PMID- 26663628
OWN - NLM
STAT- MEDLINE
DCOM- 20160831
LR  - 20220318
IS  - 2046-0260 (Electronic)
IS  - 2046-0252 (Linking)
VI  - 4
IP  - 4
DP  - 2015 Dec
TI  - Acute psychosis due to non-paraneoplastic anti-NMDA-receptor encephalitis in a 
      teenage girl: Case report.
PG  - 226-30
LID - 10.1002/pchj.121 [doi]
AB  - Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a disease occurring 
      when antibodies produced by the body's own immune system attack NMDA-type 
      glutamate receptors in the brain. Most anti-NMDAR encephalitis cases are 
      associated with paraneoplastic syndrome. We analyze the case of a 15-year-old 
      girl who was hospitalized in a child psychiatry clinic in Riga, Latvia, with de 
      novo acute polymorphic psychotic disorder gradually progressing to a catatonic 
      state. The patient received antipsychotic and electroconvulsive therapy with no 
      beneficial effect. The council of doctors discussed differential diagnoses of 
      schizophrenia-induced catatonia and the autoimmune limbic encephalitis-induced 
      catatonic condition. When the diagnosis of anti-NMDAR autoimmune encephalitis was 
      finally confirmed by repeated immunological assays (specific immunoglobulin [Ig] 
      G and IgM in her blood serum and cerebrospinal fluid), and a paraneoplastic 
      process was ruled out, she was started on immunomodulating therapy 
      (methylprednisolone, Ig, plasmapheresis, rituximab), which changed the course of 
      her disease. On immunomodulating treatment, her physical and mental health have 
      gradually improved to almost complete reconvalescence. Psychiatrists should 
      consider anti-NMDAR encephalitis as a differential diagnosis in first-episode 
      psychosis patients presenting with disorientation, disturbed consciousness, 
      pronounced cognitive deficits, movement disorder, dysautonomia, or rapid 
      deterioration, and test for specific IgG NR1 autoantibodies, even if there are no 
      specific findings on routine neuroimaging, electroencephalography (EEG), or 
      cerebrospinal fluid tests.
CI  - (c) 2015 The Institute of Psychology, Chinese Academy of Sciences and Wiley 
      Publishing Asia Pty Ltd.
FAU - Kramina, Sandra
AU  - Kramina S
AD  - Riga Stradins University, Riga, Latvia.
FAU - Kevere, Laura
AU  - Kevere L
AD  - Child Psychiatry Clinic, Children's Clinical University Hospital, Riga, Latvia.
FAU - Bezborodovs, Nikita
AU  - Bezborodovs N
AD  - Child Psychiatry Clinic, Children's Clinical University Hospital, Riga, Latvia.
FAU - Purvina, Santa
AU  - Purvina S
AD  - Department of Internal Diseases, Riga Stradins University, Riga, Latvia.
FAU - Rozentals, Guntis
AU  - Rozentals G
AD  - Child Neurology and Neurosurgery Clinic, Children's Clinical University Hospital, 
      Riga, Latvia.
FAU - Strautmanis, Jurgis
AU  - Strautmanis J
AD  - Child Neurology and Neurosurgery Clinic, Children's Clinical University Hospital, 
      Riga, Latvia.
FAU - Viksna, Zane
AU  - Viksna Z
AD  - Child Neurology and Neurosurgery Clinic, Children's Clinical University Hospital, 
      Riga, Latvia.
LA  - eng
SI  - GENBANK/S82930
PT  - Case Reports
PT  - Journal Article
PL  - Australia
TA  - Psych J
JT  - PsyCh journal
JID - 101598595
RN  - 0 (Autoantibodies)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Glutamate)
RN  - 0 (Receptors, N-Methyl-D-Aspartate)
RN  - 3KX376GY7L (Glutamic Acid)
SB  - IM
MH  - Adolescent
MH  - Anti-N-Methyl-D-Aspartate Receptor Encephalitis/*diagnosis/drug 
      therapy/psychology
MH  - Autoantibodies/blood
MH  - Catatonia/diagnosis
MH  - Delayed Diagnosis
MH  - Diagnosis, Differential
MH  - Female
MH  - Glutamic Acid/therapeutic use
MH  - Humans
MH  - Immunoglobulin G/therapeutic use
MH  - Latvia
MH  - Psychotic Disorders/*etiology
MH  - Receptors, Glutamate
MH  - Receptors, N-Methyl-D-Aspartate/*immunology
OTO - NOTNLM
OT  - acute psychosis
OT  - anti-N-methyl-d-aspartate receptor (anti-NMDAR)
OT  - non-paraneoplastic encephalitis
EDAT- 2015/12/15 06:00
MHDA- 2016/09/01 06:00
CRDT- 2015/12/15 06:00
PHST- 2015/07/12 00:00 [received]
PHST- 2015/10/08 00:00 [accepted]
PHST- 2015/12/15 06:00 [entrez]
PHST- 2015/12/15 06:00 [pubmed]
PHST- 2016/09/01 06:00 [medline]
AID - 10.1002/pchj.121 [doi]
PST - ppublish
SO  - Psych J. 2015 Dec;4(4):226-30. doi: 10.1002/pchj.121.