eISSN: 2720-5371
ISSN: 1230-2813
Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii
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2/2019
vol. 28
 
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abstract:
Case report

Autoimmune encephalitis with anti-NMDAR antibodies in multiple myeloma – case report and literature review

Anna Stanowska
1
,
Barbara Wach
1
,
Marcin Wnuk
2

  1. Department of Neurology, 5th Military Hospital with Policlinic in Cracow, Poland
  2. Department of Neurology, Jagiellonian University Medical College, Cracow, Poland
Adv Psychiatry Neurol 2019; 28 (2): 162-167
Online publish date: 2019/06/28
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Purpose
The initial presentation of autoimmune encephalitis (AIE) may resemble other disorders and a comprehensive investigation is required. In this paper we emphasize the challenges faced by a treating team performing a differential diagnosis and the necessity for insightful multidisciplinary collaboration.

Case description
We report on the case of a 67-year old man who developed transient disturbances of consciousness in the course of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, which was the first manifestation of malignant myeloma. To our knowledge, this is the first case of anti-NMDAR encephalitis associated with multiple myeloma described in the literature.

Comment
AIE with anti-NMDAR antibodies has become a well-characterised variant of the condition. AIE may or may not be associated with tumour; therefore it is necessary to use the screening approach for primary malignancy. A proper diagnosis is essential in management due to AIE’s potential to respond to immunotherapy and tumour removal if one is present.

keywords:

multiple myeloma, autoimmune encephalitis, anti-NMDAR antibodies, paraneoplastic neurological syndrome

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