{"title":"Autoimmune encephalitis with anti-NMDAR antibodies in multiple myeloma – case report and literature review","authors":"Anna Stanowska, Barbara Wach, M. Wnuk","doi":"10.5114/PPN.2019.86259","DOIUrl":null,"url":null,"abstract":"Purpose: The initial presentation of autoimmune encephalitis (AIE) may resemble other disorders and a comprehensive investigation is required. In this paper we emphasize the challenges faced by a treating team performing a differential diagnosis and the ne- cessity for insightful multidisciplinary collaboration. Case description: We report on the case of a 67-year old man who developed transient disturbances of consciousness in the course of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, which was the first manifestation of malignant myeloma. To our knowledge, this is the first case of anti-NMDAR encephalitis associated with multiple myeloma described in the literature. Comment: AIE with anti-NMDAR antibodies has become a well-characterised variant of the condition. AIE may or may not be associated with tumour; therefore it is necessary to use the screening approach for primary malignancy. A proper diagnosis is essential in management due to AIE’s potential to respond to immunotherapy and tumour removal if one is present.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2019.86259","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Postepy Psychiatrii i Neurologii","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5114/PPN.2019.86259","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The initial presentation of autoimmune encephalitis (AIE) may resemble other disorders and a comprehensive investigation is required. In this paper we emphasize the challenges faced by a treating team performing a differential diagnosis and the ne- cessity for insightful multidisciplinary collaboration. Case description: We report on the case of a 67-year old man who developed transient disturbances of consciousness in the course of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, which was the first manifestation of malignant myeloma. To our knowledge, this is the first case of anti-NMDAR encephalitis associated with multiple myeloma described in the literature. Comment: AIE with anti-NMDAR antibodies has become a well-characterised variant of the condition. AIE may or may not be associated with tumour; therefore it is necessary to use the screening approach for primary malignancy. A proper diagnosis is essential in management due to AIE’s potential to respond to immunotherapy and tumour removal if one is present.
目的:自身免疫性脑炎(AIE)的初始表现可能与其他疾病相似，需要进行全面的调查。在本文中，我们强调面临的挑战，治疗团队进行鉴别诊断和必要的有见地的多学科合作。病例描述:我们报告一例67岁男性患者在抗n -甲基- d -天冬氨酸受体(抗nmdar)脑炎过程中出现短暂性意识障碍，这是恶性骨髓瘤的第一个表现。据我们所知，这是文献中第一例与多发性骨髓瘤相关的抗nmdar脑炎。评论:带有抗nmdar抗体的AIE已成为该病的一种特征明确的变体。AIE可能与肿瘤有关，也可能与肿瘤无关;因此，有必要对原发性恶性肿瘤进行筛查。由于AIE可能对免疫治疗和肿瘤切除有反应，因此正确的诊断在治疗中至关重要。
期刊介绍：
The quarterly Advances in Psychiatry and Neurology is aimed at psychiatrists, neurologists as well as scientists working in related areas of basic and clinical research, psychology, social sciences and humanities. The journal publishes original papers, review articles, case reports, and - at the initiative of the Editorial Board – reflections or experiences on currently vivid theoretical and practical questions or controversies. Articles submitted to the journal are evaluated first by the Section Editors, specialists in the fields of psychiatry, clinical psychology, science of the brain and mind and neurology, and reviewed by acknowledged authorities in the respective field. Authors and reviewers remain anonymous to each other.
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