Precocious puberty as a consequence of anti-NMDA receptor encephalitis in children
Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is one of the most common autoimmune encephalitis in children. Most children recovered well after anti-NMDA receptor encephalitis. However, the NMDA receptor network functions are critical for the developing brain in children. The lo...
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Elsevier
2021-07-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957221000450 |
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| author | Po-Ming Wu Chao-Ku Teng Yen-Yin Chou Yi-Fang Tu |
| author_facet | Po-Ming Wu Chao-Ku Teng Yen-Yin Chou Yi-Fang Tu |
| author_sort | Po-Ming Wu |
| collection | DOAJ |
| description | Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is one of the most common autoimmune encephalitis in children. Most children recovered well after anti-NMDA receptor encephalitis. However, the NMDA receptor network functions are critical for the developing brain in children. The long-term consequences in pediatric patients of anti-NMDA receptor encephalitis are very infrequently reported. Methods: This case series study retrospectively enrolled 10 children aged below 18 years old with antibody-proved anti-NMDA receptor encephalitis in a tertiary medical center from 2010 to 2019. Long-term neurological consequences of anti-NMDA receptor encephalitis in children were followed. Results: One boy and nine girls were enrolled with a median onset age of 3.6 years. The most common initial presentation was verbal reduction and psychiatric symptoms soon after some flu-like prodromal symptoms. Nearly all patients then developed decreased level of consciousness, mutism, seizures and orofacial-lingual dyskinesia. Autonomic instability occurred in 5 patients, particularly in pre-pubertal children. Only one adolescent patient had ovarian teratoma. All patients survived after immunotherapy and were followed for 5.8 ± 3.3 years after discharge. Four had epilepsy within 2 years after encephalitis, four had a cognitive deficit, one had mild psychiatric symptoms of hallucination, and none had residual involuntary movements. Moreover, two pre-pubertal children developed central precocious puberty about 3 years after encephalitis, and one required gonadotropin-releasing hormone agonist treatment. Conclusion: Central precocious puberty could be a consequence of anti-NMDA receptor encephalitis in the pre-pubertal children. The pediatrician should pay attention to its occurrence at follow-up. |
| format | Article |
| id | doaj-art-939f686ed1e742f997a4cf8e51473e31 |
| institution | OA Journals |
| issn | 1875-9572 |
| language | English |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-939f686ed1e742f997a4cf8e51473e312025-08-20T02:10:12ZengElsevierPediatrics and Neonatology1875-95722021-07-0162436136810.1016/j.pedneo.2021.03.004Precocious puberty as a consequence of anti-NMDA receptor encephalitis in childrenPo-Ming Wu0Chao-Ku Teng1Yen-Yin Chou2Yi-Fang Tu3Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 70403, TaiwanDepartment of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 70403, TaiwanDepartment of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 70403, TaiwanDepartment of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 70403, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, 70101, Taiwan; Corresponding author. Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng-Li Road, North Dist., Tainan, 70403, Taiwan.Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is one of the most common autoimmune encephalitis in children. Most children recovered well after anti-NMDA receptor encephalitis. However, the NMDA receptor network functions are critical for the developing brain in children. The long-term consequences in pediatric patients of anti-NMDA receptor encephalitis are very infrequently reported. Methods: This case series study retrospectively enrolled 10 children aged below 18 years old with antibody-proved anti-NMDA receptor encephalitis in a tertiary medical center from 2010 to 2019. Long-term neurological consequences of anti-NMDA receptor encephalitis in children were followed. Results: One boy and nine girls were enrolled with a median onset age of 3.6 years. The most common initial presentation was verbal reduction and psychiatric symptoms soon after some flu-like prodromal symptoms. Nearly all patients then developed decreased level of consciousness, mutism, seizures and orofacial-lingual dyskinesia. Autonomic instability occurred in 5 patients, particularly in pre-pubertal children. Only one adolescent patient had ovarian teratoma. All patients survived after immunotherapy and were followed for 5.8 ± 3.3 years after discharge. Four had epilepsy within 2 years after encephalitis, four had a cognitive deficit, one had mild psychiatric symptoms of hallucination, and none had residual involuntary movements. Moreover, two pre-pubertal children developed central precocious puberty about 3 years after encephalitis, and one required gonadotropin-releasing hormone agonist treatment. Conclusion: Central precocious puberty could be a consequence of anti-NMDA receptor encephalitis in the pre-pubertal children. The pediatrician should pay attention to its occurrence at follow-up.http://www.sciencedirect.com/science/article/pii/S1875957221000450anti-NMDA receptor encephalitischildrenprecocious puberty |
| spellingShingle | Po-Ming Wu Chao-Ku Teng Yen-Yin Chou Yi-Fang Tu Precocious puberty as a consequence of anti-NMDA receptor encephalitis in children Pediatrics and Neonatology anti-NMDA receptor encephalitis children precocious puberty |
| title | Precocious puberty as a consequence of anti-NMDA receptor encephalitis in children |
| title_full | Precocious puberty as a consequence of anti-NMDA receptor encephalitis in children |
| title_fullStr | Precocious puberty as a consequence of anti-NMDA receptor encephalitis in children |
| title_full_unstemmed | Precocious puberty as a consequence of anti-NMDA receptor encephalitis in children |
| title_short | Precocious puberty as a consequence of anti-NMDA receptor encephalitis in children |
| title_sort | precocious puberty as a consequence of anti nmda receptor encephalitis in children |
| topic | anti-NMDA receptor encephalitis children precocious puberty |
| url | http://www.sciencedirect.com/science/article/pii/S1875957221000450 |
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