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Overlapping anti-NMDAR encephalitis and multiple sclerosis: A case report and literature review

Pan Liu1, Hui Yan2, Haizhe Li1

  • 1Department of Neurology, The Central Hospital of Shaoyang, Shaoyang, Hunan, China.

Frontiers in Immunology
|February 16, 2023
PubMed

Insights

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis overlapping with multiple sclerosis (MS) is rare. This study reports a case and introduces mycophenolate mofetil as a novel therapy for this rare condition.

Area of Science:

  • Neuroimmunology
  • Neurology

Background:

  • Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis presents with severe neuropsychiatric symptoms and is diagnosed by detecting antibodies against the GluN1 subunit.
  • While diagnostic methods have improved, the co-occurrence of anti-NMDAR encephalitis and multiple sclerosis (MS) remains exceptionally rare.

Approach:

  • This report details a case of a male patient diagnosed with overlapping anti-NMDAR encephalitis and MS in mainland China.
  • A comprehensive review of previously reported cases of this rare overlap syndrome was conducted.
  • Mycophenolate mofetil was utilized as an immunosuppressive therapy, representing a novel therapeutic approach.

Key Points:

  • The study highlights the rarity of anti-NMDAR encephalitis co-occurring with MS.
  • It provides a clinical case from mainland China, expanding geographical data on this rare condition.
  • Mycophenolate mofetil is presented as a potential new treatment option.

Conclusions:

  • The successful use of mycophenolate mofetil offers a new therapeutic avenue for patients with overlapping anti-NMDAR encephalitis and MS.
  • Further research into this rare autoimmune neurological overlap syndrome is warranted to understand its pathogenesis and optimize treatment strategies.
Keywords:
anti-NMDAR encephalitisdemyelinating diseasemultiple sclerosismycophenolate mofetiloverlap

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