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.
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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.
D. Mechelhoff and B. M. van Noort contributed equally to this work.
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Mechelhoff, D., van Noort, B.M., Weschke, B. et al. Anti-NMDA receptor encephalitis presenting as atypical anorexia nervosa: an adolescent case report. Eur Child Adolesc Psychiatry 24, 1321–1324 (2015). https://doi.org/10.1007/s00787-015-0682-8
- Anti-NMDA receptor encephalitis
- Atypical anorexia nervosa
- Child and adolescent psychiatry