PMID- 31505524
OWN - NLM
STAT- MEDLINE
DCOM- 20200619
LR  - 20210914
IS  - 1538-1145 (Electronic)
IS  - 1527-4160 (Linking)
VI  - 25
IP  - 5
DP  - 2019 Sep
TI  - Are We Missing Subtle Forms of Anti-N-Methyl-D-Aspartate Encephalitis With the 
      Current Diagnostic Approach? A Case Report.
PG  - 383-390
LID - 10.1097/PRA.0000000000000412 [doi]
AB  - Encephalitis related to antibodies against the N-methyl-D-aspartate receptor 
      (NMDAr) is a recently described clinical entity in which IgG autoantibodies 
      against the NR1 subunit of the NMDAr lead to the appearance of complex 
      neuropsychiatric symptoms. As psychiatric symptoms predominate in early stages, 
      anti-NMDAr encephalitis is frequently mistaken as a primary psychiatric disorder 
      which delays treatment and has serious consequences for patients. This report 
      presents the case of a 24-year-old woman with a subacute onset of psychotic and 
      catatonic symptoms in whom current diagnostic criteria for probable anti-NMDAr 
      encephalitis were not fulfilled. On the basis of the red flags that have been 
      proposed to raise suspicion of anti-NMDAr encephalitis, a study of 
      fluorodeoxyglucose positron emission tomography was requested and demonstrated 
      bilateral occipital hypometabolism consistent with clinical suspicion of 
      anti-NMDAr encephalitis. Once the appropriate treatment was established, the 
      patient recovered completely. This case supports the need to maintain clinical 
      suspicion of anti-NMDAr encephalitis, even when conventional diagnostic tests 
      have been normal. Psychiatrists should be familiar with this entity to promote 
      timely diagnosis and prompt treatment.
FAU - Bayliss, Leo
AU  - Bayliss L
FAU - Restrepo-Martinez, Miguel
AU  - Restrepo-Martinez M
FAU - Duarte, Alfonso
AU  - Duarte A
FAU - Borja, Cesar C
AU  - Borja CC
FAU - Espinola-Nadurille, Mariana
AU  - Espinola-Nadurille M
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Psychiatr Pract
JT  - Journal of psychiatric practice
JID - 100901141
RN  - 0 (Autoantibodies)
RN  - 0 (Receptors, N-Methyl-D-Aspartate)
SB  - IM
CIN - J Psychiatr Pract. 2019 Sep;25(5):383-390. PMID: 31505525
MH  - Adult
MH  - Anti-N-Methyl-D-Aspartate Receptor Encephalitis/blood/genetics/psychology
MH  - Autoantibodies/blood
MH  - *Catatonia/diagnosis/etiology
MH  - Cerebral Cortex/diagnostic imaging/metabolism
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Ovarian Neoplasms/immunology/pathology/surgery
MH  - Ovariectomy/*methods
MH  - Positron-Emission Tomography/methods
MH  - Psychotic Disorders/*diagnosis
MH  - Receptors, N-Methyl-D-Aspartate/*immunology
MH  - *Teratoma/immunology/pathology/surgery
MH  - Tomography, X-Ray Computed/methods
MH  - Treatment Outcome
EDAT- 2019/09/11 06:00
MHDA- 2020/06/20 06:00
CRDT- 2019/09/11 06:00
PHST- 2019/09/11 06:00 [entrez]
PHST- 2019/09/11 06:00 [pubmed]
PHST- 2020/06/20 06:00 [medline]
AID - 00131746-201909000-00008 [pii]
AID - 10.1097/PRA.0000000000000412 [doi]
PST - ppublish
SO  - J Psychiatr Pract. 2019 Sep;25(5):383-390. doi: 10.1097/PRA.0000000000000412.