title: Anti-N-methyl-aspartate receptor encephalitis in identical twin sisters: role for oophorectomy.
abstract: BACKGROUND
  Anti-N-methyl-aspartate receptor encephalitis is a potentially fatal form of encephalitis and frequently associated with ovarian teratomas. Surgical removal of ovarian teratomas improves clinical outcome, but it is unclear whether bilateral salpingo-oophorectomy for normal-appearing ovaries is of clinical benefit.
  
  
  METHODS
  Our report describes a unique clinical scenario of identical twin sisters with anti-N-methyl-aspartate receptor encephalitis. Neither patient responded to immunosuppressive therapy. Imaging studies showed normal-appearing ovaries. The first twin continued on medical therapy only and died of the disease. The second twin underwent a bilateral salpingo-oophorectomy followed by gradual recovery.
  
  
  CONCLUSIONS
  Based on our experience in two genetically identical individuals, we suggest considering the removal of normal-appearing ovaries in patients with anti-N-methyl-aspartate receptor encephalitis who fail to respond to medical treatment.
authors.affiliation: Department Obstetrics and Gynecology, UCLA David Geffen School of Medicine, Los Angeles, and the Department Obstetrics and Gynecology, Division of Gynecologic Oncology, Stanford School of Medicine, Stanford, California.
authors.forename: Salome
authors.initials: S
authors.lastname: Masghati
authors.forename: Mana
authors.initials: M
authors.lastname: Nosratian
authors.forename: Oliver
authors.initials: O
authors.lastname: Dorigo
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000188:drug therapy / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D010052:Ovariectomy; D014430:Twins, Monozygotic
chemical_list: D007166:Immunosuppressive Agents