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Published online: 2022-07-21
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Ovarian teratoma-associated anti- Anti-N-methyl-D-aspartate receptor encephalitis: a clinical analysis of 5 cases

Li-dan He1, Xia Zhang1, Jianbo Wu1
DOI: 10.5603/GP.a2022.0068
·
Pubmed: 36597802
Affiliations
  1. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China, China

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2022-07-21

Abstract

Objectives: To analyse the clinical features, diagnosis, treatment, and prognosis of anti-N-methyl-D-aspartic acid receptor (NMDAR) encephalitis associated with ovarian mature teratomas.

Material and methods: Retrospectively analysed the clinical-laboratory data of five patients with anti-NMDAR encephalitis combined with ovarian teratoma at a single centre between March 2016 and June 2019.

Results: The mean age of the patients was 22.40 ± 2.89 years (range, 19–26 years). Five patients had premonitory fever symptoms, clinical manifestations of mental disorder or convulsions for starting, with varying degrees of involuntary movement. Brain MRI and electroencephalography lacked specificity, and cerebrospinal fluid resistance NMDAR antibody detection was the key to diagnosis. All patients experienced good outcomes in response to immunotherapy combined with ovarian tumour resection, with a median follow-up time of 36 months (range, 16–55 months). The MRS value of five patients decreased significantly half a year after surgery, and no encephalitis or ovarian tumour relapses were reported.

Conclusions: Anti-NMDA encephalitis caused by ovarian teratoma is mostly a non-specific clinical manifestation of neurological and mental abnormalities, which can be easily misdiagnosed and delayed, and doctors should fully recognise the disease, early diagnosis, and timely surgical intervention to improve the prognosis of patients.

Abstract

Objectives: To analyse the clinical features, diagnosis, treatment, and prognosis of anti-N-methyl-D-aspartic acid receptor (NMDAR) encephalitis associated with ovarian mature teratomas.

Material and methods: Retrospectively analysed the clinical-laboratory data of five patients with anti-NMDAR encephalitis combined with ovarian teratoma at a single centre between March 2016 and June 2019.

Results: The mean age of the patients was 22.40 ± 2.89 years (range, 19–26 years). Five patients had premonitory fever symptoms, clinical manifestations of mental disorder or convulsions for starting, with varying degrees of involuntary movement. Brain MRI and electroencephalography lacked specificity, and cerebrospinal fluid resistance NMDAR antibody detection was the key to diagnosis. All patients experienced good outcomes in response to immunotherapy combined with ovarian tumour resection, with a median follow-up time of 36 months (range, 16–55 months). The MRS value of five patients decreased significantly half a year after surgery, and no encephalitis or ovarian tumour relapses were reported.

Conclusions: Anti-NMDA encephalitis caused by ovarian teratoma is mostly a non-specific clinical manifestation of neurological and mental abnormalities, which can be easily misdiagnosed and delayed, and doctors should fully recognise the disease, early diagnosis, and timely surgical intervention to improve the prognosis of patients.

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Keywords

Anti-N-methyl-D-aspartate receptor (NMDAR); autoimmune encephalitis; ovarian teratoma; tumour resection; retrospective study

About this article
Title

Ovarian teratoma-associated anti- Anti-N-methyl-D-aspartate receptor encephalitis: a clinical analysis of 5 cases

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2022-07-21

Page views

206

Article views/downloads

155

DOI

10.5603/GP.a2022.0068

Pubmed

36597802

Keywords

Anti-N-methyl-D-aspartate receptor (NMDAR)
autoimmune encephalitis
ovarian teratoma
tumour resection
retrospective study

Authors

Li-dan He
Xia Zhang
Jianbo Wu

References (21)
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