Anti-dipeptidyl-peptidase-like protein 6 encephalitis with pure cerebellar ataxia: a case report

BMC Neurol. 2022 Jul 1;22(1):242. doi: 10.1186/s12883-022-02769-0.

Abstract

Background: Anti-dipeptidyl-peptidase-like protein 6 (DPPX) encephalitis is a rare autoimmune encephalitis. The clinical symptoms of anti-DPPX encephalitis are often severe, manifested as diarrhea/weight loss, central nervous system hyperexcitability and cognitive dysfunction.

Case presentation: An 18-year-old boy was admitted for 1-week-long cerebellar symptoms including dizziness, unsteady gait and frequent vomiting. Magnetic resonance imaging (MRI) displayed no abnormal findings. However, autoimmune encephalitis panel revealed anti-DPPX antibody was positive in the serum. This patient completely recovered after immunoglobulin and corticoids therapy. In addition, repeat serum antibody test for DPPX was negative within one month.

Conclusion: In addition to the classic triad, anti-DPPX encephalitis may manifest as mild and rare symptoms due to lower antibody titers. Fast identification of rare symptoms can help to quickly diagnosis and effective treatment.

Keywords: Antibody; Autoimmune encephalitis; Case report; Cerebellar ataxia; Dipeptidyl-peptidase-like protein 6.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Cerebellar Ataxia*
  • Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
  • Encephalitis* / complications
  • Encephalitis* / diagnosis
  • Encephalitis* / drug therapy
  • Hashimoto Disease
  • Humans
  • Male
  • Nerve Tissue Proteins
  • Potassium Channels

Substances

  • Nerve Tissue Proteins
  • Potassium Channels
  • Dipeptidyl-Peptidases and Tripeptidyl-Peptidases

Supplementary concepts

  • Hashimoto's encephalitis