TY - JOUR
T1 - Anti-NMDA-Receptor encephalitis
T2 - Case report and literature review of an under-Recognized condition
AU - Day, Gregory S.
AU - High, Sasha M.
AU - Cot, Bianca
AU - Tang-Wai, David F.
PY - 2011/7
Y1 - 2011/7
N2 - Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is an immune-mediated syndrome that remains under-recognized despite a growing body of literature. This syndrome has been predominantly described in young females with a constellation of symptoms, including personality changes, autonomic dysfunction and neurologic decompensation. It is commonly associated with mature ovarian teratomas.We describe the classic presentation of anti-NMDA-R encephalitis in three dramatically different patients: Case A, a young woman with ovarian teratoma; Case B, the eldest case reported to date; and Case C, a young male with no identifiable tumor.We review the literature summarizing the differential diagnosis, investigative approach, treatment options and challenges inherent to this disorder. We advocate good supportive care, involvement of multiple health disciplines and use of immune-modulating therapies in patient management. These cases underscore the need for increased awareness and high diagnostic suspicion when approaching the patient with suspected viral encephalitis.
AB - Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is an immune-mediated syndrome that remains under-recognized despite a growing body of literature. This syndrome has been predominantly described in young females with a constellation of symptoms, including personality changes, autonomic dysfunction and neurologic decompensation. It is commonly associated with mature ovarian teratomas.We describe the classic presentation of anti-NMDA-R encephalitis in three dramatically different patients: Case A, a young woman with ovarian teratoma; Case B, the eldest case reported to date; and Case C, a young male with no identifiable tumor.We review the literature summarizing the differential diagnosis, investigative approach, treatment options and challenges inherent to this disorder. We advocate good supportive care, involvement of multiple health disciplines and use of immune-modulating therapies in patient management. These cases underscore the need for increased awareness and high diagnostic suspicion when approaching the patient with suspected viral encephalitis.
KW - Aautoimmune
KW - Encephalitis
KW - NMDA-receptor
KW - Teratoma
UR - http://www.scopus.com/inward/record.url?scp=80051551748&partnerID=8YFLogxK
U2 - 10.1007/s11606-011-1641-9
DO - 10.1007/s11606-011-1641-9
M3 - Review article
C2 - 21318640
AN - SCOPUS:80051551748
SN - 0884-8734
VL - 26
SP - 811
EP - 816
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 7
ER -