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Anti-N-methyl-d-aspartate receptor encephalitis in a pre-teenage girl: a case report

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Abstract

Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is an auto-immune and paraneoplastic encephalitis which generally affects young adults. It is a multistage illness, with prominent extrapyramidal, neuropsychiatric and autonomic symptoms. The syndrome is frequently associated with an ovarian teratoma. Recently, it has become evident that anti-NMDAR encephalitis is more common in children and adolescents than was previously believed. Prognostic factors that determine a good outcome are presence of a tumour, prompt treatment and no need for admission to an intensive care unit. Increased awareness among paediatricians of this potentially life-threatening disease is important because early recognition and treatment will improve the patients’ chances of a good clinical outcome. In this case report, we describe a 9-year-old girl with behavioural changes and severe extrapyramidal symptoms due to anti-NMDAR encephalitis associated with an ovarian teratoma. She was treated with a variety of immunomodulating therapies and made a slow, but good recovery.

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Abbreviations

Anti-NMDAR:

Anti-N-methyl-d-aspartate receptor

CSF:

Cerebrospinal fluid

NMDAR:

N-methyl-d-aspartate receptor

PICU:

Paediatric intensive care unit

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Consent

The parents of the patient gave informed consent for publication of this case report.

Conflict of Interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Academic Medical Centre, University of Amsterdam, Room H2-218, P.O. Box 22700, 1100, Amsterdam, The Netherlands

    Stephanie Nijmeijer

  2. Department of Pediatric Intensive Care, Academic Medical Centre, Emma Children’s Hospital, University of Amsterdam, Room H2-218, P.O. Box 22700, 1100, Amsterdam, The Netherlands

    Sander Bontemps

  3. Department of Pediatrics, Academic Medical Centre, Emma Children’s Hospital, University of Amsterdam, Room H2-218, P.O. Box 22700, 1100, Amsterdam, The Netherlands

    Leonie Naeije

  4. Department of Neurology, Academic Medical Centre, University of Amsterdam, Room H2-218, P.O. Box 22700, 1100, Amsterdam, The Netherlands

    Jonathan Coutinho

Authors
  1. Stephanie Nijmeijer
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  2. Sander Bontemps
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  3. Leonie Naeije
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  4. Jonathan Coutinho
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Corresponding author

Correspondence to Jonathan Coutinho.

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Nijmeijer, S., Bontemps, S., Naeije, L. et al. Anti-N-methyl-d-aspartate receptor encephalitis in a pre-teenage girl: a case report. Eur J Pediatr 173, 681–683 (2014). https://doi.org/10.1007/s00431-013-2042-3

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  • DOI: https://doi.org/10.1007/s00431-013-2042-3

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