Postpartum Anti-N-methyl-D-aspartate Receptor Encephalitis: A Case Report and Literature Review

Intern Med. 2017;56(3):357-362. doi: 10.2169/internalmedicine.56.7442. Epub 2017 Feb 1.

Abstract

We describe a 24-year-old woman with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis that developed 3 weeks after normal delivery. She was treated with methylprednisolone, intravenous immunoglobulin, and plasmapheresis, in addition to teratoma excision. However, her recovery was slow, and dysmnesia and mental juvenility persisted even two years after onset. To date, five patients with postpartum anti-NMDAR encephalitis have been reported. All of those patients showed psychotic symptoms and were suspected of having postpartum psychosis in the early period of the encephalitis. Changes in hormonal factors, modification of immune tolerance, or retrograde infection of the ovary may be contributing factors for postpartum anti-NMDAR encephalitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications*
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis*
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / drug therapy
  • Autoantibodies / immunology
  • Female
  • Humans
  • Immunoglobulins, Intravenous
  • Postpartum Period*
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / etiology*
  • Receptors, N-Methyl-D-Aspartate / immunology

Substances

  • Autoantibodies
  • Immunoglobulins, Intravenous
  • Receptors, N-Methyl-D-Aspartate