Infectious Trigger for Autoimmune Encephalitis: A Case Report and Literature Review
Herpes simplex virus 1 infection is a common cause of encephalitis (HSVE) in the United States. Post-HSVE development of N-methyl-D-aspartate receptor (NMDAR) antibodies resulting in autoimmune encephalitis is a rare complication, primarily affecting children and young adults. Anti-NMDAR develops 1–...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2019/5731969 |
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| author | Najmus Sahar Alexander Michael Nurre Ryan Q. Simon |
| author_facet | Najmus Sahar Alexander Michael Nurre Ryan Q. Simon |
| author_sort | Najmus Sahar |
| collection | DOAJ |
| description | Herpes simplex virus 1 infection is a common cause of encephalitis (HSVE) in the United States. Post-HSVE development of N-methyl-D-aspartate receptor (NMDAR) antibodies resulting in autoimmune encephalitis is a rare complication, primarily affecting children and young adults. Anti-NMDAR develops 1–4 weeks after HSVE, manifesting as choreoathetosis and/or orofacial dyskinesia in children and psychiatric symptoms in young adults. We describe a case of a 61-year-old male who presented with agitation, behavioral changes, and confusion eight months after being treated for HSVE. Extensive investigation was unrevealing except for cerebrospinal fluid lymphocytic pleocytosis, a positive anti-NMDAR Ab titer 1 : 64, and imaging changes consistent with postviral encephalitis suggestive of HSV-induced anti-NMDAR encephalitis. Aggressive therapy resulted in limited success and persistent neurologic deficits. The unique features of this case are the old age of the patient and preceding HSVE which triggered this autoimmune process. Physicians should consider anti-NMDAR encephalitis in the differentials for relapsing patients after HSVE. |
| format | Article |
| id | doaj-art-56caa3f55aa542b9bc57e08924fa6e60 |
| institution | OA Journals |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-56caa3f55aa542b9bc57e08924fa6e602025-08-20T02:05:56ZengWileyCase Reports in Infectious Diseases2090-66252090-66332019-01-01201910.1155/2019/57319695731969Infectious Trigger for Autoimmune Encephalitis: A Case Report and Literature ReviewNajmus Sahar0Alexander Michael Nurre1Ryan Q. Simon2Wright State University Boonshoft School of Medicine, Miami Valley Hospital, Dayton, Ohio, USABoonshaft School of Medicine, Class 2019, Dayton, Ohio, USAWright State University Boonshoft School of Medicine, Miami Valley Hospital, Dayton, Ohio, USAHerpes simplex virus 1 infection is a common cause of encephalitis (HSVE) in the United States. Post-HSVE development of N-methyl-D-aspartate receptor (NMDAR) antibodies resulting in autoimmune encephalitis is a rare complication, primarily affecting children and young adults. Anti-NMDAR develops 1–4 weeks after HSVE, manifesting as choreoathetosis and/or orofacial dyskinesia in children and psychiatric symptoms in young adults. We describe a case of a 61-year-old male who presented with agitation, behavioral changes, and confusion eight months after being treated for HSVE. Extensive investigation was unrevealing except for cerebrospinal fluid lymphocytic pleocytosis, a positive anti-NMDAR Ab titer 1 : 64, and imaging changes consistent with postviral encephalitis suggestive of HSV-induced anti-NMDAR encephalitis. Aggressive therapy resulted in limited success and persistent neurologic deficits. The unique features of this case are the old age of the patient and preceding HSVE which triggered this autoimmune process. Physicians should consider anti-NMDAR encephalitis in the differentials for relapsing patients after HSVE.http://dx.doi.org/10.1155/2019/5731969 |
| spellingShingle | Najmus Sahar Alexander Michael Nurre Ryan Q. Simon Infectious Trigger for Autoimmune Encephalitis: A Case Report and Literature Review Case Reports in Infectious Diseases |
| title | Infectious Trigger for Autoimmune Encephalitis: A Case Report and Literature Review |
| title_full | Infectious Trigger for Autoimmune Encephalitis: A Case Report and Literature Review |
| title_fullStr | Infectious Trigger for Autoimmune Encephalitis: A Case Report and Literature Review |
| title_full_unstemmed | Infectious Trigger for Autoimmune Encephalitis: A Case Report and Literature Review |
| title_short | Infectious Trigger for Autoimmune Encephalitis: A Case Report and Literature Review |
| title_sort | infectious trigger for autoimmune encephalitis a case report and literature review |
| url | http://dx.doi.org/10.1155/2019/5731969 |
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