Anti-LGI1 Antibody-Associated Encephalitis Misdiagnosed as Schizophrenia: A Case Report.

IF 5.3 1区 医学 Q1 PSYCHIATRY
Jin-He Zhang, Bing-Bing Fu, Wei Wang, Cong-Cong Sun, Jin-Jie Xu
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引用次数: 0

Abstract

Anti-leucine-rich glioma-inactivated 1 (LGI1) antibody-associated encephalitis is a rare but clinically significant form of autoimmune encephalitis, predominantly affecting middle-aged men. Its heterogeneous clinical presentation often leads to misdiagnosis, commonly as other neurological or psychiatric disorders. This report details the case of a 46-year-old male who initially presented with depressive symptoms, personality changes, and visual hallucinations. Over time, his condition progressed to include memory impairment, disorganized behavior, and seizures. Initially misdiagnosed with schizophrenia, the correct diagnosis of LGI1 antibody-associated encephalitis was eventually established through positive serum and cerebrospinal fluid (CSF) tests for LGI1 antibodies. Neuroimaging findings revealed characteristic bilateral temporal lobe lesions. The patient demonstrated marked improvement following treatment with methylprednisolone and intravenous immunoglobulin, ultimately achieving significant recovery. This case highlights the critical importance of comprehensive antibody testing and neuroimaging in patients presenting with nonspecific psychiatric and neurological symptoms to prevent misdiagnosis and delays in appropriate treatment. The article also reviews the pathogenesis, clinical manifestations, diagnostic approaches, and therapeutic strategies for LGI1 antibody-associated encephalitis, aiming to enhance clinical awareness and optimize patient outcomes.

被误诊为精神分裂症的抗 LGI1 抗体相关脑炎:病例报告。
富亮氨酸胶质瘤灭活1(LGI1)抗体相关脑炎是一种罕见但临床意义重大的自身免疫性脑炎,主要影响中年男性。其异质性临床表现常常导致误诊,通常被误诊为其他神经或精神疾病。本报告详细描述了一名 46 岁男性的病例,他最初表现为抑郁症状、人格改变和视觉幻觉。随着时间的推移,他的病情发展到记忆障碍、行为紊乱和癫痫发作。起初他被误诊为精神分裂症,通过对血清和脑脊液(CSF)进行LGI1抗体检测,最终确诊为LGI1抗体相关性脑炎。神经影像学检查结果显示,患者双侧颞叶出现特征性病变。患者在接受甲基强的松龙和静脉注射免疫球蛋白治疗后病情明显好转,最终获得显著康复。本病例强调了对出现非特异性精神和神经症状的患者进行全面抗体检测和神经影像学检查的重要性,以防止误诊和延误适当的治疗。文章还回顾了 LGI1 抗体相关脑炎的发病机制、临床表现、诊断方法和治疗策略,旨在提高临床认识,优化患者预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Schizophrenia Bulletin
Schizophrenia Bulletin 医学-精神病学
CiteScore
11.40
自引率
6.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.
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