Anti-NMDA receptor encephalitis due to large-cell neuroendocrine carcinoma of the uterus
| Autor: | Arisa Hayashida, Yuri Shojima, Manami Kobayashi, Kazumasa Yokoyama, Tsuyoshi Ota, Kenya Nishioka, Anri Hattori, Akiko Sumii, Yasuhisa Terao, Masashi Takanashi, Nobutaka Hattori |
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| Rok vydání: | 2017 |
| Předmět: |
Anti-NMDA receptor encephalitis
Psychosis Pathology medicine.medical_specialty business.industry Uterus Autopsy Neuroendocrine tumors medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure nervous system Neurology Uterine cancer 030220 oncology & carcinogenesis medicine Carcinoma Neurology (clinical) business psychological phenomena and processes 030217 neurology & neurosurgery Encephalitis |
| Zdroj: | Journal of the Neurological Sciences. 383:72-74 |
| ISSN: | 0022-510X |
| DOI: | 10.1016/j.jns.2017.10.024 |
| Popis: | A 44-year-old woman presented with a large-cell neuroendocrine carcinoma and uterine endometrioid carcinoma with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. Following the diagnosis of uterine cancer, the patient suddenly developed psychosis with abnormal behaviors, delusions, irritability, and forgetfulness. The cerebrospinal fluid tested positive for anti-NMDAR antibodies (encoding the NR1 subunit). The patient was diagnosed with paraneoplastic limbic encephalitis due to uterine cancer. Histology of multiple abdominal metastatic samples revealed a neuroendocrine tumor. Her consciousness improved temporarily after tumor resection and comprehensive immunomodulatory therapy. On day 104 after admission, the patient died of multiple organ failure. The autopsy revealed a perivascular infiltration of inflammatory cells in the amygdala and NMDAR-positive cells in the primary uterine cancer. Our findings demonstrated that neuroendocrine tumors can induce anti-NMDAR encephalitis, which is consistent with three previous reports. A comprehensive treatment with resection of the carcinoma, immunoglobulins, and plasma exchange can induce a partial improvement of the symptoms. |
| Databáze: | OpenAIRE |
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