Multiple co-existing antibodies in autoimmune encephalitis: A case and review of the literature

Ryan Kammeyer; Amanda L Piquet

doi:10.1016/j.jneuroim.2019.577084

Multiple co-existing antibodies in autoimmune encephalitis: A case and review of the literature

J Neuroimmunol. 2019 Dec 15:337:577084. doi: 10.1016/j.jneuroim.2019.577084. Epub 2019 Oct 15.

Authors

Ryan Kammeyer¹, Amanda L Piquet²

Affiliations

¹ University of Colorado, Department of Neurology, 12700 E. 19th Ave, Aurora, CO 80045, USA. Electronic address: Ryan.kammeyer@childrenscolorado.org.
² University of Colorado, Department of Neurology, 12700 E. 19th Ave, Aurora, CO 80045, USA. Electronic address: Amanda.piquet@ucdenver.edu.

PMID: 31655424
DOI: 10.1016/j.jneuroim.2019.577084

Abstract

A 66-year-old man with a history of chronic tobacco use presented with two months of progressive memory deficits, ataxia, diplopia, and opsoclonus. His brain magnetic resonance imaging (MRI) showed limbic and brainstem encephalitis, and antibody testing was positive for anti-Ma1/Ma2, anti-N-methyl-d-aspartate receptor (anti-NMDA-R) and anti-glutamic acid decarboxylase 65 (anti-GAD65) antibodies. His encephalitis improved with intravenous steroids, plasmapheresis, and rituximab initiation. His PET/CT was suspicious for lung malignancy, but a progressive deterioration of his respiratory status prevented full investigation. Multiple auto-antibodies may be produced in response to a malignancy and overlapping of clinical presentations may occur with multiple auto-antibodies.

Keywords: Autoimmune encephalitis; Co-existing autoantibodies; Paraneoplastic syndrome.

Publication types

Case Reports
Review

MeSH terms

Aged
Autoantibodies / blood*
Autoantibodies / cerebrospinal fluid*
Encephalitis / diagnostic imaging*
Encephalitis / metabolism*
Hashimoto Disease / diagnostic imaging*
Hashimoto Disease / metabolism*
Humans
Male

Substances

Autoantibodies

Supplementary concepts

Hashimoto's encephalitis