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Case Reports: Rare disease
Concurrent NMDAR and GFAP Antibody Encephalitis During Pregnancy
  1. Erkam Zengin1,
  2. Irina Kharisova1,
  3. Dokpe Emechebe2 and
  4. Yaacov Anziska1
  1. 1Neurology Department, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
  2. 2Pathology Department, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
  1. Correspondence to Dr Erkam Zengin; erkam.zengin{at}downstate.edu

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune antibody encephalitis, commonly affecting young women with comorbid ovarian teratoma. It typically presents with alteration of consciousness, psychosis, movement disorders eventually deteriorating with seizures, dysautonomia and central hypoventilation requiring critical level of care that may last weeks to months. Removal of teratoma and immunosuppressant therapy support can led to a dramatic recovery.

To our knowledge, this is the first illustrated case in the literature of a pregnant woman presenting with concurrent autoimmune NMDAR and anti-glial gibrillary acidic protein(GFAP) antibody encephalitis in the setting of an ovarian teratoma. Despite the teratoma removal and receiving various forms of immunosuppressant therapy, a meaningful neurological improvement was observed following the delivery. After a prolonged hospitalisation and recovery period, the patient and her offspring made an excellent recovery highlighting the significance of early diagnosis and management.

  • Immunology
  • Psychiatry
  • Neonatal health
  • Neurology

https://doi.org/10.1136/bcr-2022-250998

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: EZ, IK, DE and YA. The following authors gave final approval of the manuscript: EZ, IK, DE and YA.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.