title: Anti-NMDA receptor encephalitis presenting as atypical anorexia nervosa: an adolescent case report.
abstract: Since 2007, more than 600 patients have been diagnosed with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, with almost 40 % of those affected being children or adolescents. In early phases of the illness, this life-threatening disease is characterized by psychiatric symptoms, such as depression, anxiety, obsessions, hallucinations or delusions. Consequently, a high percentage of patients receive psychiatric diagnoses at first, hindering the crucial early diagnosis and treatment of the anti-NMDA receptor encephalitis. We report on a 15-year-old girl initially presenting with pathological eating behaviour and significant weight loss resulting in an (atypical) anorexia nervosa (AN) diagnosis. Her early course of illness, diagnostic process, treatment and short-term outcome are described. This case report aims to raise awareness about the association between anorectic behaviour and anti-NMDA receptor encephalitis and highlight the importance of multidisciplinary teams in child and adolescent services.
authors: Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors: David
authors: D
authors: Mechelhoff
authors: Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors: Betteke Maria
authors: BM
authors: van Noort
authors: Department of Pediatric Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Bernhard
authors: B
authors: Weschke
authors: Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors: Christian J
authors: CJ
authors: Bachmann
authors: Neuropaediatric Outpatient Clinic, Sana Hospital Lichtenberg, Berlin, Germany.
authors: Christiane
authors: C
authors: Wagner
authors: Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors: Ernst
authors: E
authors: Pfeiffer
authors: Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. sibylle.winter@charite.de.
authors: Sibylle
authors: S
authors: Winter
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000209:etiology* / Q000628:therapy; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D006801:Humans
keywords: Anti-NMDA receptor encephalitis; Atypical anorexia nervosa; Child and adolescent psychiatry; Paediatrics