[Ovarian teratoma associated with anti-N-methyl-D-aspartate receptor encephalitis: a report of 5 cases and review of the literature]

Zhonghua Fu Chan Ke Za Zhi. 2014 Apr;49(4):281-6.
[Article in Chinese]

Abstract

Objective: To report the clinical features of ovarian teratoma in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

Methods: The clinical information of five female patients with ovarian teratoma and anti-NMDAR encephalitis in Peking Union Medical College Hospital and Beijing Tiantan Hospital affiliated to Capital Medical University from June 2011 to May 2013 were obtained. Relevant literatures were reviewed.

Results: The initial symptoms varied from respiratory prodromes or emotional incentives before the onset of psychiatric symptoms. Patients always presented with psychosis, bizarre dyskinesia and seizures. Antibodies to NMDAR in serum and cerebrospinal fluid (CSF) were positive; The psychiatric symptoms were dramatically relieved by tumor reception and immunotherapy which occurred in inverse order of symptom development. No evidence of tumor recurrence was observed during a short-time follow-up after the surgery.

Conclusions: Ovarian teratoma with anti-NMDAR encephalitis always presents with psychiatric symptoms which could be misdiagnosed as psychiatric diseases. Patients respond to tumor resection and immunotherapy.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Adult
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / etiology*
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / therapy
  • Autoantibodies / blood
  • Autoantibodies / cerebrospinal fluid
  • Female
  • Humans
  • Immunotherapy
  • Laparoscopy
  • Ovarian Neoplasms / complications*
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / immunology
  • Ovarian Neoplasms / therapy
  • Ovary / surgery
  • Receptors, N-Methyl-D-Aspartate / immunology*
  • Teratoma / complications*
  • Teratoma / diagnosis
  • Teratoma / immunology
  • Teratoma / therapy
  • Young Adult
  • gamma-Globulins / therapeutic use

Substances

  • Autoantibodies
  • Receptors, N-Methyl-D-Aspartate
  • gamma-Globulins