ABSTRACT
BACKGROUND: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune disorder resulting in neurologic and psychiatric symptoms. Treatment is challenging in pregnancy, because little data exist to guide management. CASE: A 24-year-old woman with a known diagnosis of anti-NMDA receptor encephalitis using intravenous immunoglobulin therapy became pregnant. Her pregnancy was uncomplicated with no relapses. She delivered at 35 4/7 weeks of gestation after having preterm premature rupture of membranes. She had a relapse of symptoms after delivery. CONCLUSION: This patient with anti-NMDA receptor encephalitis had an uneventful pregnancy with overall good outcome; however, she experienced relapse soon after delivery. This disease may mimic other autoimmune diseases, with improvement during pregnancy and risk for relapse postpartum.
Subject(s)
Anti-N-Methyl-D-Aspartate Receptor Encephalitis/diagnosis , Autoimmune Diseases/diagnosis , Pregnancy Complications , Pregnancy Outcome , Adult , Female , Fetal Membranes, Premature Rupture/etiology , Humans , Immunoglobulins, Intravenous/administration & dosage , Infant, Newborn , Infant, Premature , Pregnancy , Recurrence , Young AdultABSTRACT
BACKGROUND: Patients with chronic lymphocytic leukemia (CLL) have up to a 3-fold risk of site-specific secondary cancers. The only exception is a lower incidence of cervical cancer in this population. CASE: A 70-year-old, white woman with stage IV CLL was diagnosed 2 years prior to presentation with stage Ia1 squamous cell carcinoma of the cervix. Following an abnormal Pap smear, a colposcopy and biopsies were performed. Initial pathologic impression of the cervical biopsies was high grade dysplasia. The final review was consistent with CLL without cervical dysplasia. CONCLUSION: Cervical cancer in patients with CLL is a rare occurrence. The pathologic changes on cervical epithelium caused by CLL can mimic dysplastic cellular changes. Expert pathologic review of cervical biopsies is warranted to distinguish between the diagnoses, thus altering management.