Antibody-negative autoimmune encephalitis as a complication of long-term immune-suppression for liver transplantation.
BMJ Case Rep
; 13(9)2020 Sep 15.
Article
en En
| MEDLINE
| ID: mdl-32933909
ABSTRACT
Autoimmune encephalitis is a rare spectrum of disease that can be a complication of chronic immunosuppression. Diagnosis often requires the presence of antineuronal antibodies, but many causative antibodies have not yet been identified. Antibody-negative autoimmune encephalitis (AbNAE) is especially difficult to diagnose and must rely largely on exclusion of other causes. In chronically immune-suppressed transplant recipients, the differential is broad, likely resulting in underdiagnosis and worse outcomes. Here, we present a 58-year-old liver transplant recipient taking tacrolimus for prevention of chronic rejection who presented with 5 days of confusion, lethargy and lightheadedness. He was diagnosed with AbNAE after an extensive workup and recovered fully after high-dose corticosteroids. Our case highlights the importance of recognising the association between chronic immunosuppression and autoimmune encephalitis. Autoimmune encephalitis, even in the absence of characterised antibodies, should be considered when transplant recipients present with central neurologic symptoms.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Terapia de Inmunosupresión
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Trasplante de Hígado
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Tacrolimus
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Encefalitis
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Enfermedad de Hashimoto
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Inmunosupresores
Tipo de estudio:
Prognostic_studies
Límite:
Humans
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Male
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Middle aged
Idioma:
En
Año:
2020
Tipo del documento:
Article