A case of late-onset and long term of anti-nmda-receptor encephalitis in a 50-year-old patient with psychosis and cognitive decline
| Autor: | Y. Palchikova, N. Zalutskaya, N. Gomzyakova, V. Mikhailov, N. Ananyeva |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | European Psychiatry, Vol 64, Pp S473-S473 (2021) |
| Druh dokumentu: | article |
| ISSN: | 0924-9338 1778-3585 |
| DOI: | 10.1192/j.eurpsy.2021.1263 |
| Popis: | Introduction Anti-NMDA-receptor encephalitis is a severe rare acute form of encephalitis caused by an autoimmune process with the synthesis of autoantibodies to the glutamate receptors. The average age of onser is estimated to be 23-25 years. A typical clinical picture consist of prodromal, psychotic, areactive, hyperkinetic phases, and a phase of gradual regression of symptoms. The disease usually lasts for a several weeks with spontaneous recovery or fatal outcome and caused by neoplastic process. Our case demonstrates that the course of anti-NMDAR encephalitis is possible at more mature age in the form of a long process with cultural features, without significant catadrome, inflammation and associated neoplastic process. Objectives 50-year-old woman complained about hypomnesia, anosmia and dissomnia. The disease began with impaired consciousness, disorientation, seizures and memory loss 4 years ago. After 3 weeks IgG to the herpes simplex and cytomegalovirus were detected. Then after a discharge with no improvement and visit of Lama, the symtoms described above spontaneously reduced and schizophrenia-like psychosis developed, accompanied by mild neurological and severe neurocognitive symptoms, weight loss, intolerance to antipsychotics in minimal daily doses. This state was mantained till 2020. Methods Examination included: CBC, metabolic panel, coagulogram, tumor markers, CSF, MRI, PET, specialists. Results CBC, metabolic blood analysis, tumor markers - within the reference values. CSF: cytosis 9/3, glucose 5.5 mmol/l, Pandi++, Nonnet-Apeltau+, antibodies to the NMDA receptor - 8. MRI: signs of the consequences of encephalitis. PET: no signs of metabolic activity of the malignant process. Conclusions This case brings additional data about a couse, age of onset, duration and trigger factors for anti-NMDAR encephalitis. |
| Databáze: | Directory of Open Access Journals |
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