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Erschienen in: Archives of Gynecology and Obstetrics 3/2016

07.04.2016 | Gynecologic Oncology

Treatment principles of ovarian teratoma with anti-N-methyl-d-aspartate receptor encephalitis

verfasst von: Ying Bai, Qiyun Guan, Jinting Jiang, Zhiyuan Zhang

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 3/2016

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Abstract

Purpose

Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a recently discovered paraneoplastic limbic encephalitis. Ovarian teratoma is the only tumor clearly related to anti-NMDAR encephalitis occurrence. This study aimed to assess ovarian teratoma for neurological and mental symptoms highly related with anti-NMDAR encephalitis, treatment principles, and prognosis.

Methods

Between June 2011 and October 2014, in Peking Union Medical College Hospital, ten patients with ovarian teratoma associated with anti-NMDAR encephalitis were enrolled. All patients underwent laparoscopic oophorocystectomy followed by immunotherapy.

Results

In nine patients, mental and neurological symptoms were significantly relieved 13.7 ± 5.5 days after surgery; however, symptoms persisted in one patient, who was still hospitalized when writing this paper. During the postoperative follow-up period, seven patients showed no mental symptoms or tumor recurrence; one subject had symptom recurrence 28 days after surgery, while another patient showed suspected tumor recurrence 273 days after operation.

Conclusions

Ovarian teratoma associated with anti-NMDAR encephalitis is usually associated with neurological and mental symptoms at onset. Its manifestations are complex, and nursing care is difficult. Laparoscopic oophorocystectomy followed by immunotherapy led to symptom resolution in most patients.
Literatur
1.
Zurück zum Zitat Tunkel AR, Glaser CA, Bloch KC et al (2008) The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 47(3):303–327. doi:10.1086/589747 CrossRefPubMed Tunkel AR, Glaser CA, Bloch KC et al (2008) The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 47(3):303–327. doi:10.​1086/​589747 CrossRefPubMed
3.
Zurück zum Zitat Kruse JL, Jeffrey JK, Davis MC, Dearlove J, IsHak WW, Brooks JO 3rd (2014) Anti-N-methyl-d-aspartate receptor encephalitis: a targeted review of clinical presentation, diagnosis, and approaches to psychopharmacologic management. Ann Clin Psychiatry 26(2):111–119PubMed Kruse JL, Jeffrey JK, Davis MC, Dearlove J, IsHak WW, Brooks JO 3rd (2014) Anti-N-methyl-d-aspartate receptor encephalitis: a targeted review of clinical presentation, diagnosis, and approaches to psychopharmacologic management. Ann Clin Psychiatry 26(2):111–119PubMed
5.
Zurück zum Zitat Xu CL, Zhao WQ, Li JM, Wang JW, Wang SW, Wang DX, Liu MY, Qiao SS (2010) One case of anti-NMDAR encephalitis. Chin J Neurol 43(11):781–783 Xu CL, Zhao WQ, Li JM, Wang JW, Wang SW, Wang DX, Liu MY, Qiao SS (2010) One case of anti-NMDAR encephalitis. Chin J Neurol 43(11):781–783
7.
Zurück zum Zitat Schwartz SA (1990) Intravenous immunoglobulin (IVIG) for the therapy of autoimmune disorders. J Clin Immunol 10(2):81–89CrossRefPubMed Schwartz SA (1990) Intravenous immunoglobulin (IVIG) for the therapy of autoimmune disorders. J Clin Immunol 10(2):81–89CrossRefPubMed
13.
Zurück zum Zitat Chan LW, Nilsson C, Schepel J, Lynch C (2015) A rare case of anti-N-methyl-d-aspartate receptor encephalitis during pregnancy. N Z Med J 128(1411):89–91PubMed Chan LW, Nilsson C, Schepel J, Lynch C (2015) A rare case of anti-N-methyl-d-aspartate receptor encephalitis during pregnancy. N Z Med J 128(1411):89–91PubMed
15.
16.
Zurück zum Zitat Cleverly K, Gambadauro P, Navaratnarajah R (2014) Paraneoplastic anti-N-methyl-d-aspartate receptor encephalitis: have you checked the ovaries? Acta Obstet Gynecol Scand 93(7):712–715. doi:10.1111/aogs.12386 CrossRefPubMed Cleverly K, Gambadauro P, Navaratnarajah R (2014) Paraneoplastic anti-N-methyl-d-aspartate receptor encephalitis: have you checked the ovaries? Acta Obstet Gynecol Scand 93(7):712–715. doi:10.​1111/​aogs.​12386 CrossRefPubMed
17.
Zurück zum Zitat Tachibana N, Ikeda S (2012) Localization of NMDAR-related epitopes in ovarian teratoma: comparison between patients and controls. Rinsho Shinkeigaku 52(11):982–984CrossRefPubMed Tachibana N, Ikeda S (2012) Localization of NMDAR-related epitopes in ovarian teratoma: comparison between patients and controls. Rinsho Shinkeigaku 52(11):982–984CrossRefPubMed
20.
Zurück zum Zitat Cozzolino M, Bianchi C, Mariani G, Marchi L, Fambrini M, Mecacci F (2015) Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum. Arch Gynecol Obstet 292(6):1217–1223. doi:10.1007/s00404-015-3800-4 CrossRefPubMed Cozzolino M, Bianchi C, Mariani G, Marchi L, Fambrini M, Mecacci F (2015) Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum. Arch Gynecol Obstet 292(6):1217–1223. doi:10.​1007/​s00404-015-3800-4 CrossRefPubMed
23.
Zurück zum Zitat Varvat J, Lafond P, Page Y, Coudrot M, Reynaud-Salard M, Tardy B (2010) Acute psychiatric syndrome leading young patients to ICU: consider anti-NMDA-receptor antibodies. Anaesth Intensive Care 38(4):748–750PubMed Varvat J, Lafond P, Page Y, Coudrot M, Reynaud-Salard M, Tardy B (2010) Acute psychiatric syndrome leading young patients to ICU: consider anti-NMDA-receptor antibodies. Anaesth Intensive Care 38(4):748–750PubMed
Metadaten
Titel
Treatment principles of ovarian teratoma with anti-N-methyl-d-aspartate receptor encephalitis
verfasst von
Ying Bai
Qiyun Guan
Jinting Jiang
Zhiyuan Zhang
Publikationsdatum
07.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 3/2016
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4050-9

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