Case report: Coexistence of Labbe vein thrombosis and autoimmune encephalitis with two different antibodies

Abstract

Anti-NMDA receptor encephalitis is an autoimmune encephalitis well- known to pediatric neurologists. The characteristic combination of symptoms and detection of NMDA receptor antibody can confirm the diagnosis. Most children respond well to immunosuppressive therapy. Anti-GABAB receptor encephalitis usually occurs in adult patients. Most patients present clinically with symptoms of limbic encephalitis. Cases in pediatric patients are rare. Cerebral venous thrombosis also has a very low incidence in children without underlying diseases. Patients usually present with headaches, convulsions, and focal deficits. Anticoagulants are the first choice treatment. We report a boy initially diagnosed with Labbe vein thrombosis and later tested positive for both NMDA and GABAB receptors. Anticoagulants did not relieve the boy's symptoms, and immunosuppressive therapy achieved good results. The antibody titers were significantly reduced or even turned negative. Although the Labbe vein was not recanalized at four months follow-up, the brain lesion was significantly absorbed. We learn from this case that a child can be inflicted with cerebral venous thrombosis and autoimmune encephalitis simultaneously. Child patients respond well to treatment.

Morvan’s syndrome with hypercoagulable condition in a patient positive for anti-CASPR2 antibodies: A case report

“…Two studies have documented the presence of hypercoagulable state in NMDA-related or GABA-related autoimmune encephalitis. [8,9] Morvan’s syndrome represents another variant within the spectrum of autoimmune encephalitis. It is noteworthy to highlight that the patient described in this case of Morvan’s syndrome also presented with a hypercoagulable state, as evidenced by a low APTT and an elevated platelet count.…”