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Clinical Reasoning: A Dizzy Architect.

Adrian Scutelnic1, Aikaterini Galimanis1, Michael Horn1

  • 1From the Department of Neurology (A.S., A.G., N.M.), Thun Hospital; Center of Laboratory Medicine (M.H.), University Institute of Clinical Chemistry, University Hospital, Inselspital, Bern, Switzerland; and Neurology Service (L.S.), Hospital Clinic de Barcelona and Institut d'Investigació Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

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This summary is machine-generated.

Anti-Kelch-like protein 11 (KLHL11) encephalitis can be associated with tumors. Early diagnosis is crucial, even when an active neoplasia is not apparent, as a burnt-out tumor may be suspected.

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Area of Science:

  • Neurology
  • Oncology
  • Immunology

Background:

  • Anti-Kelch-like protein 11 (KLHL11) encephalitis is increasingly linked to various neoplasms, particularly seminoma.
  • Diagnostic challenges arise when neoplasia is uncertain and symptoms mimic other conditions.

Observation:

  • A 68-year-old male presented with clinical manifestations suggestive of anti-KLHL11 encephalitis.
  • No definitive signs of active malignancy were detected during initial evaluation.

Findings:

  • A suspected burnt-out germ cell tumor was identified in the patient.
  • This case underscores the potential for anti-KLHL11 encephalitis to present without overt, active neoplasia.

Implications:

  • Highlights the necessity of maintaining a high index of suspicion for anti-KLHL11 encephalitis in patients with relevant symptoms.
  • Emphasizes the importance of considering occult or regressed tumors in the differential diagnosis of autoimmune encephalitis.