Analysis and discussion of the rare complication of autoimmune encephalitis: Two case reports

Medicine (Baltimore). 2018 Jul;97(27):e11202. doi: 10.1097/MD.0000000000011202.

Abstract

Rationale: Autoimmune encephalitis related to many antibodies against neuronal cell surface or synaptic proteins, it is increasingly recognized as the cause of a variety of neuropsychiatric syndromes.

Patient concerns: The two pediatric cases were about autoimmune encephalitis with rare complication. One patient was a 11-year-old girl and was diagnosed with Voltage-Gated Potassium Channel complex (VGKC) antibody-mediated encephalitis with rhabdomyolysis; the other was also a 11-year-old girl and was diagnosed with anti- N-methyl-D-aspartate receptor (NMDAR) encephalitis.

Diagnoses: Both patients were diagnosed as autoimmune encephalitis with rare complication.

Interventions: Intravenous methylprednisolone, oral prednisone and intravenous immunoglobulin was administered to both patients.

Outcomes: One patient was discharged after a half month's hospitalization; the other was finally with intestinal function failure, gradually developed multiple organ failure, and eventually died.

Lessons: The pathogenic mechanism of autoimmune encephalitis associated with autoimmune disease is not fully understood, but may be related to a common immune pathological mechanism with variance in susceptibility caused by genetic or environmental factors.

Publication types

  • Case Reports

MeSH terms

  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications*
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis
  • Child
  • Encephalitis / complications*
  • Encephalitis / diagnosis
  • Encephalitis / immunology
  • Fatal Outcome
  • Female
  • Glucocorticoids / therapeutic use
  • Hashimoto Disease / complications*
  • Hashimoto Disease / diagnosis
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Immunoglobulins, Intravenous / therapeutic use*
  • Multiple Organ Failure / complications
  • Potassium Channels, Voltage-Gated / adverse effects
  • Potassium Channels, Voltage-Gated / immunology
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use*
  • Rhabdomyolysis / complications
  • Rhabdomyolysis / pathology
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Immunoglobulins, Intravenous
  • Potassium Channels, Voltage-Gated
  • Prednisone

Supplementary concepts

  • Hashimoto's encephalitis