A case of anti-N-methyl-D-aspartate receptor encephalitis with ovarian teratoma showing excellent recovery with decreasing of anti-N-methyl-D-aspartate receptor antibody

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  • Taguchi Yoshiharu
    The Department of Neurology, Toyama University Hospital
  • Takashima Shutaro
    The Department of Neurology, Toyama University Hospital
  • Takano Shiho
    The Department of Molecular Neuroscience, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
  • Mori Hisashi
    The Department of Molecular Neuroscience, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
  • Tanaka Kortaro
    The Department of Neurology, Toyama University Hospital

Bibliographic Information

Other Title
  • 抗ＮＭＤＡ受容体抗体の減少と並行して神経症状の改善をみとめた抗ＮＭＤＡ受容体脳炎の１例
  • 症例報告 抗NMDA受容体抗体の減少と並行して神経症状の改善をみとめた抗NMDA受容体脳炎の1例
  • ショウレイ ホウコク コウNMDA ジュヨウタイ コウタイ ノ ゲンショウ ト ヘイコウ シテ シンケイ ショウジョウ ノ カイゼン オ ミトメタ コウNMDA ジュヨウタイ ノウエン ノ 1レイ

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Description

We report a case of a 17-year-old woman with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, who developed psychiatric symptoms. Pelvic MRI revealed a right ovarian tumor that was suspected of being an ovarian teratoma. On the 27th day after onset, the patient underwent right salpingo-oophorectomy. The histopathological diagnosis was immature ovarian teratoma. Subsequently, 4 double filtration plasmapheresises (DFPP) were performed from day 34 to day 43. Methylprednisolone (1,000mg/day for 3 days) was started on day 38. With these treatments, consciousness disturbance completely improved, and the patient was discharged on day 50. The serum and cerebrospinal fluid were positive for antibodies against the GluRζ1 (NR1)-EGFP/GluRε2 (NR2B) heteromer and the GluRζ1 (NR1) subunit of NMDAR. The patient was hence diagnosed as having anti-NMDAR encephalitis with ovarian teratoma. Serial analysis show that the antibodies against NMDAR decreased with improvement of symptoms after the immunotherapy including DFPP treatment.<br>

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 51 (7), 499-504, 2011

    Societas Neurologica Japonica

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