Document Detail

Encephalitis: a gynecologic issue?
MedLine Citation:
PMID:  24770159     Owner:  NLM     Status:  In-Data-Review    
INTRODUCTION: Anti-N-methyl-D-aspartate receptor encephalitis is a rare form of encephalitis, which occurs secondary to paraneoplastic tumors and most frequently involves the temporal lobe and hippocampus. As a result of reports of its occurrence in recent years, it is being increasingly recognized as a severe and potentially fatal but treatable illness. Although these reports are widespread in neurologic literature, our purpose was to clarify this association for gynecologists who may be asked to consult on these patients.
METHODS: We present the clinical features, laboratory data, imaging, and pathological findings of a patient cared for by the gynecology service in August 2013. We performed an extensive review of the literature specifically relating anti-N-methyl-D-aspartate receptor encephalitis to ovarian teratomas.
RESULTS: We report a case of a previously healthy 19-year-old woman who presented to the hospital with acute psychosis (agitation, irritability, and hallucinations), dyskinesias, and eventually decreasing level of consciousness. After excluding psychiatric, neurologic, and infectious etiology, full-body computed tomography imaging was performed, which demonstrated a mature cystic teratoma. Available literature supports better outcomes with early resection of the tumor as well as initiation of immunotherapy; therefore, we proceeded to initiate treatment with prompt surgical management as well as intravenous immunoglobulin.
CONCLUSIONS: Although teratomas are generally characterized as the most common benign ovarian neoplastic cyst, accounting for 10-25% of all ovarian neoplasms, in rare cases they can lead to poor outcomes. As such, it is important to increase awareness of this diagnosis among practicing gynecologists.
Priyanka N Kamath
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  123 Suppl 1     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-04-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  29S     Citation Subset:  AIM; IM    
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