Anti-GluK2 antibody-positive autoimmune encephalitis concurrent with multiple myeloma: a case report

BMC Neurol. 2025 Jan 20;25(1):27. doi: 10.1186/s12883-025-04037-3.

Abstract

Background: Autoimmune encephalitis associated with anti-GluK2 antibodies is a recently identified condition, typically characterized by cerebellar ataxia. This case report presents a unique clinical manifestation involving involuntary movements and emotional dysregulation, expanding the known phenotype spectrum.

Case presentation: A 60-year-old woman presented with a two-year history of involuntary movements predominantly affecting her lower limbs and facial muscles, occasionally accompanied by hysterical shouting. Initial investigations revealed coexisting multiple myeloma (MM) and anti-GluK2 antibody positivity. Following MM-specific therapy, including bortezomib, cyclophosphamide, and dexamethasone, the patient's symptoms resolved, and her serum anti-GluK2 antibody titers decreased significantly.

Conclusions: This case suggests that involuntary movements and psychiatric symptoms may represent novel phenotypes of anti-GluK2 antibody-associated autoimmune encephalitis. The findings underscore the importance of recognizing the diverse clinical presentations of this rare condition and prompt further research into its underlying mechanisms.

Keywords: Alginate-type glutamate receptor subunit 2 (GluK2) encephalitis; Involuntary movement; Multiple myeloma.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies* / blood
  • Autoantibodies* / immunology
  • Encephalitis* / complications
  • Encephalitis* / diagnosis
  • Encephalitis* / immunology
  • Female
  • Hashimoto Disease* / complications
  • Hashimoto Disease* / diagnosis
  • Hashimoto Disease* / immunology
  • Humans
  • Middle Aged
  • Multiple Myeloma* / complications
  • Multiple Myeloma* / diagnosis
  • Multiple Myeloma* / immunology

Substances

  • Autoantibodies

Supplementary concepts

  • Hashimoto's encephalitis