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European Child & Adolescent Psychiatry

, Volume 24, Issue 11, pp 1321–1324 | Cite as

Anti-NMDA receptor encephalitis presenting as atypical anorexia nervosa: an adolescent case report

  • David Mechelhoff
  • Betteke Maria van Noort
  • Bernhard Weschke
  • Christian J. Bachmann
  • Christiane Wagner
  • Ernst Pfeiffer
  • Sibylle Winter
Original Contribution

Abstract

Since 2007, more than 600 patients have been diagnosed with anti-N-methyl-d-aspartate (NMDA) receptor encephalitis, with almost 40 % of those affected being children or adolescents. In early phases of the illness, this life-threatening disease is characterized by psychiatric symptoms, such as depression, anxiety, obsessions, hallucinations or delusions. Consequently, a high percentage of patients receive psychiatric diagnoses at first, hindering the crucial early diagnosis and treatment of the anti-NMDA receptor encephalitis. We report on a 15-year-old girl initially presenting with pathological eating behaviour and significant weight loss resulting in an (atypical) anorexia nervosa (AN) diagnosis. Her early course of illness, diagnostic process, treatment and short-term outcome are described. This case report aims to raise awareness about the association between anorectic behaviour and anti-NMDA receptor encephalitis and highlight the importance of multidisciplinary teams in child and adolescent services.

Keywords

Anti-NMDA receptor encephalitis Atypical anorexia nervosa Child and adolescent psychiatry Paediatrics 

Notes

Acknowledgments

The authors would like to thank the patient and her family for their permission to share her interesting case with our national and international colleagues.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • David Mechelhoff
    • 1
  • Betteke Maria van Noort
    • 1
  • Bernhard Weschke
    • 2
  • Christian J. Bachmann
    • 3
  • Christiane Wagner
    • 4
  • Ernst Pfeiffer
    • 1
  • Sibylle Winter
    • 1
  1. 1.Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and PsychotherapyCharité—Universitätsmedizin BerlinBerlinGermany
  2. 2.Department of Pediatric NeurologyCharité—Universitätsmedizin BerlinBerlinGermany
  3. 3.Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  4. 4.Neuropaediatric Outpatient ClinicSana Hospital LichtenbergBerlinGermany

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