Psychotic Symptoms as the Initial Presentation of a Long-Lasting Misdiagnosed Anti-GAD65 Autoimmune Encephalitis: An Emblematic Case and Literature Review

Jianjun Wang; Shenglan Gong; Fanxin Kong; Dongbin Cai; Binqing Huang; Haotao Zheng; Songjun Lin; Jinfang Li; Tianfeng Zhang

doi:10.3389/fpsyt.2022.754938

Psychotic Symptoms as the Initial Presentation of a Long-Lasting Misdiagnosed Anti-GAD65 Autoimmune Encephalitis: An Emblematic Case and Literature Review

Front Psychiatry. 2022 Feb 23:13:754938. doi: 10.3389/fpsyt.2022.754938. eCollection 2022.

Authors

Jianjun Wang^{1

2

3}, Shenglan Gong^{1

4

5}, Fanxin Kong^{1

2}, Dongbin Cai^{1

2}, Binqing Huang^{1

2}, Haotao Zheng^{1

2}, Songjun Lin^{1

2}, Jinfang Li^{1

2}, Tianfeng Zhang^{4

5}

Affiliations

¹ Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China.
² Department of Neurology and Psychology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
³ Global Clinical Scholars Research Training (GCSRT), Harvard Medical School, Boston, MA, United States.
⁴ Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China.
⁵ Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China.

Abstract

Objective: To present a long-lasting misdiagnosed case of anti-GAD65 autoimmune encephalitis (AE) and promote the early identification of reversible psychotic symptoms in AE.

Methods: The case report was generated through detailed assessment of clinical characteristics, cerebral magnetic resonance images, and laboratory results. Meanwhile, a literatures review related to the topic was conducted.

Results: Psychotic symptoms could be presented in the early stage of anti-GAD65 autoimmune encephalitis. Even though there exists a transdisciplinary gap that hinder the timely recognition of early psychiatric symptoms as components of organic disease, a few strategies could be introduced to enable the earlier recognition and appropriate treatment.

Conclusions: Our report intends to raise awareness to promote the early identification of immune-mediated "symptomatic" forms of psychosis.

Keywords: GAD65; autoantibodies; autoimmune; autoimmune hepatitis; encephalitis; psychosis; seizure (medical records).

Publication types

Case Reports