PMID- 34230042
OWN - NLM
STAT- MEDLINE
DCOM- 20210708
LR  - 20230707
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 14
IP  - 7
DP  - 2021 Jul 6
TI  - Anti-NMDA receptor encephalitis in an adolescent with a cryptic ovarian teratoma.
LID - 10.1136/bcr-2020-236340 [doi]
LID - e236340
AB  - Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disease 
      frequently associated with ovarian teratomas. In cases where an ovarian teratoma 
      is identified, treatment involves prompt removal of the ovarian teratoma, 
      resulting in significant clinical improvement and decreased incidence of relapse. 
      We present the case of a 14-year-old female patient admitted for progressively 
      worsening psychiatric and neurological status, diagnosed with anti-NMDAR 
      encephalitis, and negative initial imaging for ovarian pathology. She was in the 
      hospital for 8 months requiring admission to the intensive care unit and multiple 
      courses of immunotherapy before clinical improvement. Three months after 
      discharge, she was readmitted with clinical relapse and repeat imaging showed an 
      ovarian teratoma. Removal of the teratoma resulted in sustained clinical 
      improvement with return to baseline and no further relapse. Our case report 
      highlights the importance of maintaining a high suspicion for an underlying 
      ovarian teratoma in a female patient with anti-NMDAR encephalitis, even when 
      initial imaging is negative. Currently, there are limited data on recommendations 
      for repeat imaging. Therefore, we recommend repeat imaging in patients resistant 
      to multiple lines of treatment or presenting with clinical relapse.
CI  - (c) BMJ Publishing Group Limited 2021. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Walker, Christopher A
AU  - Walker CA
AUID- ORCID: 0000-0002-6513-0901
AD  - Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, 
      Michigan, USA cwalker0812@gmail.com.
FAU - Poulik, Janet
AU  - Poulik J
AD  - Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA.
FAU - D'Mello, Rahul J
AU  - D'Mello RJ
AUID- ORCID: 0000-0001-8343-0572
AD  - Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, 
      Michigan, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20210706
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 0 (Receptors, N-Methyl-D-Aspartate)
SB  - IM
MH  - Adolescent
MH  - *Anti-N-Methyl-D-Aspartate Receptor Encephalitis/complications/diagnosis/therapy
MH  - Female
MH  - Humans
MH  - Immunotherapy
MH  - Neoplasm Recurrence, Local
MH  - *Ovarian Neoplasms/complications/diagnostic imaging
MH  - Receptors, N-Methyl-D-Aspartate
MH  - *Teratoma/complications/diagnostic imaging/surgery
PMC - PMC8264569
OTO - NOTNLM
OT  - epilepsy and seizures
OT  - neurological injury
OT  - paediatric intensive care
OT  - radiology
COIS- Competing interests: None declared.
EDAT- 2021/07/08 06:00
MHDA- 2021/07/09 06:00
PMCR- 2023/07/06
CRDT- 2021/07/07 06:15
PHST- 2021/07/07 06:15 [entrez]
PHST- 2021/07/08 06:00 [pubmed]
PHST- 2021/07/09 06:00 [medline]
PHST- 2023/07/06 00:00 [pmc-release]
AID - 14/7/e236340 [pii]
AID - bcr-2020-236340 [pii]
AID - 10.1136/bcr-2020-236340 [doi]
PST - epublish
SO  - BMJ Case Rep. 2021 Jul 6;14(7):e236340. doi: 10.1136/bcr-2020-236340.