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Neurology International
Volume 11
Issue 3
10.4081/ni.2019.8253
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Neurology International is published by MDPI from Volume 12 Issue 3 (2020). Previous articles were published by another publisher in Open Access under a CC-BY licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Case Report

A Critical Reflection on Our First Patient Presenting with Anti-Nmethyl- D-aspartate Receptor Encephalitis

by
Susanne Buechner
*,
Igor Florio
,
Gabriele J. Sixt
and
Francesco Teatini
Department of Neurology/Stroke Unit, General Hospital of Bolzano, Italy
*
Author to whom correspondence should be addressed.
Neurol. Int. 2019, 11(3), 8253; https://doi.org/10.4081/ni.2019.8253
Submission received: 24 July 2019 / Revised: 24 July 2019 / Accepted: 26 August 2019 / Published: 18 September 2019

Abstract

One of the best characterized autoimmune encephalitis is the Anti-Nmethyl-D-aspartate receptor (NMDAR) encephalitis, which may occur in the presence of cancer. First- and second-line immunotherapy and oncological investigations are suggested. We present here a case of an 18-year-old female who was our first patient suffering from Anti-NMDAR encephalitis more than 9 years ago. She was satisfactorily treated with intravenous immunoglobulins and high dose steroid therapy. After more than one year the patient had a relapse. First-line immunotherapy was repeated; however, a complete recovery was achieved only after plasmapheresis. Afterwards, she continued maintenance immunotherapy with steroids for two years and with Azathioprine for about five years associated to regular oncological assessment. In the last years our therapeutical approach of Anti-NMDARencephalitis has significantly changed. Nevertheless, established treatment guidelines are still missing and the role of long-term maintenance immunotherapy is largely unexplored. In addition, oncological revaluation might be indicated in selected patients.
Keywords: Anti-NMDAR encephalitis; Maintenance immunotherapy; Azathioprine; Oncological assessment Anti-NMDAR encephalitis; Maintenance immunotherapy; Azathioprine; Oncological assessment

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MDPI and ACS Style

Buechner, S.; Florio, I.; Sixt, G.J.; Teatini, F. A Critical Reflection on Our First Patient Presenting with Anti-Nmethyl- D-aspartate Receptor Encephalitis. Neurol. Int. 2019, 11, 8253. https://doi.org/10.4081/ni.2019.8253

AMA Style

Buechner S, Florio I, Sixt GJ, Teatini F. A Critical Reflection on Our First Patient Presenting with Anti-Nmethyl- D-aspartate Receptor Encephalitis. Neurology International. 2019; 11(3):8253. https://doi.org/10.4081/ni.2019.8253

Chicago/Turabian Style

Buechner, Susanne, Igor Florio, Gabriele J. Sixt, and Francesco Teatini. 2019. "A Critical Reflection on Our First Patient Presenting with Anti-Nmethyl- D-aspartate Receptor Encephalitis" Neurology International 11, no. 3: 8253. https://doi.org/10.4081/ni.2019.8253

APA Style

Buechner, S., Florio, I., Sixt, G. J., & Teatini, F. (2019). A Critical Reflection on Our First Patient Presenting with Anti-Nmethyl- D-aspartate Receptor Encephalitis. Neurology International, 11(3), 8253. https://doi.org/10.4081/ni.2019.8253

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