SLE and Anti-NMDA Receptor Encephalitis in an 18 Year-Old Presenting with a Skin Rash

Abstract

Encephalitides such as anti-NMDA receptor encephalitis have been on the rise in recent years. Anti-NMDA receptor encephalitis most commonly presents as psychosis, delusions, and other neurological deficits. As with most autoimmune disorders, anti-NMDA receptor encephalitis has a higher incidence in females and the average age of onset is 23 An(An what is mean) 18 year old male presented with a rash and agitation that was diagnosed as HSV, and suffered TEN after beginning acyclovir treatment. After the patient deteriorated and was unsuccessful in responding to multiple sedatives for agitation, the proper autoimmune pathology was narrowed down to anti-NMDA receptor encephalitis. In previous cases of anti-NMDA receptor encephalitis -patients responded to some sedative agents like dexmedetomidine. The patient responded well to IVIG, methylprednisone, and hydroxychloroquine treatment. 80% of people show full recovery from the condition if treated properly, this patient passed away from cardiac arrest 8 months after recovering. The unique case presented discusses the challenges of diagnosing and managing anti-NMDA receptor encephalitis, and warrants the need for further investigation of the pathophysiology and differing responses to sedative agents in patients.