Neurosyphilis with positive anti-N-methyl-D-aspartate receptor antibody: a case report
A case of neurosyphilis with a positive anti-N-methyl-D-aspartate receptor (NMDAR) antibody was reported. A 54-year-old man who presented with acute memory deficits was admitted to our hospital. Acute ischemic stroke (AIS) was initially considered, and he was prescribed intravenous thrombolysis with...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1164605/full |
| _version_ | 1797824095267586048 |
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| author | Zhu Sha Shi Jing Gao Feng Gao Feng Hao Hongjun Liu Xianzeng |
| author_facet | Zhu Sha Shi Jing Gao Feng Gao Feng Hao Hongjun Liu Xianzeng |
| author_sort | Zhu Sha |
| collection | DOAJ |
| description | A case of neurosyphilis with a positive anti-N-methyl-D-aspartate receptor (NMDAR) antibody was reported. A 54-year-old man who presented with acute memory deficits was admitted to our hospital. Acute ischemic stroke (AIS) was initially considered, and he was prescribed intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA). However, the intermittent onset of episodic memory and orientation disorder still occurred. No diffusion restriction was indicated by magnetic resonance imaging (MRI), and subclinical seizures were frequently found by electroencephalogram (EEG). Rapid plasma reagin (RPR) test of serum showed positive results for syphilis. Analysis of cerebrospinal fluid (CSF) revealed elevated leukocyte count and protein level. RPR test, Treponema pallidum particle agglutination (TPPA) assay, and Treponema pallidum antibody (TP-Ab) in CSF showed positive results, and the anti-NMDAR antibodies were positive in CSF and serum. Finally, the patient was diagnosed with neurosyphilis with a positive anti-NMDAR antibody. The clinical symptoms were improved, and the leukocyte count in CSF was reduced after treatment with intravenous penicillin G and levetiracetam. This case suggests that in cases with positive results for neurosyphilis and NMDAR antibodies, the proper treatment has to be decided based on all of the available clinical and diagnostic testing data. |
| first_indexed | 2024-03-13T10:33:53Z |
| format | Article |
| id | doaj.art-42b0910d634b45769111c39a894bd717 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-13T10:33:53Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-42b0910d634b45769111c39a894bd7172023-05-18T07:20:19ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-05-011410.3389/fneur.2023.11646051164605Neurosyphilis with positive anti-N-methyl-D-aspartate receptor antibody: a case reportZhu Sha0Shi Jing1Gao Feng2Gao Feng3Hao Hongjun4Liu Xianzeng5Department of Neurology, Peking University International Hospital, Beijing, ChinaDepartment of Neurology, Peking University International Hospital, Beijing, ChinaDepartment of Neurology, Peking University International Hospital, Beijing, ChinaDepartment of Radiology, Peking University First Hospital, Beijing, ChinaDepartment of Radiology, Peking University First Hospital, Beijing, ChinaDepartment of Neurology, Peking University International Hospital, Beijing, ChinaA case of neurosyphilis with a positive anti-N-methyl-D-aspartate receptor (NMDAR) antibody was reported. A 54-year-old man who presented with acute memory deficits was admitted to our hospital. Acute ischemic stroke (AIS) was initially considered, and he was prescribed intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA). However, the intermittent onset of episodic memory and orientation disorder still occurred. No diffusion restriction was indicated by magnetic resonance imaging (MRI), and subclinical seizures were frequently found by electroencephalogram (EEG). Rapid plasma reagin (RPR) test of serum showed positive results for syphilis. Analysis of cerebrospinal fluid (CSF) revealed elevated leukocyte count and protein level. RPR test, Treponema pallidum particle agglutination (TPPA) assay, and Treponema pallidum antibody (TP-Ab) in CSF showed positive results, and the anti-NMDAR antibodies were positive in CSF and serum. Finally, the patient was diagnosed with neurosyphilis with a positive anti-NMDAR antibody. The clinical symptoms were improved, and the leukocyte count in CSF was reduced after treatment with intravenous penicillin G and levetiracetam. This case suggests that in cases with positive results for neurosyphilis and NMDAR antibodies, the proper treatment has to be decided based on all of the available clinical and diagnostic testing data.https://www.frontiersin.org/articles/10.3389/fneur.2023.1164605/fullneurosyphilisencephalitisanti-N-methyl-D-aspartate receptor (anti-NMDAR)epilepsycase report |
| spellingShingle | Zhu Sha Shi Jing Gao Feng Gao Feng Hao Hongjun Liu Xianzeng Neurosyphilis with positive anti-N-methyl-D-aspartate receptor antibody: a case report Frontiers in Neurology neurosyphilis encephalitis anti-N-methyl-D-aspartate receptor (anti-NMDAR) epilepsy case report |
| title | Neurosyphilis with positive anti-N-methyl-D-aspartate receptor antibody: a case report |
| title_full | Neurosyphilis with positive anti-N-methyl-D-aspartate receptor antibody: a case report |
| title_fullStr | Neurosyphilis with positive anti-N-methyl-D-aspartate receptor antibody: a case report |
| title_full_unstemmed | Neurosyphilis with positive anti-N-methyl-D-aspartate receptor antibody: a case report |
| title_short | Neurosyphilis with positive anti-N-methyl-D-aspartate receptor antibody: a case report |
| title_sort | neurosyphilis with positive anti n methyl d aspartate receptor antibody a case report |
| topic | neurosyphilis encephalitis anti-N-methyl-D-aspartate receptor (anti-NMDAR) epilepsy case report |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1164605/full |
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