Antibody Negative Autoimmune Encephalitis: A Case Report

Detalhes bibliográficos
Autor(a) principal: Sequeira, Carolina
Data de Publicação: 2021
Outros Autores: Lopes, Pedro
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793
Resumo: Encephalitis is characterized by inflammation of the brain. Literature describes autoimmune as one of the most common aetiology of non-infectious encephalitis. Given the similarities in clinical, imagological and laboratory findings with viral encephalitis and due to the wide variety of clinical features, the diagnosis is rather challenging and therefore physicians need an increased clinical suspicion to make the correct diagnosis. We report a case of a 35-year-old male with no past medical history that presented with two episodes of autoimmune encephalitis in a 6-month period. Despite having the typical clinical presentation and imagological findings consistent with autoimmune encephalitis, this case had negative results for antibodies, which delayed the diagnosis. It is essential to highlight the importance of considering the hypothesis of autoimmune aetiology on the differential diagnosis of all patients presenting with clinical and magnetic resonance imaging results suggestive of probable encephalitis, regardless of the negative antibodies results. This case clearly depicts the difficulties of diagnosing and treating an autoimmune encephalitis. The main goal of this case report is to increase awareness towards early diagnosis to promptly implement a specific treatment that has proven to improve the outcome and prognosis.
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spelling Antibody Negative Autoimmune Encephalitis: A Case ReportEncefalite Autoimune Sem Anticorpo Identificado: Um Relato de CasoAutoantibodiesEncephalitis/diagnosisEncephalitis/diagnostic imagingImmunotherapyAutoanticorposEncefalite/diagnósticoEncefalite/diagnóstico por imagemImunoterapiaEncephalitis is characterized by inflammation of the brain. Literature describes autoimmune as one of the most common aetiology of non-infectious encephalitis. Given the similarities in clinical, imagological and laboratory findings with viral encephalitis and due to the wide variety of clinical features, the diagnosis is rather challenging and therefore physicians need an increased clinical suspicion to make the correct diagnosis. We report a case of a 35-year-old male with no past medical history that presented with two episodes of autoimmune encephalitis in a 6-month period. Despite having the typical clinical presentation and imagological findings consistent with autoimmune encephalitis, this case had negative results for antibodies, which delayed the diagnosis. It is essential to highlight the importance of considering the hypothesis of autoimmune aetiology on the differential diagnosis of all patients presenting with clinical and magnetic resonance imaging results suggestive of probable encephalitis, regardless of the negative antibodies results. This case clearly depicts the difficulties of diagnosing and treating an autoimmune encephalitis. The main goal of this case report is to increase awareness towards early diagnosis to promptly implement a specific treatment that has proven to improve the outcome and prognosis.A encefalite é caracterizada por inflamação cerebral. A literatura descreve a etiologia autoimune como uma das causas mais frequentes de encefalite não infeciosa. Dadas as semelhanças dos resultados laboratoriais e imagiológicos com a encefalite viral, e devido a uma extensa variedade de manifestações clínicas, o diagnóstico é desafiante, pelo que os médicos precisam de maior suspeita clínica realizarem um diagnóstico correto. Relatamos o caso de um indivíduo de 35 anos, do sexo masculino, sem antecedentes pessoais de relevo, que apresentou dois episódios de encefalite autoimune num período de seis meses. Não obstante uma apresentação clínica e imagiológica típica de encefalite autoimune, o doente apresentava resultados negativos para anticorpos, o que atrasou o diagnóstico. É importante considerar a hipótese de etiologia autoimune no diagnóstico diferencial de todos os pacientes que apresentem sintomas clínicos ou resultados de ressonância magnética nuclear sugestivos de provável encefalite, independentemente da presença ou ausência de anticorpos. Este caso retrata claramente as dificuldades de diagnóstico e tratamento de uma encefalite autoimune. O principal objetivo deste relato de caso é salientar a importância do diagnóstico precoce, que permite implementar rapidamente umaterapêutica específica, e demonstrou melhorar o prognóstico e suavizar as consequências da doença.Ordem dos Médicos2021-05-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentimage/tiffimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793oai:ojs.www.actamedicaportuguesa.com:article/13793Acta Médica Portuguesa; Vol. 34 No. 5 (2021): May; 378-382Acta Médica Portuguesa; Vol. 34 N.º 5 (2021): Maio; 378-3821646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/6225https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12435https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12446https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12447https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12527https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12604https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12824https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12825https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12826https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12827https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12828https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12829https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13793/12830Direitos de Autor (c) 2020 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSequeira, CarolinaLopes, Pedro2022-12-20T11:07:00Zoai:ojs.www.actamedicaportuguesa.com:article/13793Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:23.923071Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Antibody Negative Autoimmune Encephalitis: A Case Report
Encefalite Autoimune Sem Anticorpo Identificado: Um Relato de Caso
title Antibody Negative Autoimmune Encephalitis: A Case Report
spellingShingle Antibody Negative Autoimmune Encephalitis: A Case Report
Sequeira, Carolina
Autoantibodies
Encephalitis/diagnosis
Encephalitis/diagnostic imaging
Immunotherapy
Autoanticorpos
Encefalite/diagnóstico
Encefalite/diagnóstico por imagem
Imunoterapia
title_short Antibody Negative Autoimmune Encephalitis: A Case Report
title_full Antibody Negative Autoimmune Encephalitis: A Case Report
title_fullStr Antibody Negative Autoimmune Encephalitis: A Case Report
title_full_unstemmed Antibody Negative Autoimmune Encephalitis: A Case Report
title_sort Antibody Negative Autoimmune Encephalitis: A Case Report
author Sequeira, Carolina
author_facet Sequeira, Carolina
Lopes, Pedro
author_role author
author2 Lopes, Pedro
author2_role author
dc.contributor.author.fl_str_mv Sequeira, Carolina
Lopes, Pedro
dc.subject.por.fl_str_mv Autoantibodies
Encephalitis/diagnosis
Encephalitis/diagnostic imaging
Immunotherapy
Autoanticorpos
Encefalite/diagnóstico
Encefalite/diagnóstico por imagem
Imunoterapia
topic Autoantibodies
Encephalitis/diagnosis
Encephalitis/diagnostic imaging
Immunotherapy
Autoanticorpos
Encefalite/diagnóstico
Encefalite/diagnóstico por imagem
Imunoterapia
description Encephalitis is characterized by inflammation of the brain. Literature describes autoimmune as one of the most common aetiology of non-infectious encephalitis. Given the similarities in clinical, imagological and laboratory findings with viral encephalitis and due to the wide variety of clinical features, the diagnosis is rather challenging and therefore physicians need an increased clinical suspicion to make the correct diagnosis. We report a case of a 35-year-old male with no past medical history that presented with two episodes of autoimmune encephalitis in a 6-month period. Despite having the typical clinical presentation and imagological findings consistent with autoimmune encephalitis, this case had negative results for antibodies, which delayed the diagnosis. It is essential to highlight the importance of considering the hypothesis of autoimmune aetiology on the differential diagnosis of all patients presenting with clinical and magnetic resonance imaging results suggestive of probable encephalitis, regardless of the negative antibodies results. This case clearly depicts the difficulties of diagnosing and treating an autoimmune encephalitis. The main goal of this case report is to increase awareness towards early diagnosis to promptly implement a specific treatment that has proven to improve the outcome and prognosis.
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dc.rights.driver.fl_str_mv Direitos de Autor (c) 2020 Acta Médica Portuguesa
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rights_invalid_str_mv Direitos de Autor (c) 2020 Acta Médica Portuguesa
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 34 No. 5 (2021): May; 378-382
Acta Médica Portuguesa; Vol. 34 N.º 5 (2021): Maio; 378-382
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