Encefalitis autoinmune; síndrome paraneoplásico por teratoma maduro ovárico
Background: The anti-N-methyl-D-aspartate (NMDAr) encephalitis was first described in 2005 and in 2007 the antibodies against the NMDA were identified by Dalmau et al.It is estimated that it affects 1.5 per million individuals every year, but it is more frequent in young women ranging from 15 to 2...
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| Format: | Article |
| Language: | Spanish |
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Colegio Médico de Honduras
2023-12-01
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| Series: | Revista Médica Hondureña |
| Subjects: | |
| Online Access: | https://www.camjol.info/index.php/RMH/article/view/16927 |
| _version_ | 1797374289135009792 |
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| author | Andrea Trejo Aldo Blanco Rony López |
| author_facet | Andrea Trejo Aldo Blanco Rony López |
| author_sort | Andrea Trejo |
| collection | DOAJ |
| description | Background: The anti-N-methyl-D-aspartate (NMDAr) encephalitis was first described in 2005 and in 2007 the antibodies against the NMDA were identified by Dalmau et al.It is estimated that it affects 1.5 per million individuals every year, but it is more frequent in young women ranging from 15 to 25 years, and 37% of them can manifest as a paraneoplasic syndrome in association with an ovarian teratoma.Case description: A 17-year-old female with personal history of left ovarian teratoma, one week after its surgical removal presents: auditory hallucinations, persecutory delusions, insomnia, anhedonia, agitation, speech impairment, orofacial dyskinesia, and gait alterations during one month. An electroencephalogram (ECG) reported severe cortical-subcortical. The cerebral Magnetic Resonance Imaging (MRI) and the Cerebrospinal Fluid (CSF) analysis, reported no findings. Given the clinical suspicion, immunosuppressive treatment with intravenous corticosteroids was initiated, along with symptomatic management antipsychotic, for agitation and anxiety; initially with midazolam infusion and then with olanzapine, risperidone, and clonazepam; obtaining satisfactory clinical improvement. Finally, the diagnosis was confirmed by a positive IgG against the N1 glutamate subunit (Glu N1) of the NMDAr. Conclusion: The anti NMDAr encephalitis is a rare and underdiagnosed condition, which can be mistaken as a primary psychiatric disease. Given a first psychotic episode, an extense interrogatory and evaluation must be done to exclude secondary causes, such as, autoimmune disorders with neurologic repercusions. |
| first_indexed | 2024-03-08T19:03:39Z |
| format | Article |
| id | doaj.art-4b259d1aae3940e6b1492726a3ef7548 |
| institution | Directory Open Access Journal |
| issn | 0375-1112 1995-7068 |
| language | Spanish |
| last_indexed | 2024-03-08T19:03:39Z |
| publishDate | 2023-12-01 |
| publisher | Colegio Médico de Honduras |
| record_format | Article |
| series | Revista Médica Hondureña |
| spelling | doaj.art-4b259d1aae3940e6b1492726a3ef75482023-12-28T03:50:45ZspaColegio Médico de HondurasRevista Médica Hondureña0375-11121995-70682023-12-0191, No. 212513010.5377/rmh.v91i2.16927Encefalitis autoinmune; síndrome paraneoplásico por teratoma maduro ováricoAndrea Trejo0https://orcid.org/0000-0002-8721-9165Aldo Blanco1https://orcid.org/0000-0002-7324-3789Rony López2https://orcid.org/0000-0002-1023-9272Universidad Nacional Autónoma de Honduras, Facultad de Ciencias Médicas; Tegucigalpa, Honduras.Hospital María, Especialidades Pediátricas, Servicio de Neurología Pediátrica; Tegucigalpa, Honduras.Hospital María, Especialidades Pediátricas, Servicio de Pediatría; Tegucigalpa, Honduras.Background: The anti-N-methyl-D-aspartate (NMDAr) encephalitis was first described in 2005 and in 2007 the antibodies against the NMDA were identified by Dalmau et al.It is estimated that it affects 1.5 per million individuals every year, but it is more frequent in young women ranging from 15 to 25 years, and 37% of them can manifest as a paraneoplasic syndrome in association with an ovarian teratoma.Case description: A 17-year-old female with personal history of left ovarian teratoma, one week after its surgical removal presents: auditory hallucinations, persecutory delusions, insomnia, anhedonia, agitation, speech impairment, orofacial dyskinesia, and gait alterations during one month. An electroencephalogram (ECG) reported severe cortical-subcortical. The cerebral Magnetic Resonance Imaging (MRI) and the Cerebrospinal Fluid (CSF) analysis, reported no findings. Given the clinical suspicion, immunosuppressive treatment with intravenous corticosteroids was initiated, along with symptomatic management antipsychotic, for agitation and anxiety; initially with midazolam infusion and then with olanzapine, risperidone, and clonazepam; obtaining satisfactory clinical improvement. Finally, the diagnosis was confirmed by a positive IgG against the N1 glutamate subunit (Glu N1) of the NMDAr. Conclusion: The anti NMDAr encephalitis is a rare and underdiagnosed condition, which can be mistaken as a primary psychiatric disease. Given a first psychotic episode, an extense interrogatory and evaluation must be done to exclude secondary causes, such as, autoimmune disorders with neurologic repercusions.https://www.camjol.info/index.php/RMH/article/view/16927encephalitisn-methyl-d-aspartate receptormature teratoma |
| spellingShingle | Andrea Trejo Aldo Blanco Rony López Encefalitis autoinmune; síndrome paraneoplásico por teratoma maduro ovárico Revista Médica Hondureña encephalitis n-methyl-d-aspartate receptor mature teratoma |
| title | Encefalitis autoinmune; síndrome paraneoplásico por teratoma maduro ovárico |
| title_full | Encefalitis autoinmune; síndrome paraneoplásico por teratoma maduro ovárico |
| title_fullStr | Encefalitis autoinmune; síndrome paraneoplásico por teratoma maduro ovárico |
| title_full_unstemmed | Encefalitis autoinmune; síndrome paraneoplásico por teratoma maduro ovárico |
| title_short | Encefalitis autoinmune; síndrome paraneoplásico por teratoma maduro ovárico |
| title_sort | encefalitis autoinmune sindrome paraneoplasico por teratoma maduro ovarico |
| topic | encephalitis n-methyl-d-aspartate receptor mature teratoma |
| url | https://www.camjol.info/index.php/RMH/article/view/16927 |
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