Anti-NMDA Autoimmune Encephalitis due to Ovarian Teratoma: A Pediatric Case Report - Abstract
Encephalitis is a complex condition characterized by dysfunction in brain tissue resulting from infectious or autoimmune causes. Anti-NMDA receptor encephalitis is especially relevant in children and adolescents, often associated with ovarian teratomas. Diagnosis involves imaging exams, cerebrospinal fluid (CFS) analysis and laboratory tests, although differentiating between autoimmune and infectious causes is still challenging.
Objective: To understand the difficulties of diagnosing autoimmune encephalitis through a case report. Study design: Case report with authorization from the patient’s guardian. Results and Conclusion: The clinical case presented illustrates this difficulty, where behavioral and neurological symptoms were accompanied by a suspicion of autoimmune encephalitis, corroborated by an identified ovarian teratoma. Diagnostic confirmation, however, was hampered by the availability and cost of serology for anti-NMDA antibodies. Treatment involves early immunotherapy, especially when combined with surgical removal of the teratoma, resulting in a better prognosis. In the case described, immunotherapy was started quickly with methylprednisone and immunoglobulin associated with the removal of the ovarian teratoma; however, complete clinical improvement occurred after administration of rituximab.