Naslov
Anti-AMPAR and anti-GAD positive limbic encephalitis and intermittent plasmapheresis therapy - a case report

Autori
Šulentić, Vlatko ; Bujan Kovač, Andreja ; Hajnšek, Sanja ; Petelin Gadže, Željka ; Nanković, Sibila ; Kovačević, Ivana

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Epilepsia, Vol. 54 (suppl.3) / - , 2013, 141-141

Skup
30th International Epilepsy Congress

Mjesto i datum
Montréal, Kanada, 23–27.06.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Anti-AMPAR, anti-GAD, limbic encephalitis, plasmapheresis

Sažetak
Background: Limbic encephalitis is an inflammatory disorder that can be paraneoplastic with the existence of intracellural antibodies or autoimmune and related to the existence of antibodies to antigens located on the surface of cell membranes. These include anti-VGCK, anti- NMDA, anti-AMPAR, anti-CASPAR and anti-GAD antibodies. Each of these antibodies are connected with some specificity in the clinical presentation and clinical course. Case Presentation: A 24-year old patient initially manifested with complex partial epileptic seizures (CPS), myoclonus and then gradually developed mental decline and impairment of consciousness. After intensive-care treatment and immunoglobulin therapy, the state of consciousness improved but frequent generalized action-related myoclonus and CPS with damage to short-term memory remained. Diagnostic examinations found the existence of anti-AMPAR and anti-GAD antibodies and additional treatment excluded the existence of an underlying malignancy. Despite several antiepileptic drugs and the first immunotherapy, corticosteroids and mycophenolate mofetil (Cell-Cept) there was no clinical improvement, and new active lesions on brain MRI were visualised. We decided to start with intermittent plasmapheresis therapy (each month three cycles) which lead to significant reduction of epileptic seizures and myoclonus and also mild cognitive improvement. Conclusion: Anti-AMPAR and anti-GAD limbic encephalitis are rare autoimmune disorders that tend to frequent relapses and there is a need for long-term immunotherapy. Our case shows the potential effectiveness of intermittent plasmapheresis in these patients, with extremely rare simultaneously occurrence of anti-GAD and anti-AMPAR antibodies.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA