Reporte de un caso fatal de encefalitis autoinmunitaria asociada a teratoma ovárico

Santiago Rueda-Espinel, Julio Vargas-Anaya, Nathalia J. Gamarra-Ramírez

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Resumen

Introduction: The ovarian teratoma is the most common cell germ tumor. Some paraneoplastic syndromes have been described, including the anti-N-methyl-D-aspartate (NMDA) receptor encephalitis as part of its complications. Case report: A 22 years old female patient with no important medical history, consults due to an acute psychotic disorder and a convulsion. A meningoencephalitis was considered and broad-spectrum antibiotics and antivirals were started. Faced with deterioration, an autoimmune encephalitis is considered as well. Imaging studies revealed an ovarian teratoma and diagnosis was confirmed with antibodies against NMDA receptor in cerebrospinal fluid. Despite its resection and systemic management, the patient dies after 5 months. Discussion: The autoimmune encephalitis associated with an ovarian teratoma is rare, it's a complication that must be suspected as an exclusion diagnosis and most have a favorable prognosis, however up to a quarter of cases can be associated with irreversible damage to the hippocampal cortex and even death, mainly when late diagnosis and treatment are made. Conclusions: This case is a clinical challenge, no evidence is available since there is no standard for teratoma management. It is proposed that once a teratoma is diagnosed, an ovarian cystectomy is performed. Further studies are necessary to validate this recommendation.

Título traducido de la contribuciónReport of a fatal case of autoimmune encephalitis associated with an ovarian teratoma
Idioma originalEspañol
Páginas (desde-hasta)403-409
Número de páginas7
PublicaciónRevista Chilena de Obstetricia y Ginecologia
Volumen86
N.º4
DOI
EstadoPublicada - 2021
Publicado de forma externa

Palabras clave

  • Anti-N-methyl-D-aspartate receptor encephalitis
  • Encephalitis
  • Paraneoplastic syndromes
  • Psychotic disorders
  • Teratoma

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