Anti-N-methyl-D-aspartate receptor encephalitis associated with chronic myelogenous leukemia, causality or

Ying Yu1, Jun-Li Liu2, Dai-Shi Tian3

  • 1Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

BMC Neurology
|April 24, 2022
PubMed
Abstract

Insights

This study reports the first association between anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and chronic myelogenous leukemia (CML). This finding suggests CML may be a potential underlying malignancy in limbic encephalitis cases.

Area of Science:

  • Neurology
  • Oncology
  • Immunology

Background:

  • Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a common autoimmune neurological disorder, frequently linked to ovarian teratomas.
  • This condition involves antibodies attacking NMDARs in the brain, leading to inflammation and neurological symptoms.

Observation:

  • A patient presented with symptoms of anti-NMDAR encephalitis, including fever, headache, and seizures.
  • Diagnostic tests confirmed anti-NMDAR antibodies in serum and cerebrospinal fluid (CSF).
  • A year later, the patient developed extreme leukocytosis, leading to a diagnosis of chronic myelogenous leukemia (CML) with the Philadelphia chromosome and BCR/ABL1 fusion transcripts.

Findings:

  • This case represents the first documented instance of anti-NMDAR encephalitis occurring in a patient with chronic myelogenous leukemia (CML).
  • The diagnosis of CML was made during the recovery phase of the encephalitis.

Implications:

  • This association suggests that CML should be considered as a potential paraneoplastic condition in patients diagnosed with limbic encephalitis.
  • Clinicians should maintain a high index of suspicion for underlying malignancies, including CML, in patients with autoimmune encephalitis.