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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.

Clinical Medicine Insights. Case Reports
|July 12, 2013
PubMed

Insights

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.
Keywords:
MRIParkinsonismanti-GluR antibody-positive encephalitisautonomic failure

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