Encephalitis associated with anti-mGluR5 antibodies.
| Autor: | Pedrosa DA; Hospital Israelita Albert Einstein, São Paulo, Brazil., Ferreira JHF; Hospital Israelita Albert Einstein, São Paulo, Brazil., Gleizer R; Hospital Israelita Albert Einstein, São Paulo, Brazil., Carra RB; Hospital Municipal Dr Moysés Deutsch, São Paulo, Brazil., de Carvalho RM; Hospital Municipal Dr Moysés Deutsch, São Paulo, Brazil., Endmayr V; Department of Neurology, Medical University of Vienna, Wien, Austria., Hoftberger R; Department of Neurology, Medical University of Vienna, Wien, Austria., Dutra LA; Hospital Israelita Albert Einstein, São Paulo, Brazil livia.dutra@einstein.br. |
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| Jazyk: | angličtina |
| Zdroj: | Practical neurology [Pract Neurol] 2024 Jul 16; Vol. 24 (4), pp. 306-309. Date of Electronic Publication: 2024 Jul 16. |
| DOI: | 10.1136/pn-2024-004089 |
| Abstrakt: | A 30-year-old woman had 5 days of visual hallucinations, nystagmus, memory impairment and mutism. On examination, she was disorientated with reduced attention span, gaze-evoked nystagmus, paratonia and abnormal frontal reflexes. Cerebrospinal fluid (CSF) showed 80 cells, protein 0.41 g/L and glucose 3.2 mmol/L (plasma glucose 5.0 mmol/L). MR scan of the brain showed involvement of limbic and extra-limbic regions and brainstem. Commercial cell-based assays were negative, but tissue-based assays showed neuropil staining, and cell-based assays for anti-metabotropic glutamate receptor 5 (mGluR5) antibodies were positive in serum and CSF. Six months later, she was diagnosed with Hodgkin's lymphoma. This case emphasises the broader clinical spectrum of anti-mGluR5 encephalitis, challenging its initial characterisation as Ophelia syndrome. It underscores the significance of interpreting commercial cell-based assays and advocates for tissue-based assay testing followed by cell-based assay testing in serum and CSF for diagnosing rare autoimmune encephalitis. Competing Interests: Competing interests: RH reports speaker’s honoraria from Novartis and Biogen. LAD reports receiving funding from Fleury Laboratory for the BrAIN (Braziian Autoimmune Encephalitis Network) Project and BrAIN Registry (Brazilian National Registry on Autoimmune Encephalitis). The other authors report no disclosures relevant to the manuscript. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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