Anti-NMDAR encephalitis misdiagnosed as Hashimoto's encephalopathy |
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| Affiliation: | 1. Second Department of Neurology, University of Athens, School of Medicine, “Attikon” University Hospital, Athens, Greece;2. International Clinical Research Center, St. Anne''s University Hospital, Brno, Czech Republic;3. Second Department of Radiology, University of Athens, School of Medicine, “Attikon” University Hospital, Athens, Greece;4. Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany;5. First Department of Neurology, University of Athens, School of Medicine, “Eginition” University Hospital, Athens, Greece;6. Department of Enzymology and Cellular Function, Institute of Child Health, Aghia Sophia Children''s Hospital, Athens, Greece;1. Departments of Laboratory Medicine/Pathology and Neurology, Mayo Clinic, College of Medicine, Rochester, MN, USA;2. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK |
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| Abstract: | ![]()
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a well-defined autoimmune disorder. Hashimoto's encephalopathy (HE) is a still controversial entity, lacking definite diagnostic criteria.We described a 14-year-old-girl presenting with a clinical picture consistent with the diagnosis of anti-NMDAR encephalitis, confirmed by NMDAR antibody testing. Four years earlier, she had presented a similar episode of acute encephalopathy diagnosed as HE.Anti-NMDAR encephalitis and HE share similar clinical features so that the differential diagnosis can be difficult if specific antibodies are not tested. The correct diagnosis of anti-NMDAR encephalitis is crucial to plan the appropriate management and follow-up, namely in term of oncological screening, since it can be paraneoplastic in origin. We suggest to re-evaluate the clinical history of all subjects with previous HE diagnosis in order to evaluate the possible diagnosis of anti-NMDAR encephalitis and plan the appropriate management of these patients. |
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| Keywords: | Hashimoto encephalopathy Anti-N-methyl-D-aspartate receptor encephalitis Epilepsy Neuronal surface antibodies Paraneoplastic |
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