Psychosis as the Initial Presenting Symptom of Anti-Hu Encephalitis: A Case Series with Literature Review
Introduction Anti-Hu related Paraneoplastic Neurological Syndrome (PNS) is one of the most common paraneoplastic-associated neurological syndromes (Kayser 2010). While the primary clinical manifestations are neurologic in nature (Smitt 2002), only rare reports exist regarding psychiatric manifestat...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2022-06-01
|
| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S092493382201690X/type/journal_article |
| _version_ | 1797617390488387584 |
|---|---|
| author | E. Garrels A. Zamiri S. Pakniyat-Jahromi S. Gunturu |
| author_facet | E. Garrels A. Zamiri S. Pakniyat-Jahromi S. Gunturu |
| author_sort | E. Garrels |
| collection | DOAJ |
| description |
Introduction
Anti-Hu related Paraneoplastic Neurological Syndrome (PNS) is one of the most common paraneoplastic-associated neurological syndromes (Kayser 2010). While the primary clinical manifestations are neurologic in nature (Smitt 2002), only rare reports exist regarding psychiatric manifestations. Our poster presents two cases of Anti-Hu Encephalitis manifesting as psychosis as well as a systematic literature review on the co-occurrence of psychosis and PNS.
Objectives
The aim of this case series is to show psychosis as the primary symptom of a paraneoplastic syndrome that does not typically present in this way. It also serves as a reminder to have a detailed work-up and maintain a wide differential diagnosis when evaluating patients with first-episode psychosis.
Methods
Two cases of anti-Hu encephalitis primarily presenting with psychiatric symptoms are discussed. A systematic literature review was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model on three electronic databases: PubMed, Embase, and PsycINFO. Search terms included were (Anti-Hu) AND (Psychosis OR Hallucinations OR Schizophrenia OR Schizoaffective).
Results
Our case series reports on two patients with diagnosed anti-Hu encephalitis who were treated by our psychiatry team, where the primary manifestations of the illness were psychiatric in nature. Psychotic symptoms in these cases were managed with Risperidone, Olanzapine, and Paliperidone.
Conclusions
Psychotic symptoms are seldom reported in the literature and cases like the ones presented emphasize the importance of a full medical work-up for first episode psychosis as well as a wide differential. Given the increased association between PNS and psychiatric illness, more emphasis and further research is warranted.
Disclosure
No significant relationships.
|
| first_indexed | 2024-03-11T07:55:17Z |
| format | Article |
| id | doaj.art-0765274b31394ae0b982d75c79b8e647 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:55:17Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-0765274b31394ae0b982d75c79b8e6472023-11-17T05:05:48ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S658S65810.1192/j.eurpsy.2022.1690Psychosis as the Initial Presenting Symptom of Anti-Hu Encephalitis: A Case Series with Literature ReviewE. Garrels0A. Zamiri1S. Pakniyat-Jahromi2S. Gunturu3BronxCare Health System, Psychiatry, Bronx, United States of AmericaBronxCare Health System, Psychiatry, Bronx, United States of AmericaBronxCare Health System, Psychiatry, Bronx, United States of AmericaBronxCare Health System, Psychiatry, Bronx, United States of America Introduction Anti-Hu related Paraneoplastic Neurological Syndrome (PNS) is one of the most common paraneoplastic-associated neurological syndromes (Kayser 2010). While the primary clinical manifestations are neurologic in nature (Smitt 2002), only rare reports exist regarding psychiatric manifestations. Our poster presents two cases of Anti-Hu Encephalitis manifesting as psychosis as well as a systematic literature review on the co-occurrence of psychosis and PNS. Objectives The aim of this case series is to show psychosis as the primary symptom of a paraneoplastic syndrome that does not typically present in this way. It also serves as a reminder to have a detailed work-up and maintain a wide differential diagnosis when evaluating patients with first-episode psychosis. Methods Two cases of anti-Hu encephalitis primarily presenting with psychiatric symptoms are discussed. A systematic literature review was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model on three electronic databases: PubMed, Embase, and PsycINFO. Search terms included were (Anti-Hu) AND (Psychosis OR Hallucinations OR Schizophrenia OR Schizoaffective). Results Our case series reports on two patients with diagnosed anti-Hu encephalitis who were treated by our psychiatry team, where the primary manifestations of the illness were psychiatric in nature. Psychotic symptoms in these cases were managed with Risperidone, Olanzapine, and Paliperidone. Conclusions Psychotic symptoms are seldom reported in the literature and cases like the ones presented emphasize the importance of a full medical work-up for first episode psychosis as well as a wide differential. Given the increased association between PNS and psychiatric illness, more emphasis and further research is warranted. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S092493382201690X/type/journal_articlePsychosisAnti-Hu Encephalitis |
| spellingShingle | E. Garrels A. Zamiri S. Pakniyat-Jahromi S. Gunturu Psychosis as the Initial Presenting Symptom of Anti-Hu Encephalitis: A Case Series with Literature Review European Psychiatry Psychosis Anti-Hu Encephalitis |
| title | Psychosis as the Initial Presenting Symptom of Anti-Hu Encephalitis: A Case Series with Literature Review |
| title_full | Psychosis as the Initial Presenting Symptom of Anti-Hu Encephalitis: A Case Series with Literature Review |
| title_fullStr | Psychosis as the Initial Presenting Symptom of Anti-Hu Encephalitis: A Case Series with Literature Review |
| title_full_unstemmed | Psychosis as the Initial Presenting Symptom of Anti-Hu Encephalitis: A Case Series with Literature Review |
| title_short | Psychosis as the Initial Presenting Symptom of Anti-Hu Encephalitis: A Case Series with Literature Review |
| title_sort | psychosis as the initial presenting symptom of anti hu encephalitis a case series with literature review |
| topic | Psychosis Anti-Hu Encephalitis |
| url | https://www.cambridge.org/core/product/identifier/S092493382201690X/type/journal_article |
| work_keys_str_mv | AT egarrels psychosisastheinitialpresentingsymptomofantihuencephalitisacaseserieswithliteraturereview AT azamiri psychosisastheinitialpresentingsymptomofantihuencephalitisacaseserieswithliteraturereview AT spakniyatjahromi psychosisastheinitialpresentingsymptomofantihuencephalitisacaseserieswithliteraturereview AT sgunturu psychosisastheinitialpresentingsymptomofantihuencephalitisacaseserieswithliteraturereview |