Pediatric anti-NMDA receptor autoimmune encephalitis masquerading as depression: A case report from a tertiary care center in South India
Autoimmune disorders are now widely recognized as playing a larger role in encephalitis than previously thought. The most common disorder appears to be anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. Psychological symptoms, memory difficulties, and autonomic instability are all part of the...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Annals of Indian Psychiatry |
| Subjects: | |
| Online Access: | http://www.anip.co.in/article.asp?issn=2588-8358;year=2023;volume=7;issue=4;spage=382;epage=385;aulast=Serrao |
| _version_ | 1797352273994579968 |
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| author | Shawn Serrao Suhas Chandran Avinash Kamath Gosala R K Sarma |
| author_facet | Shawn Serrao Suhas Chandran Avinash Kamath Gosala R K Sarma |
| author_sort | Shawn Serrao |
| collection | DOAJ |
| description | Autoimmune disorders are now widely recognized as playing a larger role in encephalitis than previously thought. The most common disorder appears to be anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. Psychological symptoms, memory difficulties, and autonomic instability are all part of the complicated presentation and are being considered an important differential diagnosis for children presenting with acute behavioral disturbances. We present the case of a 17-year-old girl, who presented with a 1.5-year history of psychiatric symptoms such as pervasive low mood, decreased ability to concentrate on her studies, academic decline, memory disturbances along with poor social interaction, decreased self-esteem, and ideas of guilt. This was accompanied by altered biological functions. Within a week, the symptoms changed dramatically, with labile mood, over familiarity, over identification, déjà vu, auditory hallucinations and anxiety symptoms, nonspecific somatic symptoms such as fever, vomiting, and neurological symptoms including seizures and dyskinesia. Diagnosis of anti-NMDAR encephalitis was made by electroencephalography and serum antibody testing. Symptom improvement was noted with five cycles of plasmapheresis and injection of rituximab. Psychiatric manifestations are common, and child and adolescent psychiatrists are frequently the first to be contacted for patients with anti-NMDAR encephalitis. There is, therefore, an increasing need for them to become aware of the disorder and consider it in their differential diagnosis. A better prognosis can be achieved with appropriate evaluation by a multi-disciplinary team. |
| first_indexed | 2024-03-08T13:13:01Z |
| format | Article |
| id | doaj.art-1c74b2c00ac34bd4b01d88740bf83ac5 |
| institution | Directory Open Access Journal |
| issn | 2588-8358 2588-8366 |
| language | English |
| last_indexed | 2024-03-08T13:13:01Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Psychiatry |
| spelling | doaj.art-1c74b2c00ac34bd4b01d88740bf83ac52024-01-18T10:33:23ZengWolters Kluwer Medknow PublicationsAnnals of Indian Psychiatry2588-83582588-83662023-01-017438238510.4103/aip.aip_170_22Pediatric anti-NMDA receptor autoimmune encephalitis masquerading as depression: A case report from a tertiary care center in South IndiaShawn SerraoSuhas ChandranAvinash KamathGosala R K SarmaAutoimmune disorders are now widely recognized as playing a larger role in encephalitis than previously thought. The most common disorder appears to be anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. Psychological symptoms, memory difficulties, and autonomic instability are all part of the complicated presentation and are being considered an important differential diagnosis for children presenting with acute behavioral disturbances. We present the case of a 17-year-old girl, who presented with a 1.5-year history of psychiatric symptoms such as pervasive low mood, decreased ability to concentrate on her studies, academic decline, memory disturbances along with poor social interaction, decreased self-esteem, and ideas of guilt. This was accompanied by altered biological functions. Within a week, the symptoms changed dramatically, with labile mood, over familiarity, over identification, déjà vu, auditory hallucinations and anxiety symptoms, nonspecific somatic symptoms such as fever, vomiting, and neurological symptoms including seizures and dyskinesia. Diagnosis of anti-NMDAR encephalitis was made by electroencephalography and serum antibody testing. Symptom improvement was noted with five cycles of plasmapheresis and injection of rituximab. Psychiatric manifestations are common, and child and adolescent psychiatrists are frequently the first to be contacted for patients with anti-NMDAR encephalitis. There is, therefore, an increasing need for them to become aware of the disorder and consider it in their differential diagnosis. A better prognosis can be achieved with appropriate evaluation by a multi-disciplinary team.http://www.anip.co.in/article.asp?issn=2588-8358;year=2023;volume=7;issue=4;spage=382;epage=385;aulast=Serraoadolescentanti- anti-n-methyl-d-aspartate receptor encephalitisneurological manifestationspsychiatric manifestations |
| spellingShingle | Shawn Serrao Suhas Chandran Avinash Kamath Gosala R K Sarma Pediatric anti-NMDA receptor autoimmune encephalitis masquerading as depression: A case report from a tertiary care center in South India Annals of Indian Psychiatry adolescent anti- anti-n-methyl-d-aspartate receptor encephalitis neurological manifestations psychiatric manifestations |
| title | Pediatric anti-NMDA receptor autoimmune encephalitis masquerading as depression: A case report from a tertiary care center in South India |
| title_full | Pediatric anti-NMDA receptor autoimmune encephalitis masquerading as depression: A case report from a tertiary care center in South India |
| title_fullStr | Pediatric anti-NMDA receptor autoimmune encephalitis masquerading as depression: A case report from a tertiary care center in South India |
| title_full_unstemmed | Pediatric anti-NMDA receptor autoimmune encephalitis masquerading as depression: A case report from a tertiary care center in South India |
| title_short | Pediatric anti-NMDA receptor autoimmune encephalitis masquerading as depression: A case report from a tertiary care center in South India |
| title_sort | pediatric anti nmda receptor autoimmune encephalitis masquerading as depression a case report from a tertiary care center in south india |
| topic | adolescent anti- anti-n-methyl-d-aspartate receptor encephalitis neurological manifestations psychiatric manifestations |
| url | http://www.anip.co.in/article.asp?issn=2588-8358;year=2023;volume=7;issue=4;spage=382;epage=385;aulast=Serrao |
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