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Case Reports in Immunology
Volume 2019, Article ID 4762937, 6 pages
https://doi.org/10.1155/2019/4762937
Case Series

Anti-N-Methyl-D-Aspartate Encephalitis as Paraneoplastic Manifestation of Germ-Cells Tumours: A Cases Report and Literature Review

1Department of Immunology. Hospital Universitario Ramón y Cajal, Ctra. Colmenar Km 9,1, 28034 Madrid, Spain
2Department of Neurology. Hospital Universitario Ramón y Cajal, Ctra. Colmenar Km 9,1, 28034 Madrid, Spain

Correspondence should be addressed to Claudia Geraldine Rita; moc.liamg@gatiraidualc

Received 24 November 2018; Revised 18 February 2019; Accepted 19 February 2019; Published 10 March 2019

Academic Editor: Christian Drouet

Copyright © 2019 Claudia Geraldine Rita et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is the most common form of autoimmune encephalitis, caused by the interaction between an antibody and its target, located on glutamate receptor type N-methyl-D-aspartate (NMDA) of neuronal surface. There is a wide spectrum of clinical features starting by a viral-like prodrome, followed by symptoms such as psychosis, aggressive behaviour, memory loss, seizures, movement disorders, and autonomic instability. Up to 50% of the affected young female patients have germ-cells tumours as ovarian teratoma, making it essential to establish an early diagnosis through detection of specific antibodies in serum and cerebrospinal fluid (CSF). This retrospective observational study was performed in patients whom positive anti-NMDA receptor antibodies have been tested, associated with clinical manifestations that suggest autoimmune encephalitis and a germ-cell tumour confirmed by pathology. Six patients have tested positive for anti-NMDA receptor antibodies associated with a germ-cell tumour and clinical manifestations of autoimmune encephalitis. Management includes aggressive immunosuppression and surgical removal.