A case of anti-NMDAR encephalitis induced by ovarian teratoma.
A young woman was received in the hospital with gradually worsening neurological symptoms consistent with encephalitis. After several cerebrospinal fluid examinations, infectious encephalitis (viral, bacterial, or linked to tuberculosis or parasites) and autoimmune encephalitis were ruled out. The possibility of autoantibody-mediated encephalitis was considered, and anti-N-methyl-D-aspartate receptor (anti-NMDAR) antibodies were detected in cerebrospinal fluid and blood, thus confirming the diagnosis of anti-NMDAR encephalitis. After initial successful treatment, the disease relapsed and the repeated ultrasound investigation revealed teratoma in the left ovary, which was not observed at initial examination. Tumor was removed by laparoscopic oophorocystectomy, and the treatment with hormones and gamma globulin was continued after the surgery. The patient's conditions were gradually improving after the treatment. Correct diagnostic and prompt treatment of anti-NMDAR encephalitis remains a serious clinical challenge due to its unspecific manifestations and varying response to treatments. This article describes the details of a recent complicated case of a patient with this condition. The information will be of interest to clinicians working with encephalitis patients.
Renji Hospital Shanghai Jiaotong University School of Medicine, No.1260 East Road, Shanghai Pudong New Area, Shanghai, 200127, China.
Shanji
S
Li
Aimin
A
Zhao
D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000150:complications*; D013724:Teratoma / Q000150:complications*; D016896:Treatment Outcome; D055815:Young Adult