Rapidly progressive neurological deterioration in anti-AMPA receptor encephalitis with additional CRMP5 antibodies
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Anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) encephalitis positive for additional onconeural antibodies is rarely reported. Here we report the clinical features of a patient who developed limbic encephalitis with both glutamate receptor 2 (GluR2) and collapsin response mediator protein 5 (CRMP5) antibodies. Brain magnetic resonance imaging revealed multifocal encephalopathy. Chest computed tomography showed a highly suspicious malignant thymoma. He experienced rapid neurological deterioration during hospitalization. This report indicates that the clinical diversity of anti-AMPAR encephalitis and the presence of onconeural antibodies may lead to poor prognosis.
KeywordsAutoimmune Encephalitis AMPAR CRMP5 Antibodies Thymoma
This study was supported by grant from Natural Science Foundation of China (No. 81301007 to Jie Qin).
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Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Lai M, Hughes EG, Peng X, Zhou L, Gleichman AJ, Shu H, Mata S, Kremens D, Vitaliani R, Geschwind MD, Bataller L, Kalb RG, Davis R, Graus F, Lynch DR, Balice-Gordon R, Dalmau J (2009) AMPA receptor antibodies in limbic encephalitis alter synaptic receptor location. Ann Neurol 65(4):424–434. doi: 10.1002/ana.21589 CrossRefPubMedPubMedCentralGoogle Scholar
- 2.Hoftberger R, van Sonderen A, Leypoldt F, Houghton D, Geschwind M, Gelfand J, Paredes M, Sabater L, Saiz A, Titulaer MJ, Graus F, Dalmau J (2015) Encephalitis and AMPA receptor antibodies: novel findings in a case series of 22 patients. Neurology 84(24):2403–2412. doi: 10.1212/WNL.0000000000001682 CrossRefPubMedPubMedCentralGoogle Scholar
- 3.Graus F, Saiz A, Lai M, Bruna J, Lopez F, Sabater L, Blanco Y, Rey MJ, Ribalta T, Dalmau J (2008) Neuronal surface antigen antibodies in limbic encephalitis: clinical-immunologic associations. Neurology 71(12):930–936. doi: 10.1212/01.wnl.0000325917.48466.55 CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Hoftberger R, Titulaer MJ, Sabater L, Dome B, Rozsas A, Hegedus B, Hoda MA, Laszlo V, Ankersmit HJ, Harms L, Boyero S, de Felipe A, Saiz A, Dalmau J, Graus F (2013) Encephalitis and GABAB receptor antibodies: novel findings in a new case series of 20 patients. Neurology 81(17):1500–1506. doi: 10.1212/WNL.0b013e3182a9585f CrossRefPubMedPubMedCentralGoogle Scholar