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Obstet Gynecol. 2014 Feb;123(2 Pt 2 Suppl 2):433-5. doi: 10.1097/AOG.0000000000000078.

Anti-N-methyl-aspartate receptor encephalitis in identical twin sisters: role for oophorectomy.

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  • 1Department Obstetrics and Gynecology, UCLA David Geffen School of Medicine, Los Angeles, and the Department Obstetrics and Gynecology, Division of Gynecologic Oncology, Stanford School of Medicine, Stanford, California.

Abstract

BACKGROUND:

Anti-N-methyl-aspartate receptor encephalitis is a potentially fatal form of encephalitis and frequently associated with ovarian teratomas. Surgical removal of ovarian teratomas improves clinical outcome, but it is unclear whether bilateral salpingo-oophorectomy for normal-appearing ovaries is of clinical benefit.

CASE:

Our report describes a unique clinical scenario of identical twin sisters with anti-N-methyl-aspartate receptor encephalitis. Neither patient responded to immunosuppressive therapy. Imaging studies showed normal-appearing ovaries. The first twin continued on medical therapy only and died of the disease. The second twin underwent a bilateral salpingo-oophorectomy followed by gradual recovery.

CONCLUSION:

Based on our experience in two genetically identical individuals, we suggest considering the removal of normal-appearing ovaries in patients with anti-N-methyl-aspartate receptor encephalitis who fail to respond to medical treatment.

PMID:
24413237
[PubMed - indexed for MEDLINE]
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