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Case Report
Anti-NMDA antibody autoimmune encephalitis post-HSV encephalitis: A rare case report
1 DrNB Neurology, Department of Neurology, Indraprastha Apollo Hospital, New Delhi, India
2 Professor/Senior Consultant, Department of Neurology, Indraprastha Apollo Hospital, New Delhi, India
3 Attending Consultant, Department of Neurology, Indraprastha Apollo Hospital, New Delhi, India
4 Senior Consultant, Department of Radiology, Indraprastha Apollo Hospital, New Delhi, India
Address correspondence to:
Pushpendra Nath Renjen
Professor/Senior Consultant, Department of Neurology, Indraprastha Apollo Hospital, New Delhi,
India
Message to Corresponding Author
Article ID: 100018N06NS2024
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How to cite this article
Sahu N, Renjen PN, Goswami A, Kanuga S, Goyal N. Anti-NMDA antibody autoimmune encephalitis post-HSV encephalitis: A rare case report. Edorium J Neurol 2024;9(1):1–4.ABSTRACT
Introduction: Autoimmune encephalitis is a group of neuropsychiatric disorder in which antibodies interact directly to their target antigen and produce neuronal dysfunction. Generally herpes simplex encephalitis is a monophasic illness although in few patients neurological worsening can develop some weeks later. This worsening is generally due to autoimmune encephalitis after herpes simplex encephalitis (AEaHSE).
Case Report: We report an interesting case report of 67 years old female patient who initially was diagnosed to have herpes simplex virus (HSV) encephalitis, showed improvement in her clinical status followed subsequently by deterioration in cognitive status. Anti-N-methyl-D-aspartate (NMDA) antibody was positive in cerebrospinal fluid (CSF) and serum. The patient was managed with intravenous immunoglobulin (IVIG) and subsequently showed improvement in her clinical state.
Conclusion: The discovery and clinical application of anti-NMDA receptor antibodies has helped to define the mechanism behind immune-based relapse of herpes simplex virus encephalitis (HSVE). This case illustrates the usefulness of testing for anti-NMDA receptor antibodies following worsening few weeks after treatment of herpes simplex encephalitis.
Keywords: Anti-NMDA encephalitis, Autoimmune, HSV encephalitis, Post-infection
SUPPORTING INFORMATION
Author Contributions
Neelam Sahu - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Pushpendra Nath Renjen - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Avinash Goswami - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Shams Kanuga - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nidhi Goyal - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Neelam Sahu et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
