Case report

• Verfasst von: Moldavski, Alexander [VerfasserIn]
• Verfasst von: Wenz, Holger [VerfasserIn]
• Verfasst von: Lange, Bettina [VerfasserIn]
• Verfasst von: Rohleder, Cathrin [VerfasserIn]
• Verfasst von: Leweke, F. Markus [VerfasserIn]
• Titel: Case report
• Titelzusatz: severe adolescent major depressive syndrome turns out to be an unusual case of anti-NMDA receptor encephalitis
• Verf.angabe: Alexander Moldavski, Holger Wenz, Bettina E. Lange, Cathrin Rohleder and F. Markus Leweke
• E-Jahr: 2021
• Jahr: 25 May 2021
• Umfang: 6 S.
• Fussnoten: Gesehen am 23.09.2021
• Titel Quelle: Enthalten in: Frontiers in psychiatry
• Ort Quelle: Lausanne : Frontiers Research Foundation, 2007
• Jahr Quelle: 2021
• Band/Heft Quelle: 12(2021) vom: Mai, Artikel-ID 679996, Seite 1-6
• ISSN Quelle: 1664-0640
• DOI: doi:10.3389/fpsyt.2021.679996
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Anti-neuronal autoantibodies
• Sach-SW: autoimmune encephalitis (AE)
• Sach-SW: Cerebrospinal Fluid
• Sach-SW: Depression
• Sach-SW: isolated psychiatric presentation
• Sach-SW: Young Adult
• K10plus-PPN: 1759083682
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a neuroinflammatory condition mediated by autoantibodies against the GluN1 subunit of the receptor. Clinically, it is characterized by a complex neuropsychiatric presentation with rapidly progressive psychiatric symptoms, cognitive deficits, seizures, and abnormal movements. Isolated psychiatric manifestations of anti-NMDAR encephalitis are rare and usually dominated by psychotic symptoms. We present a case of an 18-year-old female high school student - without a previous history of psychiatric disorders - with a rapid onset severe depressive syndrome. Surprisingly, we found pleocytosis and anti-NMDAR autoantibodies in the cerebrospinal fluid (CSF), despite an otherwise unremarkable diagnostic workup, including blood test, clinical examination, and cranial magnetic resonance imaging (MRI). After intravenous immunoglobulins treatment, a complete remission of the initial symptoms was observed. In a follow-up five years later, the young woman did not experience any relapse or sequelae. Anti-NMDAR encephalitis can present in rare cases as an organic disorder with major depressive symptoms without distinct concomitant psychotic or neurological symptoms. A clinical presentation such as a rapid onset of symptoms, distinct disturbance in the thought process, restlessness, and cognitive deficits should prompt screening for NMDAR- and other neural autoantibodies to rule out this rare but debilitating pathology.