Critical Analysis of a Challenging Case of Post-Infectious N-Methyl-D-Aspartate Receptor Encephalitis.
autoimmune diseases of the nervous system
central nervous system infections
central nervous system viral diseases
clinical specialty
encephalitis
neuroimmunology
Journal
The Neurohospitalist
ISSN: 1941-8744
Titre abrégé: Neurohospitalist
Pays: United States
ID NLM: 101558199
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
entrez:
1
4
2021
pubmed:
2
4
2021
medline:
2
4
2021
Statut:
ppublish
Résumé
Infections are increasingly recognized as a common trigger of autoimmune disease, including autoimmune encephalitis. A significant association is particularly shown between HSV-1 encephalitis (HSVE) and a post-infectious autoimmune encephalitis mediated by neuronal autoantibodies, most notably anti-N-methyl-D-aspartate receptor (NMDAR) antibodies. The clinical significance of these and other novel post-infectious autoantibodies has led to new diagnostic and treatment challenges for clinicians. Here we present a case of a 19-year-old female with premorbid psychiatric disease and neuropsychiatric sequelae from HSVE who presented over a year after her initial HSVE with behavioral changes and positive anti-NMDAR antibodies. The clinical challenges encountered during this case are explored in detail based on a review of the literature. Research is needed to help guide management in these complex clinical situations.
Identifiants
pubmed: 33791062
doi: 10.1177/1941874420964356
pii: 10.1177_1941874420964356
pmc: PMC7958680
doi:
Types de publication
Case Reports
Langues
eng
Pagination
160-164Subventions
Organisme : NINDS NIH HHS
ID : K23 NS105935
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD074944
Pays : United States
Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
Lancet Neurol. 2013 Feb;12(2):157-65
pubmed: 23290630
Neurol Neuroimmunol Neuroinflamm. 2016 Jun 01;3(4):e245
pubmed: 27308306
Lancet Neurol. 2018 Sep;17(9):760-772
pubmed: 30049614
Ann Neurol. 2014 Feb;75(2):317-23
pubmed: 24318406
Ther Adv Neurol Disord. 2017 Aug 16;11:1756285617722347
pubmed: 29399043
Ther Adv Neurol Disord. 2018 Apr 23;11:1756286418768778
pubmed: 29774053
Ther Clin Risk Manag. 2014 Jul 01;10:517-25
pubmed: 25061311
Ann Neurol. 2012 Dec;72(6):902-11
pubmed: 23280840
J Neuroimmunol. 2019 Jul 15;332:1-7
pubmed: 30913507
Front Mol Neurosci. 2016 May 31;9:37
pubmed: 27303263
Neurol Neuroimmunol Neuroinflamm. 2018 Dec 26;6(2):e529
pubmed: 30697582
Lancet Neurol. 2011 Jan;10(1):63-74
pubmed: 21163445
Ann Neurol. 2007 Jan;61(1):25-36
pubmed: 17262855
Lancet Neurol. 2019 Nov;18(11):1045-1057
pubmed: 31326280
Lancet Neurol. 2014 Feb;13(2):167-77
pubmed: 24360484