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Anti-N-methyl-D-aspartate receptor encephalitis: case report A 22-year-old woman developed anti-N-methyl-D-aspartate (NMDA) receptor encephalitis following vaccination with Dtap-poliovirus-vaccine. The woman experienced an acute polymorph psychotic episode following administration of Dtap-poliovirus-vaccine [Repevax; Tdap-IPV booster]. She received vaccine at the beginning of January 2019 and experienced an immediate "strange" feeling. She rapidly developed flu-like symptoms (headache, jittering). After 3 days, she was admitted due to psychosis-like symptoms: she was hearing her thoughts and developed paranoia. Anti-NMDA receptor IgG antibodies against the GluN1 subunit (titer 1:80 3 days following the symptom-onset; titer 1:320 following 6 days) were detected in her serum. After 6 days, she was discharged. Her mother reported that she behaved like a toddler. She was helpless, dependent and unbalanced. She was readmitted 47 days after the vaccination due to persistent anxiety and ambivalence. Therefore, the woman received lorazepam, and her anxiety slightly improved. Fifty three days following the vaccination, she presented herself to hospital and compained of pronounced anxiety, strong restlessness, an inability to make decisions, sensory overload and cognitive deficits. She was emotionally unstable. She also reported difficulties in falling asleep and sleeping through the night, reduced appetite and a 4–5kg of weight loss over 2 months. Additionally, she reported experiencing burning sensations on the chest and head with intermittent tachycardia. A brain MRI showed few slight, nonspecific bi-frontal white matter lesions. An EEG revealed a βrhythm with rare intermittent slow wave activity of 6–7/s. Independent component analysis demonstrated a frontocentral topography compatible with tiredness. AntiNMDA receptor GluN1-IgG antibodies were still positive. A [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) examination revealed pronounced relative hypermetabolism of parts of the association cortices and a relative hypometabolism of the primary cortices, and these findings were well compatible with encephalitis. A long-term ECG revealed recurrent sinus tachycardia, which stopped at night. Neuropsychological examination showed significant deficits in working memory. The vaccination titres showed the following: anti-tetanus toxoid IgG 5 IU/mL, diphtheria antitoxin IgG 2 IU/mL, anti-pertussis IgG 154.67 IU/mL, antipolio 1 >1:512, and anti-polio 3 >1:512. Subsequently, lorazepam was stopped, and her anxiety symptoms worsened. Then, she was treated with diazepam and methylprednisolone. Later, diazepam was stopped. On day 5 of methylprednisolone, she felt well. Over the following 2 weeks, her ambivalence and fear reduced, emotions stabilised. A slight form of sleeping disorder persisted; however, her appetite improved. At a follow.-up, an improvement was noted. Her anti-NMDA antibody titres decreased. Approximately, after a half year of treatment with methylprednisolone, she was completely free from sympt