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Anti-N-methyl-D-aspartate receptor encephalitis associated with hepatic neuroendocrine carcinoma: A case report

Ee Wei Lim1, Chun Wai Yip1

  • 1National Neuroscience Institute, Singapore General Hospital Campus, 20 College Road, Academia 169856, Singapore.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|March 7, 2017
PubMed

Insights

This case report highlights anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis in an older male associated with a rare hepatic neuroendocrine carcinoma. Early treatment showed partial symptom improvement, emphasizing the importance of considering this diagnosis in elderly patients.

Area of Science:

  • Neurology
  • Oncology

Background:

  • Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis is an autoimmune disorder.
  • Tumor association is less frequent in older individuals with Anti-NMDAR encephalitis.

Observation:

  • A 65-year-old male presented with symptoms of Anti-NMDAR encephalitis, including altered behavior and hallucinations.
  • Cerebrospinal fluid and plasma tests confirmed the presence of anti-NMDA receptor antibodies.
  • A hepatic neuroendocrine carcinoma was diagnosed in the patient.

Findings:

  • The patient received intravenous methylprednisolone, resulting in partial symptom improvement.
  • The co-occurrence of Anti-NMDAR encephalitis and hepatic neuroendocrine carcinoma in an elderly patient is rare.
  • The patient's advanced age and comorbidities precluded surgical or chemotherapeutic interventions.

Implications:

  • This case underscores the possibility of Anti-NMDAR encephalitis associated with uncommon tumors like hepatic neuroendocrine carcinoma in older adults.
  • Early diagnosis and treatment of Anti-NMDAR encephalitis can lead to partial symptom recovery, even in the presence of malignancy.
  • Further research is needed to understand the specific mechanisms and management strategies for paraneoplastic NMDAR encephalitis in the elderly population.
Keywords:
Anti-NMDAR encephalitisNeuroendocrine carcinomaParaneoplastic encephalitis

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