PMID- 32894089
OWN - NLM
STAT- MEDLINE
DCOM- 20201208
LR  - 20201214
IS  - 1471-2377 (Electronic)
IS  - 1471-2377 (Linking)
VI  - 20
IP  - 1
DP  - 2020 Sep 7
TI  - A rare case of anti-LGI1 limbic encephalitis with concomitant positive NMDAR 
      antibodies.
PG  - 336
LID - 10.1186/s12883-020-01918-7 [doi]
LID - 336
AB  - BACKGROUND: N-methyl-D-aspartate receptor (NMDAR) and leucine-rich 
      glioma-inactivated 1 (LGI1) antibodies define the most prevalently recognized 
      autoimmune encephalitis syndromes, while the simultaneous occurrence of both 
      conditions has hardly been published before. CASE PRESENTATION: We report the 
      case of a 67-year-old patient who presented with generalized tonic-clonic 
      seizures (GTCS) followed by behavioral changes, psychosis, sleep disorders, 
      decreased consciousness, and faciobrachial dystonic seizures. Ancillary findings 
      included serum hyponatremia and imaging evidence of high-intensity lesions within 
      bilateral medial temporal lobes on T2-weighted fluid attenuation inversion 
      recovery. Both LGI1 and NMDAR antibodies were positive in serum and cerebral 
      spinal fluid using transfected cell based assays. Despite prominent clinical 
      features of anti-LGI1 limbic encephalitis (LGI1-LE), the patient also exhibited 
      overlapping symptoms of anti-NMDAR encephalitis, like early-onset GTCS, which 
      might be related to the concomitant positive NMDAR antibodies. CONCLUSIONS: We 
      report a rare case of LGI1-LE with overlapping symptoms and simultaneous positive 
      NMDAR antibodies. It is necessary to evaluate the presence of NMDAR antibodies in 
      certain LGI1-LE patients with unusual symptoms. However, caution should be 
      exercised in interpreting the observation, given the fact of a single-case study.
FAU - Ji, Tuo
AU  - Ji T
AD  - Department of neurology, First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou City, 450052, Henan Province, China.
FAU - Huang, Zhi
AU  - Huang Z
AD  - Department of neurology, First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou City, 450052, Henan Province, China.
FAU - Lian, Yajun
AU  - Lian Y
AUID- ORCID: 0000-0002-0422-9078
AD  - Department of neurology, First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou City, 450052, Henan Province, China. lianyajun369@yeah.net.
FAU - Wang, Chengze
AU  - Wang C
AD  - Department of neurology, First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou City, 450052, Henan Province, China.
FAU - Zhang, Qiaoman
AU  - Zhang Q
AD  - Department of neurology, First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou City, 450052, Henan Province, China.
FAU - Li, Jinghong
AU  - Li J
AD  - Department of neurology, First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou City, 450052, Henan Province, China.
LA  - eng
GR  - 81771397/National Natural Science Foundation of China/
PT  - Case Reports
PT  - Journal Article
DEP - 20200907
PL  - England
TA  - BMC Neurol
JT  - BMC neurology
JID - 100968555
RN  - 0 (Autoantibodies)
RN  - 0 (Intracellular Signaling Peptides and Proteins)
RN  - 0 (LGI1 protein, human)
RN  - 0 (Receptors, N-Methyl-D-Aspartate)
RN  - Hashimoto's encephalitis
SB  - IM
MH  - Aged
MH  - Anti-N-Methyl-D-Aspartate Receptor Encephalitis/diagnosis
MH  - Autoantibodies/*blood
MH  - Encephalitis/immunology
MH  - Hashimoto Disease/immunology
MH  - Humans
MH  - Hyponatremia/diagnosis
MH  - Intracellular Signaling Peptides and Proteins
MH  - Limbic Encephalitis/*immunology
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Receptors, N-Methyl-D-Aspartate/*immunology
MH  - Seizures/etiology
PMC - PMC7487823
OTO - NOTNLM
OT  - Anti-leucine-rich glioma-inactivated 1
OT  - Antibody
OT  - Limbic encephalitis
OT  - N-methyl-D-aspartate receptor
COIS- All authors declared that there are no conflicts of interest.
EDAT- 2020/09/08 06:00
MHDA- 2020/12/15 06:00
PMCR- 2020/09/07
CRDT- 2020/09/07 12:09
PHST- 2020/07/07 00:00 [received]
PHST- 2020/09/02 00:00 [accepted]
PHST- 2020/09/07 12:09 [entrez]
PHST- 2020/09/08 06:00 [pubmed]
PHST- 2020/12/15 06:00 [medline]
PHST- 2020/09/07 00:00 [pmc-release]
AID - 10.1186/s12883-020-01918-7 [pii]
AID - 1918 [pii]
AID - 10.1186/s12883-020-01918-7 [doi]
PST - epublish
SO  - BMC Neurol. 2020 Sep 7;20(1):336. doi: 10.1186/s12883-020-01918-7.