Article Text
Neurological dilemma
Autoimmune encephalitis (NMDAR antibody) in a patient receiving chronic post-transplant immunosuppression
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