Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=26152327
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Anti-N-methyl-D-aspartate receptor encephalitis concomitant with multifocal
subcortical white matter lesions on magnetic resonance imaging: a case report and
review of the literature
#MMPMID26152327
Wang RJ
; Chen BD
; Qi D
BMC Neurol
2015[Jul]; 15
(?): 107
PMID26152327
show ga
BACKGROUND: Anti-N-methyl-D-aspartate receptor encephalitis is a severe
autoimmune disorder characterized by severe psychiatric symptoms, seizures,
decreased consciousness, autonomic dysregulation, and dyskinesias. Multifocal
subcortical white matter lesions on fluid-attenuated inversion recovery and
diffuse weighted images have rarely been reported in previous literature, and
serial magnetic resonance imaging changes after plasma exchange have not been
presented before. CASE PRESENTATION: A previously healthy 24-year-old Chinese
woman presented with acute psychiatric symptoms characterized by fear and
agitation followed by decreased consciousness, dyskinesias, and seizures.
Magnetic resonance imaging revealed hyperintense lesions on fluid-attenuated
inversion recovery and diffuse weighted images in bilateral subcortical white
matter. Cerebrospinal fluid analysis revealed a mild pleocytosis with lymphocytic
predominance. Protein and glucose levels were normal. Aquaporin-4 antibodies in
serum and cerebrospinal fluid were negative. Identification of
anti-N-methyl-D-aspartate receptor antibodies in serum and cerebrospinal fluid
confirmed the diagnosis of anti-N-methyl-D-aspartate receptor encephalitis. She
was initially treated with combined intravenous immunoglobulin and
methylprednisolone without improvement. Plasma exchange was then initiated with
good response; the patient made a full recovery after several cycles of plasma
exchange. Repeat magnetic resonance imaging performed 1 month after plasma
exchange showed partial resolution of the hyperintense lesions in bilateral
subcortical white matter, and follow-up magnetic resonance imaging 2 months after
plasma exchange showed complete resolution. CONCLUSION: Anti-N-methyl-D-aspartate
receptor encephalitis may be concomitant with multifocal subcortical white matter
lesions. Such lesions may resolve after appropriate immunotherapy.
free
free
free
