Anti-NMDAR encephalitis misdiagnosed as Hashimoto's encephalopathy
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 d...
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| Veröffentlicht in: | European journal of paediatric neurology 2014-01, Vol.18 (1), p.72-74 |
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| container_title | European journal of paediatric neurology |
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| creator | Mirabelli-Badenier, M Biancheri, R Morana, G Fornarino, S Siri, L Celle, M.E Veneselli, E Vincent, A Gaggero, R Mancardi, M.M |
| description | 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. |
| doi_str_mv | 10.1016/j.ejpn.2013.07.002 |
| format | Article |
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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.</description><identifier>ISSN: 1090-3798</identifier><identifier>EISSN: 1532-2130</identifier><identifier>DOI: 10.1016/j.ejpn.2013.07.002</identifier><identifier>PMID: 23953644</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Anti-N-methyl-D-aspartate receptor encephalitis ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - drug therapy ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - physiopathology ; Brain Diseases - diagnosis ; Brain Diseases - drug therapy ; Diagnostic Errors ; Electroencephalography ; Encephalitis ; Epilepsy ; Female ; Hashimoto Disease - diagnosis ; Hashimoto Disease - drug therapy ; Hashimoto encephalopathy ; Humans ; Immunoglobulins, Intravenous - administration & dosage ; Immunoglobulins, Intravenous - pharmacology ; Immunologic Factors - administration & dosage ; Immunologic Factors - pharmacology ; Magnetic Resonance Imaging ; Neurology ; Neuronal surface antibodies ; Paraneoplastic ; Pediatrics ; Treatment Outcome</subject><ispartof>European journal of paediatric neurology, 2014-01, Vol.18 (1), p.72-74</ispartof><rights>European Paediatric Neurology Society</rights><rights>2013 European Paediatric Neurology Society</rights><rights>Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-5ffb466b2093efb27704a4994c2906e4d4f3b7a88318aa68924cb7153d55fbf33</citedby><cites>FETCH-LOGICAL-c444t-5ffb466b2093efb27704a4994c2906e4d4f3b7a88318aa68924cb7153d55fbf33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1090379813001256$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23953644$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mirabelli-Badenier, M</creatorcontrib><creatorcontrib>Biancheri, R</creatorcontrib><creatorcontrib>Morana, G</creatorcontrib><creatorcontrib>Fornarino, S</creatorcontrib><creatorcontrib>Siri, L</creatorcontrib><creatorcontrib>Celle, M.E</creatorcontrib><creatorcontrib>Veneselli, E</creatorcontrib><creatorcontrib>Vincent, A</creatorcontrib><creatorcontrib>Gaggero, R</creatorcontrib><creatorcontrib>Mancardi, M.M</creatorcontrib><title>Anti-NMDAR encephalitis misdiagnosed as Hashimoto's encephalopathy</title><title>European journal of paediatric neurology</title><addtitle>Eur J Paediatr Neurol</addtitle><description>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.</description><subject>Adolescent</subject><subject>Anti-N-methyl-D-aspartate receptor encephalitis</subject><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis</subject><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - drug therapy</subject><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - physiopathology</subject><subject>Brain Diseases - diagnosis</subject><subject>Brain Diseases - drug therapy</subject><subject>Diagnostic Errors</subject><subject>Electroencephalography</subject><subject>Encephalitis</subject><subject>Epilepsy</subject><subject>Female</subject><subject>Hashimoto Disease - diagnosis</subject><subject>Hashimoto Disease - drug therapy</subject><subject>Hashimoto encephalopathy</subject><subject>Humans</subject><subject>Immunoglobulins, Intravenous - administration & dosage</subject><subject>Immunoglobulins, Intravenous - pharmacology</subject><subject>Immunologic Factors - administration & dosage</subject><subject>Immunologic Factors - pharmacology</subject><subject>Magnetic Resonance Imaging</subject><subject>Neurology</subject><subject>Neuronal surface antibodies</subject><subject>Paraneoplastic</subject><subject>Pediatrics</subject><subject>Treatment Outcome</subject><issn>1090-3798</issn><issn>1532-2130</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1u1DAUha2KipbCC3SBZkc3Sa9_YscSQhpNC0UqIPGzthznhnHIxGmcqTRv02fpk-FoShdd0JW9-M6R_R1CTinkFKg8b3Nshz5nQHkOKgdgB-SYFpxljHJ4ke6gIeNKl0fkVYwtAGjB5EtyxLguuBTimKyW_eSzr18ult8X2Dsc1rbzk4-LjY-1t7_7ELFe2Hh_d2Xj2m_CFN7FRzIMdlrvXpPDxnYR3zycJ-TXx8ufq6vs-tunz6vldeaEEFNWNE0lpKwYaI5NxZQCYYXWwjENEkUtGl4pW5acltbKUjPhKpX-UxdFUzWcn5Czfe8whpstxsmkRzrsOttj2EZDCyqV0ELq51GhodQq4Qlle9SNIcYRGzOMfmPHnaFgZs-mNbNnM3s2oEzynEJvH_q31Qbrx8g_sQl4vwcwCbn1OJro_Kyt9iO6ydTB_7__w5O463zvne3-4A5jG7Zjn1QbaiIzYH7MS89Dp92BskLyvymioro</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Mirabelli-Badenier, M</creator><creator>Biancheri, R</creator><creator>Morana, G</creator><creator>Fornarino, S</creator><creator>Siri, L</creator><creator>Celle, M.E</creator><creator>Veneselli, E</creator><creator>Vincent, A</creator><creator>Gaggero, R</creator><creator>Mancardi, M.M</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20140101</creationdate><title>Anti-NMDAR encephalitis misdiagnosed as Hashimoto's encephalopathy</title><author>Mirabelli-Badenier, M ; Biancheri, R ; Morana, G ; Fornarino, S ; Siri, L ; Celle, M.E ; Veneselli, E ; Vincent, A ; Gaggero, R ; Mancardi, M.M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-5ffb466b2093efb27704a4994c2906e4d4f3b7a88318aa68924cb7153d55fbf33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Anti-N-methyl-D-aspartate receptor encephalitis</topic><topic>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis</topic><topic>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - drug therapy</topic><topic>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - physiopathology</topic><topic>Brain Diseases - diagnosis</topic><topic>Brain Diseases - drug therapy</topic><topic>Diagnostic Errors</topic><topic>Electroencephalography</topic><topic>Encephalitis</topic><topic>Epilepsy</topic><topic>Female</topic><topic>Hashimoto Disease - diagnosis</topic><topic>Hashimoto Disease - drug therapy</topic><topic>Hashimoto encephalopathy</topic><topic>Humans</topic><topic>Immunoglobulins, Intravenous - administration & dosage</topic><topic>Immunoglobulins, Intravenous - pharmacology</topic><topic>Immunologic Factors - administration & dosage</topic><topic>Immunologic Factors - pharmacology</topic><topic>Magnetic Resonance Imaging</topic><topic>Neurology</topic><topic>Neuronal surface antibodies</topic><topic>Paraneoplastic</topic><topic>Pediatrics</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mirabelli-Badenier, M</creatorcontrib><creatorcontrib>Biancheri, R</creatorcontrib><creatorcontrib>Morana, G</creatorcontrib><creatorcontrib>Fornarino, S</creatorcontrib><creatorcontrib>Siri, L</creatorcontrib><creatorcontrib>Celle, M.E</creatorcontrib><creatorcontrib>Veneselli, E</creatorcontrib><creatorcontrib>Vincent, A</creatorcontrib><creatorcontrib>Gaggero, R</creatorcontrib><creatorcontrib>Mancardi, M.M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>European journal of paediatric neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mirabelli-Badenier, M</au><au>Biancheri, R</au><au>Morana, G</au><au>Fornarino, S</au><au>Siri, L</au><au>Celle, M.E</au><au>Veneselli, E</au><au>Vincent, A</au><au>Gaggero, R</au><au>Mancardi, M.M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anti-NMDAR encephalitis misdiagnosed as Hashimoto's encephalopathy</atitle><jtitle>European journal of paediatric neurology</jtitle><addtitle>Eur J Paediatr Neurol</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>18</volume><issue>1</issue><spage>72</spage><epage>74</epage><pages>72-74</pages><issn>1090-3798</issn><eissn>1532-2130</eissn><abstract>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.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>23953644</pmid><doi>10.1016/j.ejpn.2013.07.002</doi><tpages>3</tpages></addata></record> |
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| subjects | Adolescent Anti-N-methyl-D-aspartate receptor encephalitis Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis Anti-N-Methyl-D-Aspartate Receptor Encephalitis - drug therapy Anti-N-Methyl-D-Aspartate Receptor Encephalitis - physiopathology Brain Diseases - diagnosis Brain Diseases - drug therapy Diagnostic Errors Electroencephalography Encephalitis Epilepsy Female Hashimoto Disease - diagnosis Hashimoto Disease - drug therapy Hashimoto encephalopathy Humans Immunoglobulins, Intravenous - administration & dosage Immunoglobulins, Intravenous - pharmacology Immunologic Factors - administration & dosage Immunologic Factors - pharmacology Magnetic Resonance Imaging Neurology Neuronal surface antibodies Paraneoplastic Pediatrics Treatment Outcome |
| title | Anti-NMDAR encephalitis misdiagnosed as Hashimoto's encephalopathy |
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