Anti-NMDAR encephalitis presenting after immature teratoma resection

Deandra Kimberly Chetram; Kelsey Pan; Aisha Elfasi; Merry Markham

doi:10.1136/bcr-2021-244637

Anti-NMDAR encephalitis presenting after immature teratoma resection

BMJ Case Rep. 2021 Nov 19;14(11):e244637. doi: 10.1136/bcr-2021-244637.

Authors

Deandra Kimberly Chetram¹, Kelsey Pan², Aisha Elfasi³, Merry Markham⁴

Affiliations

¹ Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
² Internal Medicine, University of Florida Health, Gainesville, Florida, USA [email protected].
³ Neurology, University of Florida Health, Gainesville, Florida, USA.
⁴ Medicine, Division of Hematology & Oncology, University of Florida, Gainesville, Florida, USA.

Abstract

This is a case of a young woman who developed neurological and psychiatric symptoms 3 days after resection of an immature teratoma. She was diagnosed with anti-NMDA receptor encephalitis via positive serum antibody titres, which was later confirmed with cerebrospinal fluid antibody titres. Given her cancer diagnosis, she underwent treatment with bleomycin, etoposide and cisplatin chemotherapy in addition to 5 days of high-dose steroids (1 g of intravenous methylprednisolone) for the encephalitis. This treatment regimen led to significant clinical improvement 3 weeks after completion of one cycle of chemotherapy.

Keywords: cancer intervention; gynaecological cancer; neurology.

Publication types

Case Reports

MeSH terms

Anti-N-Methyl-D-Aspartate Receptor Encephalitis* / diagnosis
Anti-N-Methyl-D-Aspartate Receptor Encephalitis* / drug therapy
Female
Humans
Methylprednisolone / therapeutic use
Ovarian Neoplasms*
Receptors, N-Methyl-D-Aspartate
Teratoma* / drug therapy
Teratoma* / surgery

Substances

Receptors, N-Methyl-D-Aspartate
Methylprednisolone