Paraneoplastic Encephalitis Due to Anti-NMDA Receptor Antibodies in a Young Woman with Ovarian Teratoma:: Science Publishing Group

Paraneoplastic Encephalitis Due to Anti-NMDA Receptor Antibodies in a Young Woman with Ovarian Teratoma

Gonzalez Manrique Guillermo¹, Zabaleta Orozco Mario Alberto¹, Claros Ortiz Katherine Viviana¹, Cano Arias Luis Guillermo², Velasco Hoyos Maria Fernanda³, Solano Vega Irina Isabel³, Lizcano Aros Jose Alfredo³, Luna Tavera Rina Liliana⁴

¹Neurophysiology Department, Hospital Universitario Hernando Moncaleano Perdomo, Investigation Group MI DNeuropsy, Neiva, Colombia

²Gynecologic Oncology Department, Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Colombia

³Internal Medicine Department, Universidad Surcolombiana, Investigation Group MI DNeuropsy, Neiva, Colombia

⁴Department of Pathology, Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Colombia

European Journal of Clinical and Biomedical Sciences, Volume 9, Issue 4, August 2023

Pages: 51-54

Received: Mar. 16, 2023

Accepted: Apr. 01, 2023

Published: Sep. 25, 2023

DOI: 10.11648/j.ejcbs.20230904.12

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Abstract

Anti-N-methyl D-aspartate receptor (NMDAR) encephalitis is a rare condition, often associated with neoplasms and characterized by neuropsychiatric symptoms and dysautonomia. Affecting approximately 0.01% of cancer patients, it is the second most frequent autoimmune encephalitis after acute disseminated encephalomyelitis, its clinical presentation is usually acute and severe, so prompt identification and treatment improve prognosis. We present the case of a 23-year-old female patient from a rural area of Caquetá, Colombia, previously healthy, who presented persistent psychotic symptoms of two weeks of evolution and was initially treated in a psychiatric unit where she evolved with systemic compromise. Finally, a diagnosis of paraneoplastic anti-NDMAR encephalitis was made. The patient received IV immunoglobulin G plus adjuvant systemic management with chemotherapy. She had complete resolution of her neuropsychiatric disorder and was asymptomatic when discharged. In conclusion, anti-NMDAR encephalitis is a condition with an underlying autoimmune mechanism, with production of autoantibodies mainly against the NR1 and NR2 subunits of NMDA receptors in the brain. These autoantibodies are produced in response to a breakdown of immune tolerance usually secondary to a neoplastic process, mostly ovarian teratoma, or infectious as in the case of herpes viral encephalitis. Despite its severe and potentially fatal nature, AE typically exhibits a positive response to treatment if a prompt diagnosis is established and management is initiated. However, it is acknowledged in some texts that there is still a gap in recognizing this entity, which encourages future valuable research.

Keywords

Anti-N-Methyl-D-Aspartate Receptor Encephalitis, Encephalitis, Psychosis, Autoimmune Diseases, Paraneoplastic Encephalitis

To cite this article

Gonzalez Manrique Guillermo, Zabaleta Orozco Mario Alberto, Claros Ortiz Katherine Viviana, Cano Arias Luis Guillermo, Velasco Hoyos Maria Fernanda, et al. (2023). Paraneoplastic Encephalitis Due to Anti-NMDA Receptor Antibodies in a Young Woman with Ovarian Teratoma. European Journal of Clinical and Biomedical Sciences, 9(4), 51-54. https://doi.org/10.11648/j.ejcbs.20230904.12

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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