Cryptococcus Meningitis Can Co-occur with Anti-NMDA Receptor Encephalitis.
Adrenal Cortex Hormones
/ therapeutic use
Anti-N-Methyl-D-Aspartate Receptor Encephalitis
/ complications
Antifungal Agents
/ therapeutic use
Cerebral Infarction
/ complications
Humans
Limbic Encephalitis
/ complications
Magnetic Resonance Imaging
Male
Meningitis, Cryptococcal
/ complications
Middle Aged
Receptors, Glutamate
Receptors, N-Methyl-D-Aspartate
/ immunology
NMDA receptor
cerebral infarction
cryptococcal meningitis
glutamate receptor (GluR)
limbic encephalitis
Journal
Internal medicine (Tokyo, Japan)
ISSN: 1349-7235
Titre abrégé: Intern Med
Pays: Japan
ID NLM: 9204241
Informations de publication
Date de publication:
15 Sep 2020
15 Sep 2020
Historique:
pubmed:
12
6
2020
medline:
27
1
2021
entrez:
12
6
2020
Statut:
ppublish
Résumé
We herein report a 50-year-old man with alcoholic cirrhosis who developed loss of consciousness and tremor of the upper limbs. Magnetic resonance imaging findings were suggestive of limbic encephalitis with bilateral hippocampal damage, and a cerebrospinal fluid (CSF) examination confirmed anti-N-methyl-D-aspartate (NMDA) and anti-glutamate receptor antibodies. Despite initial corticosteroid therapy, meningeal irritation symptoms appeared, owing to the development of cryptococcal meningitis (CM), diagnosed by the detection of cryptococcal capsular polysaccharide antigen in the follow-up CSF analysis. Cerebral infarction with reversible stenosis of major cerebral arteries during the clinical course was also observed. Following administration of antifungals and corticosteroids, the number of cells in the CSF gradually declined, and NMDA receptor antibodies disappeared. Our study demonstrates the unique coexistence of CM with anti-NMDA receptor encephalitis in adults.
Identifiants
pubmed: 32522922
doi: 10.2169/internalmedicine.4629-20
pmc: PMC7578615
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Antifungal Agents
0
Receptors, Glutamate
0
Receptors, N-Methyl-D-Aspartate
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2301-2306Références
BMC Neurol. 2017 Aug 9;17(1):157
pubmed: 28793877
J Clin Microbiol. 1994 Jul;32(7):1680-4
pubmed: 7929757
Ann Neurol. 2014 Feb;75(2):317-23
pubmed: 24318406
Ann Neurol. 2007 Jan;61(1):25-36
pubmed: 17262855
Rinsho Shinkeigaku. 2017 Jan 31;57(1):37-40
pubmed: 27980287
Int Rev Immunol. 2002 Jul-Oct;21(4-5):423-38
pubmed: 12486822
Neurology. 2013 Oct 29;81(18):1637-9
pubmed: 24089390
Eur J Clin Microbiol Infect Dis. 2017 Aug;36(8):1367-1372
pubmed: 28247152
Int J STD AIDS. 2019 Feb;30(2):194-197
pubmed: 30253732
AJNR Am J Neuroradiol. 1991 Mar-Apr;12(2):283-9
pubmed: 1902029
BMC Neurol. 2011 Jan 26;11:12
pubmed: 21269442
N Engl J Med. 1979 Jul 19;301(3):126-31
pubmed: 449951