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Autoimmune encephalitis (NMDAR antibody) in a patient receiving chronic post-transplant immunosuppression
  1. Anna Randall,
  2. Saif Huda,
  3. Anu Jacob,
  4. Andrew J Larner
  1. Walton Centre for Neurology and Neurosurgery, Liverpool, UK
  1. Correspondence to Dr Andrew J Larner, Walton Centre for Neurology and Neurosurgery, Liverpool L9 7LJ, UK; a.larner{at}thewaltoncentre.nhs.uk

Abstract

Autoimmune encephalitis associated with antibodies (Abs) directed against the synaptic ligand-gated ion channel NMDA receptor (NMDAR) was first described as a paraneoplastic disorder in association with ovarian teratoma. Other forms of neoplasia have subsequently been reported although many patients do not have a tumour. Tumour removal, where applicable, and immunotherapy form the mainstays of treatment. We present a patient who developed NMDAR-Ab encephalitis despite being chronically immunosuppressed following organ transplantation, and who was eventually found to have an occult malignancy in the form of non-Hodgkin’s lymphoma.

  • autoimmunity
  • immunosuppression
  • lymphoma
  • NMDAR encephalitis
  • renal transplantation

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Footnotes

  • Contributors All authors contributed to the preparation and revision of this manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Provenance and peer review Not commissioned; externally peer reviewed by Sarosh Irani, Oxford, UK.

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