ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2015) 37 EP135 | DOI: 10.1530/endoabs.37.EP135

NMDA receptor mediated limbic encephalitis in a woman with mature cystic ovarian teratoma: a case report

Melinda Vanya1, Zoltan Kovacs2,4, Nikos Gorgoraptis3, Afram Salek-Haddadi3, Laszlo Kovacs4 & Gyorgy Bartfai1


1Department of Obstetrics and Gynaecology, Faculty of Medicine, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, Hungary; 2Department of Psychiatry, Faculty of General Medicine, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, Hungary; 3Department of Neurology, Centre for Neurosciences, The Royal London Hospital, London, UK; 4Department of Rheumatology, Faculty of General Medicine, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, Hungary.


Objective: Our aim was to present a case of paraneoplastic NMDA-R antibody-mediated limbic encephalitis in a woman with OT thereby providing information facilitating diagnosis of OT in women, who present with symptoms of paraneoplastic limbic encephalitis (LE) for obstetricians and gynaecologists with appropriate.

Case: We report the case of a 25-year-old women, who developed NMDA-R-antibody mediated autoimmune encephalitis and who displayed confusion, disorientation, a behavioural disturbance with agitation and features of paranoia and at least one reported generalised tonic clonic seizure associated with orofacial dyskinesia. Magnetic resonance imaging revealed 3.3 cm functional ovarian cyst measuring which was removed surgically and demonstrated histologically to be a mature cystic OT. The serum was positive for antibodies to NMDA receptors. Following i.v. immunoglobulin treatment, oophorectomy and a 5-day course of plasma exchange, followed by corticosteroid and azathioprine immunosuppressive therapy, the patient displayed a significant clinical improvement.

Conclusion: Cystic teratomas are common benign ovarian lesions in women of reproductive age. Although the association of OTs and NMDA-R antibody-mediated encephalitis has been described in the neurologic literature, this relationship needs to be considered from on interdisciplinary aspect by the healthcare providers.

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