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Two Unique Cases with Anti-GluR Antibody-Positive Encephalitis
Kosuke Matsuzono1, Tomoko Kurata, Shoko Deguchi
1Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Two male patients with anti-glutamic acid receptor (anti-GluR) antibody encephalitis presented with Parkinsonism and autonomic dysfunction. Delayed MRI lesions in the claustrum and pons were observed, with antibodies detected in cerebrospinal fluid but not serum.
Area of Science:
- Neurology
- Immunology
- Neuroscience
Background:
- Anti-glutamic acid receptor (anti-GluR) antibody encephalitis is a rare autoimmune disorder.
- Early diagnosis and treatment are crucial for favorable outcomes.
Observation:
- Two male patients presented with anti-GluR antibody-positive encephalitis.
- Clinical manifestations included Parkinsonism, urinary retention, and paralytic ileus.
- Magnetic resonance imaging (MRI) revealed delayed lesions in the bilateral claustrum and pons, atypical for early-stage non-herpetic encephalitis.
Findings:
- Cerebrospinal fluid (CSF) analysis confirmed the presence of anti-GluRɛ2 and δ2 antibodies in both cases.
- Serum antibody testing was negative in both patients.
- The findings highlight a distinct pattern of neurological involvement and antibody detection.
Implications:
- This case report underscores the importance of considering anti-GluR antibody encephalitis in patients with unexplained neurological and autonomic symptoms.
- The delayed MRI findings and specific antibody profile suggest a unique pathogenic mechanism.
- Prompt diagnosis and initiation of treatment, even with initially negative serum tests, may be critical for patient recovery.
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