomarkers. From the analyzed results, it may be concluded that (i) there is a relationship between these tumors and anti-NMDAR encephalitis, and (ii) this disease occurs more often in females than in males. This sheds light on this issue through miRNA intervention.

Sign in / Sign up

Export Citation Format

Share Document