Encefalitis autoinmune por anticuerpos NMDA-R en tiempos del COVID-19

Bazalar, Giuliana; Azañero-Haro, Johan; Piscoya, Tatiana; Chambi, Liliana; Soto, Alonso

doi:10.36393/spmi.v36i1.724

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Autoimmune encephalitis exhibits a prevalence of 13.7 cases per 100,000 people annually, with anti-Nmethyl-D-aspartate (NMDA) encephalitis being the most common cause [3]. In the United States, an estimated 20,000 cases of encephalitis occur yearly, with 50% remaining inconclusive for infectious causes, indicating a potential autoimmune link [4,5].…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Neuroimaging Correlations in Autoimmune Encephalitis: A Report of Two Cases

Graos,

Montalvan,

Torres

et al. 2024

Cureus

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Autoimmune encephalitis is an infrequent pathological occurrence documented within our local context. When clinical suspicion arises, employing electroencephalogram and brain magnetic resonance imaging (MRI) proves valuable. However, for conclusive diagnosis confirmation, lumbar puncture for cerebrospinal fluid (CSF) analysis is indispensable. Managing this condition involves a combination of immunosuppression and, when necessary, tumor resection. We document the initial cases reported in our city, featuring two young patients without significant pre-existing conditions. Patients initially displayed behavioral alterations progressing to altered consciousness, febrile peaks, and challenging epileptic status, requiring intensive care and mechanical ventilation. The diagnosis was made based on MRI and anti-Nmethyl-D-aspartate (anti-NMDA) antibodies. Treatment involved intravenous (IV) immunoglobulins, plasmapheresis, and corticosteroids. After discharge, both had cognitive sequelae. Autoimmune encephalitis is a pathological condition that still lacks thorough exploration and reporting. It predominantly affects young patients without a history of acute psychiatric symptoms, necessitating consideration when behavioral alterations emerge. The challenges faced by small cities, including a shortage of technical resources, further impede the timely and precise diagnosis of this intricate condition.

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Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Neuroimaging Correlations in Autoimmune Encephalitis: A Report of Two Cases

Graos,

Montalvan,

Torres

et al. 2024

Cureus

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Possible temporal relationship between SARS-CoV-2 infection and anti-NMDA receptor encephalitis: a meta-analysis

Vasilevska,

Guest,

Szardenings

et al. 2024

Transl Psychiatry

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The global impact of SARS-CoV-2 infection has raised concerns about secondary diseases beyond acute illness. This review explores the significance and potential underlying mechanisms of how SARS-CoV-2 infection might elicit an immune response targeting N-methyl-D-aspartate (NMDA) receptors, and its implications for autoimmune-driven neuropsychiatric manifestations. We identified 19 published case reports of NMDA receptor encephalitis associated with SARS-CoV-2 infection or vaccination by a systematic literature search. The significance of these reports was limited since it is not clear if a coincidental or causal relationship exists between SARS-CoV-2 infection or vaccination and manifestation of NMDA receptor encephalitis. The included studies were hampered by difficulties in establishing if these patients had pre-existing NMDA receptor antibodies which entered the brain by infection- or vaccination-associated transient blood-brain barrier leakage. In addition, four cases had comorbid ovarian teratoma, which is a known trigger for development of NMDA receptor encephalitis. Considering that billions of people have contracted COVID-19 or have been vaccinated against this virus, the publication of only 19 case reports with a possible link to NMDA receptor encephalitis, indicates that it is rare. In conclusion, these findings do not support the case that SARS-CoV-2 infection or vaccination led to an increase of existing or de novo encephalitis mediated by an autoimmune response targeting NMDA receptor function. Nevertheless, this work underscores the importance of ongoing vigilance in monitoring viral outbreaks and their potential impact on the central nervous system through basic, epidemiological and translational research.

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Encefalitis autoinmune por anticuerpos NMDA-R en tiempos del COVID-19

Cited by 2 publications

References 17 publications

Clinical Characteristics and Neuroimaging Correlations in Autoimmune Encephalitis: A Report of Two Cases

Clinical Characteristics and Neuroimaging Correlations in Autoimmune Encephalitis: A Report of Two Cases

Possible temporal relationship between SARS-CoV-2 infection and anti-NMDA receptor encephalitis: a meta-analysis

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