Association of ovarian teratoma with anti-N-methyl-D-aspartate receptor encephalitis: a case report and narrative review.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Konrad Joseph, Sarah van der Hock, Ishith Seth, Nipuni Hapangama, Lara Gibson, Roberto Cuomo, Warren M Rozen, Nita Dhupar
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Abstract

Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a potentially life-threatening autoimmune disorder which is strongly associated with ovarian teratomas in young female patients. The primary aim is to highlight the importance of considering NMDAR encephalitis in the differential diagnosis of young female patients presenting with acute or subacute neuropsychiatric symptoms, especially when accompanied by ovarian teratomas.

Case description: This case report and literature review detail the presentation, diagnosis, and treatment of a 35-year-old G4P3 Indigenous woman who initially presented with neuropsychiatric symptoms and fever, having a history of extensive drug and alcohol use. Misdiagnosed initially, the patient's lack of response to standard treatments led to further investigations, revealing paraneoplastic anti-NMDAR encephalitis secondary to a left ovarian teratoma. The report examines the treatment regimen followed, including prednisolone, intravenous immunoglobulin, rituximab injections, and laparoscopic bilateral salpingo-oophorectomy.

Conclusions: This case underscores the critical need for increased clinical vigilance for anti-NMDAR encephalitis in patients, particularly young females, presenting with neuropsychiatric symptoms and potential ovarian teratomas. The literature review accompanying the case report provides valuable insights into the presentation, diagnosis, and management of this complex condition. Lastly, this study emphasised the diagnostic challenges inherent in paraneoplastic neuropsychiatric syndromes, advocating for a multidisciplinary approach in similar clinical scenarios.

卵巢畸胎瘤与抗 N-甲基-D-天冬氨酸受体脑炎的关系:病例报告和综述。
背景:抗 N-甲基-D-天冬氨酸受体(NMDAR)脑炎是一种可能危及生命的自身免疫性疾病,与年轻女性患者的卵巢畸胎瘤密切相关。主要目的是强调在对出现急性或亚急性神经精神症状的年轻女性患者进行鉴别诊断时考虑 NMDAR 脑炎的重要性,尤其是伴有卵巢畸胎瘤的患者:本病例报告和文献综述详细描述了一名 35 岁 G4P3 土著妇女的表现、诊断和治疗情况,该妇女最初出现神经精神症状和发热,有大量吸毒和酗酒史。该患者最初被误诊,但由于对标准治疗缺乏反应,医生对其进行了进一步检查,结果发现她患有继发于左侧卵巢畸胎瘤的副肿瘤性抗 NMDAR 脑炎。报告探讨了治疗方案,包括泼尼松龙、静脉注射免疫球蛋白、利妥昔单抗注射和腹腔镜双侧输卵管切除术:本病例强调,临床上需要提高对出现神经精神症状和潜在卵巢畸胎瘤的患者(尤其是年轻女性)抗 NMDAR 脑炎的警惕。该病例报告所附的文献综述为这一复杂病症的表现、诊断和处理提供了宝贵的见解。最后,本研究强调了副肿瘤性神经精神综合征固有的诊断难题,提倡在类似临床情况下采用多学科方法。
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
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
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