Four-year-old anti-N-methyl-D-aspartate receptor encephalitis patient with ovarian teratoma: A case report

Area of Science:

• Neurology
• Immunology
• Gynecologic Oncology

Background:

• Autoimmune encephalitis, including anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis, has a prevalence comparable to infectious encephalitis.
• Detection rates for autoimmune encephalitis are increasing, with some cases associated with ovarian teratomas.
• Tumor association in autoimmune encephalitis is less common in younger patients.

Observation:

• This case report details the successful treatment of a 4-year-old female child with NMDAR encephalitis.
• The treatment involved early laparoscopic ovarian cystectomy and immunotherapy.
• This represents the youngest patient reported to undergo laparoscopic ovarian cystectomy for NMDAR encephalitis.

Findings:

• Early surgical intervention (laparoscopic ovarian cystectomy) combined with immunotherapy can lead to successful treatment outcomes.
• Even in young patients, ovarian tumors should be considered as a potential complication of NMDAR encephalitis.
• Prompt diagnosis and treatment are critical for favorable prognoses.

Implications:

• All patients with suspected or confirmed NMDAR encephalitis should undergo ovarian tumor screening.
• Timely immunotherapy and surgical management of ovarian tumors are crucial for improving patient outcomes.
• This case highlights the importance of considering and managing potential underlying tumors in pediatric autoimmune encephalitis.