Case report: Pediatric anti-gamma aminobutyric acid-B receptor encephalitis with benign prognosis

Yeping Wang; Xiaoyan Ren; Yu Shen; Yi Hua; Lu Xu; Weiran Zhang; Guoxia Sheng; Peifang Jiang; Zhefeng Yuan; Liu Liu; Feng Gao

doi:10.3389/fped.2023.1104001

Case report: Pediatric anti-gamma aminobutyric acid-B receptor encephalitis with benign prognosis

Front Pediatr. 2023 Mar 3:11:1104001. doi: 10.3389/fped.2023.1104001. eCollection 2023.

Authors

Yeping Wang^{1

2}, Xiaoyan Ren^{1

3}, Yu Shen^{1

3}, Yi Hua¹, Lu Xu¹, Weiran Zhang¹, Guoxia Sheng¹, Peifang Jiang¹, Zhefeng Yuan¹, Liu Liu¹, Feng Gao¹

Affiliations

¹ Department of Neurology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
² Department of Pediatric, Jinhua Maternity and Child Health Care Hospital, Jinhua, China.
³ Department of Neurology, Ningbo Women and Children's Hospital, Ningbo, China.

Abstract

Objective: To explore the clinical characteristics of pediatric anti-gamma-aminobutyric acid-B receptor (GABA_BR) encephalitis to enhance the understanding and improve the diagnostic and therapeutic strategies for this disease.

Methods: We report a rare case of a female pediatric patient with anti-GABA_BR encephalitis who was treated at the Children's Hospital of Zhejiang University School of Medicine. Literature search was performed to explore the clinical characteristics of pediatric anti-GABA_BR encephalitis.

Results: The patient exhibited recurrent epileptic seizure, status epilepticus, and psychiatric symptoms at the age of 11 years and 10 months. Anti-GABA_BR antibodies were positive in cerebrospinal fluid and serum. Brain magnetic resonance imaging (MRI) exhibited abnormal signals in the left hippocampus. Symptoms and abnormality of brain MRI were improved after administration of immunosuppressants, anti-seizure and antipsychotic drugs. Two of pediatric anti-GABA_BR encephalitis with clinical data were identified through literature search. Analysis of these three cases suggested that the pediatric patients primarily experienced limbic encephalitis, with no tumor incidence. A favorable immunotherapy response was demonstrated with a superior prognosis in all the cases.

Conclusions: We reported a pediatric anti-GABA_BR encephalitis case with early age of onset. Promt autoimmune antibody testing and tumor screening, as well as immunomodulatory treatment immediately after a definitive diagnosis are warranted to improve prognosis.

Keywords: anti-GABABR encephalitis; autoimmune encephalitis; benign prognosis; immunotherapy; pediatric.

Publication types

Case Reports

Grants and funding

Key Research and Development Programme of Zhejiang Province (Grant No. 2020C03038), National Natural Science Foundation of China (Grant No. 82001232), Zhejiang Provincial Natural Science Foundation of China (Grant No. LQ19H090002); Key social development projects of Jinhua science and technology plan project, Grant NO. 2022-3-128; Research and cultivation fund project of Jinhua Maternity and Child Health Care Hospital, Grant NO. HFB2021-2-03.