Successful treatment of anti-NMDA receptor encephalitis with a prompt ovarian tumour removal and prolonged course of plasmapheresis: A case report

Rypulak,Elzbieta; Borys,Michal; Piwowarczyk,Pawel; Fijalkowska,Magdalena; Potrec,Beata; Sysiak,Justyna; Spustek,Janusz; Bartkowska-Sniatkowska,Alicja; Kotarski ,Jan; Turski,Waldemar   A.; Rejdak,Konrad; Czuczwar,Miroslaw

doi:10.3892/mco.2016.1054

Successful treatment of anti-NMDA receptor encephalitis with a prompt ovarian tumour removal and prolonged course of plasmapheresis: A case report

Authors:
- Elzbieta Rypulak
- Michal Borys
- Pawel Piwowarczyk
- Magdalena Fijalkowska
- Beata Potrec
- Justyna Sysiak
- Janusz Spustek
- Alicja Bartkowska-Sniatkowska
- Jan Kotarski
- Waldemar A. Turski
- Konrad Rejdak
- Miroslaw Czuczwar
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Affiliations: The Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland, Department of Neurology, Neuropsychiatric Hospital, Lublin, Poland, Department of Paediatric Anaesthesiology and Intensive Therapy, Poznań University of Medical Sciences, Poznań, Poland, Department of Gynaecological Oncology and Gynaecology, Medical University of Lublin, Lublin, Poland, Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland, Department of Neurology, Medical University of Lublin, Lublin, Poland
Published online on: October 19, 2016 https://doi.org/10.3892/mco.2016.1054
Pages: 845-849

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Abstract

Anti-N-methyl-d-aspartate-receptor (NMDAR) encephalitis is an uncommon autoimmune disorder with a wide spectrum of neuropsychiatric symptoms. There is a great requirement to emphasize the importance of a multidisciplinary team approach in the process of diagnosis and treatment of the potentially fatal condition, including psychiatrists, neurologists, gynaecologists and intensivists. Physicians must be aware that psychiatric and neurological disorders, which are typical features for NMDAR encephalitis in young women with ovarian tumours, may progress into status epilepticus and respiratory insufficiency. This disease can only be successfully treated with prompt surgical intervention and an early implementation of a wide array of immunosuppressive therapies. Optimal timing of initiation of therapeutic plasma exchange, as well as duration of treatment necessary to achieve desirable outcomes in patients with NMDAR remains unknown. The present case report aims to raise awareness about the importance of early implementation of this potentially life-saving therapy and continuing the treatment courses until full subsidence of symptoms.

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