Autoimmune encephalitis associated with an ovarian teratoma in a 29-year old woman

Main Article Content

A Plaikner
A Jacob
J Rother
C Kohler

Abstract

NMDA receptor encephalitis is a rare disease first described in 2007. Anti-NMDA receptor encephalitis affects mostly young women as neoplasms, mostly ovarian teratomas, are the underlying cause. The disease is caused by antibodies binding to extracellular epitopes of neuronal cell-surface, which leads to an internalization of NMDA-receptors. The characteristic syndrome of patients with anti-NMDAR as well as its recovery follows a certain pattern. Treatment includes immunotherapy and removal of the immunologic trigger. This case report describes a young woman with anti-NMDA receptor encephalitis caused by an ovarian teratoma.

Article Details

Plaikner, A., Jacob, A., Rother, J., & Kohler, C. (2019). Autoimmune encephalitis associated with an ovarian teratoma in a 29-year old woman. Clinical Journal of Obstetrics and Gynecology, 2(1), 013–016. https://doi.org/10.29328/journal.cjog.1001018
Case Reports

Copyright (c) 2019 Plaikner A, et al.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Dalmau J, Lancaster E, Martinez-Hernandez E, Rosenfeld MR, Balice-Gordon R. Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol. 2011; 10: 63-74. Ref.: https://tinyurl.com/y66m2kmr

Liu CY, Zhu J, Zheng XY, Ma C, Wang X. Anti-N-Methyl-D-aspartate Receptor Encephalitis: A Severe, Potentially Reversible Autoimmune Encephalitis. Mediators Inflamm. 2017; 6361479. Ref.: https://tinyurl.com/y69ak8pr

Granerod J, Ambrose HE, Davies NW, Clewley JP, Walsh AL, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis Dec. 2010; 10: 835-844. Ref.: https://tinyurl.com/y39y4tm5

Gable MS, Sheriff H, Dalmau J, Tilley DH, Glaser CA. The frequency of autoimmune N-methyl-D-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project. Clin Infect Dis Apr. 2012; 54: 899-904. Ref.: https://tinyurl.com/y38emwag

Dalmau J, Graus F. Antibody-Mediated Encephalitis. N Engl J Med. 2018; 378: 840-851. Ref.: https://tinyurl.com/yygubeje

Pruss H, Dalmau J, Harms L, Holtje M, Ahnert-Hilger G, et al. Retrospective analysis of NMDA receptor antibodies in encephalitis of unknown origin. Neurology. 2010; 75: 1735-1739. Ref.: https://tinyurl.com/y3267stu

Pruss H, Dalmau J, Arolt V, Wandinger KP. [Anti-NMDA-receptor encephalitis. An interdisciplinary clinical picture]. Nervenarzt. 2010; 81: 396. 398, 400, passim. Ref.: https://tinyurl.com/y5wm6foy

Dalmau J, Gleichman AJ, Hughes EG, Rossi JE, Peng X, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol. 2008; 7: 1091-1098. Ref.: https://tinyurl.com/yxuep6p5

Jones BP, Rees R, Saso S, Stalder C, Smith JR, et al. Ultrasound-guided laparoscopic ovarian preserving surgery to treat anti-NMDA receptor encephalitis. BJOG. 2017; 124: 337-341. Ref.: https://tinyurl.com/y6tzoxp3

Naoura I, Didelot A, Walker F, Luton D, Koskas M. Anti-N-methyl-D-aspartate receptor encephalitis complicating ovarian teratomas: a case report. Am J Obstet Gynecol. 2011; 205: e6-8. Ref.: https://tinyurl.com/y6nz7h8q

Asai S, Ishimoto H, Yabuno A, Asada H, Seki M, et al. Laparoscopic cystectomy of ovarian teratoma in anti-NMDAR encephalitis: 2 case reports. J Minim Invasive Gynecol. 2011; 18:135-137. Ref.: https://tinyurl.com/y3ohsp9v