Postępy Psychiatrii i Neurologii

Abstract

2/2019 vol. 28
Case report

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

  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.

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