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BMC Res Notes. 2016 Jul 29;9:374. doi: 10.1186/s13104-016-2180-6.

First-episode psychosis in a 15 year-old female with clinical presentation of anti-NMDA receptor encephalitis: a case report and review of the literature.

Author information

1
Unit of Child and Adolescent Psychiatry, Department of Psychiatry, Hospital Vila Franca de Xira, R. do Parque Res. dos Povos 1, 2600-009, Vila Franca de Xira, Portugal.
2
Department of Psychiatry, Hospital Vila Franca de Xira, R. do Parque Res. dos Povos 1, 2600-009, Vila Franca de Xira, Portugal. amilcarss@gmail.com.
3
Faculty of Medicine, Institute of Pharmacology and Neurosciences, University of Lisbon, Lisbon, Portugal. amilcarss@gmail.com.
4
Unit of Neurosciences, Institute of Molecular Medicine, University of Lisbon, Av. Professor Egas Moniz, 1649-028, Lisbon, Portugal. amilcarss@gmail.com.
5
Child and Adolescent Psychiatry Unit, Hospital Dona Estefânia-Centro Hospitalar de Lisboa Central, R. Jacinta Marto, 1169-045, Lisbon, Portugal.
6
Department of Psychiatry, Hospital Vila Franca de Xira, R. do Parque Res. dos Povos 1, 2600-009, Vila Franca de Xira, Portugal.
7
CEDOC, Chronic Diseases Research Centre, Nova Medical School, Faculdade de Ciencias Médicas, New University of Lisbon, Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal.

Abstract

BACKGROUND:

Anti-NMDA receptor encephalitis is an autoimmune disease that was identified in 2007, and manifests in a stepwise manner with psychiatric, neurological and autonomic symptoms. The disease is caused by autoantibodies against NMDA receptors. It can have a paraneoplastic origin, mainly secondary to ovarian teratomas, but it can also be unrelated to the tumor. This disease can affect both sexes and all ages.

CASE PRESENTATION:

Here, we present a case of a 15 year-old female adolescent with first-episode psychosis with anti-NMDA receptor encephalitis not related to tumor, which manifested with delusion, hallucinations, panic attacks, agitation, and neurological symptoms, and later with autonomic instability. She was treated with immunotherapy and psychiatric medication resulting in improvement of her main psychiatric and neurological symptoms.

CONCLUSION:

Our main objective in presenting this case is to alert clinicians to this challenging and recent disease that has a clinical presentation that might resemble a functional psychiatric condition and can be underdiagnosed in the context of child and adolescent psychiatry.

KEYWORDS:

Adolescent; Anti-NMDA receptor encephalitis; Case report; First-episode psychosis; Psychosis

PMID:
27473459
PMCID:
PMC4966559
DOI:
10.1186/s13104-016-2180-6
[Indexed for MEDLINE]
Free PMC Article

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