title: Anti-N-Methyl-D-Aspartate Receptor Encephalitis in HIV Infection.
abstract: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare condition characterized by emotional and behavioral disturbances, dyskinesias, and extrapyramidal signs. It occurs in young women of reproductive age and is classically described as a paraneoplastic phenomenon. We present a 36-year-old, HIV-positive female who was admitted to the hospital in an acute confusional state, with a stiff posture, periods of motor agitation, and myoclonic jerks of the hands. Her mental state progressively deteriorated. Without evidence of infection, the presence of anti-NMDAR antibodies both in serum and cerebrospinal fluid clinched the diagnosis of autoimmune encephalitis. No evidence of neoplastic disease was found, and the beneficial response to immunosuppressive therapy was exceptional. This is the first report of anti-NMDAR encephalitis in an HIV-infected individual, reminding us that autoimmune encephalitis should be included in the differential diagnosis of a young patient presenting in an acute confusional state.
authors.affiliation: Unidade de Doenças Auto-imunes/Serviço Medicina 7.2, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
authors.forename: Eunice
authors.initials: E
authors.lastname: Patarata
authors.affiliation: Unidade de Doenças Auto-imunes/Serviço Medicina 7.2, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
authors.forename: Vera
authors.initials: V
authors.lastname: Bernardino
authors.affiliation: Unidade de Cuidados Intensivos, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Martins
authors.affiliation: Unidade de Cuidados Intensivos, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Pereira
authors.affiliation: Medicina Interna, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
authors.forename: Conceição
authors.initials: C
authors.lastname: Loureiro
authors.affiliation: Unidade de Doenças Auto-imunes/Serviço Medicina 7.2, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
authors.forename: Maria Francisca
authors.initials: MF
authors.lastname: Moraes-Fontes
keywords: Acute confusional state; Anti-N-methyl-D-aspartate receptor antibodies; Autoimmune encephalitis; HIV; Immunosuppressive therapy