Anti- N-Methyl-D Receptor Encephalitis During Long-Term Adalimumab Therapy for Crohn's Disease

Scott MacKay; Baljinder Salh

doi:10.14309/crj.0000000000001360

Anti- N-Methyl-D Receptor Encephalitis During Long-Term Adalimumab Therapy for Crohn's Disease

ACG Case Rep J. 2024 May 9;11(5):e01360. doi: 10.14309/crj.0000000000001360. eCollection 2024 May.

Authors

Scott MacKay¹, Baljinder Salh²

Affiliations

¹ Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
² Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Abstract

A 46-year-old woman with fistulizing Crohn's disease in clinical remission in the setting of long-term adalimumab therapy presented to hospital and was ultimately diagnosed with anti-N-methyl-D (NMDA) receptor antibody-mediated autoimmune encephalitis (NMDAr-AE). Inflammatory central nervous system and antibody-mediated adverse effects have been found to be associated with anti-tumor necrosis factor agents, with 5 previous case reports noting cases of NMDAr-AE in patients on these medications. The current article reports this case, which is unique for the length of adalimumab therapy before this presentation, as well as a summary of literature regarding anti-tumor necrosis factors and NMDAr-AE.

Keywords: Crohn's disease; NMDA encephalitis; anti-TNF therapies.

Publication types

Case Reports