Cordero MI, Camacho SAE, Sainz MA, Araya MC

Language: Spanish
References: 13
Page: 89-95
PDF size: 405.66 Kb.

ABSTRACT

Autoimmune encephalitis against the N-methyl-Daspartate receptor (NMDA-R) is a newly discovered disease that occurs mainly in young women. It is characterized by the presence of autoantibodies against NMDA receptor, specifically against the GluN1 subunit; which generates psychotic symptoms, movement disorders, autonomic dysfunction and even coma. About 50% of patients present ovarian teratoma when completing the studies. This disease is reversible and treatable, therefore diagnosis and treatment are essential. The first line of treatment includes steroids, intravenous G immunoglobulin or plasmapheresis. The second line consists of rituximab and cyclophosphamide. In addition, in the cases where a tumor is documented, the extirpation of it is considered fundamental

REFERENCES

1. Guasp M Dalmau J. Encephalitis associated with antibodies against the NMDA receptor. Med Clin Barc. 2018; 151 (2): 71-79.

2. Tzang R Hsu K Chang Y Liu T. Immunotherapy for anti-NMDAR encephalitis: A review of paraneoplastic, autoimmune encephalopathy. Journal of Cancer Research and Practice. 2017; 4(1), 1-4.

3. Esposito S Principi N Calabresi P Rigante D. An evolving redefinition of autoimmune encephalitis. Autoimmunity Reviews. 2019;18(2):155-163.

4. Lazar-Molnar E Tebo A. Autoimmune NMDA receptor encephalitis. Clinica Chimica Acta. 2015; 438:90-97.

5. Señeris A Toral M Toral J. Recognizing the link between ovarian teratoma and autoimmune encephalitis: A case report of ovarian teratomaassociated anti-N-methyl-D-aspartate receptor encephalitis. Phillippine Journal of Obstetrics, 2016; 40 (3):29-33.

6. Liang Z Yang S Sun X et al. Teratoma-associated anti-NMDAR encephalitis. Medicine. 2017; 96(49):e9177.

7. Bush L Silva C Jurcik Y Perez M. Ovarian Teratoma–Associated Anti–N-Methyl-D-Aspartate Receptor Autoimmune Encephalitis: A Case Report. Laboratory Medicine. 2013; 44(3), 271-277.

8. Jiménez A Cárdenas O Ruiz J. L. Encefalitis autoinmunitaria secundaria a teratoma ovárico: un nuevo síndrome neuropsiquiátrico. Reporte de caso. Ginecología y obstetricia de México. 2017; 85(7), 472-479.

9. Acién P Acién M Ruiz E Martín C. Ovarian teratoma-associated anti-NMDAR encephalitis: a systematic review of reported cases. Orphanet journal of rare diseases. 2014; 9(1), 157.

10. Omata T Kodama K Watanabe et al. Ovarian teratoma development after anti-NMDA receptor encephalitis treatment. Brain and Development. 2017; 39(5), 448-451.

11. Braverman J Marcus C Garg R. Anti-NMDAreceptor encephalitis: A neuropsychiatric syndrome associated with ovarian teratoma. Gynecologic Oncology Reports. 2015;14:1-3.

12. Graus F Titulaer M Balu R Benseler S Bien C Cellucci T et al. A clinical approach to diagnosis of autoimmune encephalitis. The Lancet Neurology. 2016;15(4):391-404.

13. Titulaer M McCraken L Gabilondo I et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013; 12: 157-65.