Format

Send to

Choose Destination
Eur J Paediatr Neurol. 2014 Jan;18(1):72-4. doi: 10.1016/j.ejpn.2013.07.002. Epub 2013 Aug 15.

Anti-NMDAR encephalitis misdiagnosed as Hashimoto's encephalopathy.

Author information

1
Neuroscience Department, Istituto Giannina Gaslini, Genoa, Italy. Electronic address: marisol.mirabelli@gmail.com.
2
Neuroscience Department, Istituto Giannina Gaslini, Genoa, Italy.
3
Paediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy.
4
Paediatric Unit, San Paolo Hospital, Savona, Italy.
5
Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a well-defined autoimmune disorder. Hashimoto's encephalopathy (HE) is a still controversial entity, lacking definite diagnostic criteria. We described a 14-year-old-girl presenting with a clinical picture consistent with the diagnosis of anti-NMDAR encephalitis, confirmed by NMDAR antibody testing. Four years earlier, she had presented a similar episode of acute encephalopathy diagnosed as HE. Anti-NMDAR encephalitis and HE share similar clinical features so that the differential diagnosis can be difficult if specific antibodies are not tested. The correct diagnosis of anti-NMDAR encephalitis is crucial to plan the appropriate management and follow-up, namely in term of oncological screening, since it can be paraneoplastic in origin. We suggest to re-evaluate the clinical history of all subjects with previous HE diagnosis in order to evaluate the possible diagnosis of anti-NMDAR encephalitis and plan the appropriate management of these patients.

KEYWORDS:

Anti-N-methyl-D-aspartate receptor encephalitis; Epilepsy; Hashimoto encephalopathy; Neuronal surface antibodies; Paraneoplastic

PMID:
23953644
DOI:
10.1016/j.ejpn.2013.07.002
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center