Anti-N-methyl-D-aspartate Receptor (NMDAR) Encephalitis: Neuronal Burden of a Comorbid Ovarian Teratoma / 대한소아신경학회지
Journal of the Korean Child Neurology Society
; (4): 62-65, 2017.
Article
em En
| WPRIM
| ID: wpr-139254
Biblioteca responsável:
WPRO
ABSTRACT
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a disease that is characterized by acute psychiatric symptoms, seizures, and central hypoventilation. Patients with anti-NMDAR encephalitis exhibit speech alterations, insomnia, seizures, and movement disorders. We describe a previously healthy 6-year-old girl who presented with seizures, disorientation, and fever. Over the five weeks of treatment, the patient exhibited progressive neurologic symptoms, including a change in mental status. Her serum and cerebrospinal fluid contained high titers of antibodies against the NMDAR, and she was diagnosed with anti-NMDAR encephalitis. She was treated with plasmapheresis, steroid pulse therapy, intravenous immunoglobulins, and repeated doses of rituximab. After the patient was diagnosed with a concomitant ovarian teratoma, a unilateral salpingo-oophorectomy was performed. A histopathologic examination revealed that neuronal elements accounted for 60% of the resected ovarian teratoma. The patient's clinical symptoms and antibody titers improved after the surgical treatment and rituximab therapy. These observations suggested that patients with high titers of anti-NMDAR antibodies should be examined for the presence and quantity of neuronal components in concurrent ovarian teratomas.
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Texto completo:
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Base de dados:
WPRIM
Assunto principal:
Convulsões
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Teratoma
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Líquido Cefalorraquidiano
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Plasmaferese
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Imunoglobulinas Intravenosas
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Encefalite
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Epilepsia
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Febre
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Encefalite Antirreceptor de N-Metil-D-Aspartato
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Rituximab
Limite:
Child
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Female
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Humans
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article