Anti-N-methyl-d-aspartate receptor encephalitis during pregnancy: A case report

The Journal of Obstetrics and Gynaecology Research
Ahmet O KeskinVesile Ozturk

Abstract

Following a generalized tonic-clonic seizure, a previously healthy 27-year-old pregnant woman (18-week pregnancy) was admitted to our emergency department. She experienced lethargy, forgetfulness and persecutory hallucinations the day before hospitalization. Cerebrospinal fluid examination revealed moderate pleocytosis, and abdominal ultrasonography did not detect neoplasia. Orofacial dyskinesia, catatonia and central hypoventilation gradually developed despite medical intervention to ameliorate the symptoms. At 32 weeks of pregnancy, vaginal bleeding and hypotension occurred. Further, owing to septic shock due to fetal demise, the patient died. N-methyl-d-aspartate antibody test results obtained after the patient's death were positive (2++). Currently, no consensus exists on the appropriate treatment and follow-up for pregnant women with anti-N-methyl-d-aspartate receptor encephalitis; however, immunomodulators and teratoma resection may be helpful. Second line immunotherapy (rituximab, cyclophosphamide) and teratoma resection may be necessary in pregnant patients with high N-methyl-d-aspartate receptor antibody titers and inadequate response to first-line treatment.

References

Jul 14, 2010·Archives of Neurology·Monisha A KumarJosep Dalmau
Nov 26, 2010·Blood·Eliza F ChakravartyPamela Farmer
Dec 18, 2010·Lancet Neurology·Josep DalmauRita Balice-Gordon
Mar 7, 2012·Acta Obstetricia Et Gynecologica Scandinavica·Janos L TanyiChristina S Chu
Mar 24, 2012·Autoimmunity Reviews·Harry E PeeryWarren G Foster
Dec 3, 2014·Schizophrenia Research·Matthew S Kayser, Josep Dalmau
Feb 25, 2015·Obstetrics and Gynecology·Leah M Lamale-SmithJulie B Scott
Jun 11, 2017·Taiwanese Journal of Obstetrics & Gynecology·Yan-Chao ShiDa-Yong Du

❮ Previous
Next ❯

Citations

Jan 18, 2020·Neurology. Neuroimmunology and Neuroinflammation·Bastien JoubertJosep Dalmau
Sep 15, 2020·Therapeutic Advances in Neurological Disorders·Ayse AltintasKerstin Hellwig
Aug 17, 2021·The Journal of Obstetrics and Gynaecology Research·Jiaxin GuRuiqi Duan

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anti-N-Methyl-D-Aspartate Receptor Encephalitis

Anti-N-Methyl-D-Aspartate (NMDA) receptor encephalitis is a form of of brain inflammation due to antibodies against NMDA receptors. Discover the latest research on anti-NMDA receptor encephalitis here.

CSF & Lymphatic System

This feed focuses on Cerebral Spinal Fluid (CSF) and the lymphatic system. Discover the latest papers using imaging techniques to track CSF outflow into the lymphatic system in animal models.

Catatonia

Catatonia is a psychomotor syndrome with motor and behavioral symptoms, and can occur in both patients with or without psychiatric illness. Discover the latest research on Catatonia here.

Related Papers

Actas españolas de psiquiatría
Ana Iglesias-Alonso, Celso Iglesias-García
The American Journal of Emergency Medicine
Joseph FisherNoah Tolby
Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
Daniel G StoverDavid H Johnson
© 2022 Meta ULC. All rights reserved