Not everything is as ir seems: regarding a case of trantrums in a child
DOI:
https://doi.org/10.24197/cl.29.2024.48-51Keywords:
Anti-NMDA receptor antibodies, Anti-NMDA encephalitis, Inmunotherapy, Neuropsychiatric symptomsAbstract
Introduction: Anti-N-methyl-D-aspartate receptor encephalitis is a pathology with an increasing incidence in childhood in recent years. We report a two-year-old patient whose early diagnosis and treatment was important to his recovery.
Clinical case: 2-year-old patient who comes to the emergency room brought by his parents due to behavioral alterations, agitation and insomnia. Clinical features progress: choreo-athetotic movements, language regression and seizures that require ICU. Positive anti-NMDAr antibodies in CSF, conclude the diagnosis. The patient receives treatment with intravenous infusion of corticosteroids and immunoglobulins, making it necessary to combine rituximab. Six months after the onset of symptoms, the patient has made a practically complete recovery.
Conclusion: Autoinmune encephalitis should be suspected in a patient with acute neuropsychiatric symptoms. Early diagnosis and treatment can be beneficial for the outcome.
Downloads
References
Rincón López E, Rodríguez Vega H, Pietropaolo D, Mejías A. Encefalitis por anticuerpos anti-NMDA en pediatría: una entidad potencialmente tratable [Anti-NMDA antibody encephalitis in paediatrics: A potentially treatable condition]. An Pediatr (Barc). 2015 May;82(5):e252-4. Spanish. doi: 10.1016/j.anpedi.2014.08.007. Epub 2014 Oct 27. PMID: 25443326.
González-Toro MC, Jadraque- Rodríguez R, Sempere-Pérez A, Martínez-Pastor P, Jover-Cerdá J, Gómez-Gosálvez F. Encefalitis antirreceptor de NMDA: dos casos pediátricos. Rev Neurol 2013; 57: 504-8.
Muñoz Bonet JI, Roselló Millet P, Morales Lozano MJ. Meningitis y encefalitis. En: López-Herce Cid J, Calvo Rey C, Rey Galán C, Rodríguez Núñez A. Manual de Cuidados Intensivos Pediátricos, 5a edición. Madrid: PubliMed, 2019, pp. 234-43.
Nosadini M, Thomas T, Eyre M, Anlar B, Armangue T, Benseler SM, Cellucci T, Deiva K, Gallentine W, Gombolay G, Gorman MP, Hacohen Y, Jiang Y, Lim BC, Muscal E, Ndondo A, Neuteboom R, Rostásy K, Sakuma H, Sharma S, Tenembaum SN, Van Mater HA, Wells E, Wickstrom R, Yeshokumar AK, Irani SR, Dalmau J, Lim M, Dale RC. International Consensus Recommendations for the Treatment of Pediatric NMDAR Antibody Encephalitis. Neurol Neuroimmunol Neuroinflamm. 2021 Jul 22;8(5):e1052. doi: 10.1212/NXI.0000000000001052. PMID: 34301820; PMCID: PMC8299516.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Estefanía Fekete López, Sara Vilches Fraile, Mario Urbano Martín, Alba Hernández Prieto, Ramón Cancho Candela
This work is licensed under a Creative Commons Attribution 4.0 International License.
The articles published at Clínica will have a Creative Commons Attribution 4.0 International License (CC BY 4.0).
The journal allows the authors to retain publishing rights. Authors may reprint their articles in other media without having to request authorization, provided they indicate that the article was originally published in Clínica.