PMID- 26089673
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20150619
LR  - 20200930
IS  - 1176-6328 (Print)
IS  - 1178-2021 (Electronic)
IS  - 1176-6328 (Linking)
VI  - 11
DP  - 2015
TI  - Anti-N-methyl-d-aspartate receptor encephalitis in a patient with a 7-year 
      history of being diagnosed as schizophrenia: complexities in diagnosis and 
      treatment.
PG  - 1437-42
LID - 10.2147/NDT.S82930 [doi]
AB  - Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a form of autoimmune 
      encephalitis associated with antibodies against the NR1 subunits of NMDARs. 
      Although new-onset acute prominent psychotic syndromes in patients with NMDAR 
      encephalitis have been well documented, there is a lack of case studies on 
      differential diagnosis and treatment of anti-NMDAR encephalitis after a long-term 
      diagnostic history of functional psychotic disorders. The present study reports 
      an unusual case of anti-NMDAR encephalitis. The patient had been diagnosed with 
      schizophrenia 7 years earlier, and was currently hospitalized for acute-onset 
      psychiatric symptoms. The diagnosis became unclear when the initial psychosis was 
      confounded with considerations of other neurotoxicities (such as neuroleptic 
      malignant syndrome). Finally, identification of specific immunoglobulin G NR1 
      autoantibodies in the cerebrospinal fluid and greater effectiveness of 
      immunotherapy over antipsychotics alone (which has been well documented in 
      anti-NMDAR encephalitis) indicated the diagnosis of anti-NMDAR encephalitis in 
      this case. Based on the available evidence, however, the relationship between the 
      newly diagnosed anti-NMDAR encephalitis and the seemingly clear, long-term 
      history of schizophrenia in the preceding 7 years is uncertain. This case report 
      illustrates that psychiatrists should consider anti-NMDAR encephalitis and order 
      tests for specific immunoglobulin G NR1 autoantibodies in patients presenting 
      with disorientation, disturbance of consciousness, cognitive deficit, dyskinesia, 
      autonomic disturbance, or rapid deterioration, even with a seemingly clear 
      history of a psychiatric disorder and no specific findings on routine 
      neuroimaging, electroencephalography, or cerebrospinal fluid tests in the early 
      stage of the illness.
FAU - Huang, Chaohua
AU  - Huang C
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China ; State Key Laboratory of Biotherapy, Psychiatric 
      Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, People's 
      Republic of China ; Mental Health Center, Affiliated Hospital of Luzhou Medical 
      College, Luzhou, People's Republic of China.
FAU - Kang, Yukun
AU  - Kang Y
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China.
FAU - Zhang, Bo
AU  - Zhang B
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China.
FAU - Li, Bin
AU  - Li B
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China.
FAU - Qiu, Changjian
AU  - Qiu C
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China.
FAU - Liu, Shanming
AU  - Liu S
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China.
FAU - Ren, Hongyan
AU  - Ren H
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China ; State Key Laboratory of Biotherapy, Psychiatric 
      Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, People's 
      Republic of China.
FAU - Yang, Yanchun
AU  - Yang Y
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China.
FAU - Liu, Xiehe
AU  - Liu X
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China.
FAU - Li, Tao
AU  - Li T
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China ; State Key Laboratory of Biotherapy, Psychiatric 
      Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, People's 
      Republic of China ; Mental Health Education Center, Sichuan University, Chengdu, 
      Sichuan, People's Republic of China.
FAU - Guo, Wanjun
AU  - Guo W
AD  - Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 
      People's Republic of China ; State Key Laboratory of Biotherapy, Psychiatric 
      Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, People's 
      Republic of China.
LA  - eng
PT  - Case Reports
DEP - 20150611
PL  - New Zealand
TA  - Neuropsychiatr Dis Treat
JT  - Neuropsychiatric disease and treatment
JID - 101240304
PMC - PMC4468991
OTO - NOTNLM
OT  - anti-N-methyl-d-aspartate receptor encephalitis
OT  - differential diagnosis
OT  - schizophrenia
OT  - treatment
EDAT- 2015/06/20 06:00
MHDA- 2015/06/20 06:01
PMCR- 2015/06/11
CRDT- 2015/06/20 06:00
PHST- 2015/06/20 06:00 [entrez]
PHST- 2015/06/20 06:00 [pubmed]
PHST- 2015/06/20 06:01 [medline]
PHST- 2015/06/11 00:00 [pmc-release]
AID - ndt-11-1437 [pii]
AID - 10.2147/NDT.S82930 [doi]
PST - epublish
SO  - Neuropsychiatr Dis Treat. 2015 Jun 11;11:1437-42. doi: 10.2147/NDT.S82930. 
      eCollection 2015.