Immunotherapy Responsive Autoimmune Subacute Encephalitis: A Report of Two Cases

Objective. To describe the clinical characteristics and radiological findings in two patients with subacute encephalitis associated with elevated serum voltage-gated potassium channel antibody (VGKCAb) and antithyroperoxidase (TPO) antibody. Case Reports. Case 1: 63-year-old woman was admitted for...

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Main Authors: Manoj Mittal, Nancy Hammond, Sharon G. Lynch
Format: Article
Language:English
Published: Wiley 2010-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2010/837371
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author Manoj Mittal
Nancy Hammond
Sharon G. Lynch
author_facet Manoj Mittal
Nancy Hammond
Sharon G. Lynch
author_sort Manoj Mittal
collection DOAJ
description Objective. To describe the clinical characteristics and radiological findings in two patients with subacute encephalitis associated with elevated serum voltage-gated potassium channel antibody (VGKCAb) and antithyroperoxidase (TPO) antibody. Case Reports. Case 1: 63-year-old woman was admitted for altered mental status and possible seizure activity. MRI brain showed hyperintensity in the bilateral hippocampal areas. She was positive for VGKCAb and anti-TPO antibodies. She was treated with steroids, IVIG, plasma exchange and azathioprine. After 8 months, she had marked improvement in her memory and seizures. Case 2: 61-year-old woman was admitted for video EEG monitoring of unclassified seizure and cognitive function decline. MRI of the brain showed mild hyperintensity in bilateral hippocampal areas and significant atrophy in the frontotemporal lesion. Anti-TPO antibody and VGKCAb were positive. She was treated with steroids, plasma exchange and azathioprine. After 9 months, she had marked improvement in her memory and seizures. Conclusion. Autoimmune subacute encephalitis appears to be an underdiagnosed entity. It is important to screen patients with subacute encephalitis for anti-TPO antibody and VGKCAb, particularly in the presence of seizures. Immunosuppressive therapy appears to be effective in treating this entity.
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spelling doaj-art-742f905d45564c0a86730ffdffc7044e2025-02-03T01:25:57ZengWileyCase Reports in Medicine1687-96271687-96352010-01-01201010.1155/2010/837371837371Immunotherapy Responsive Autoimmune Subacute Encephalitis: A Report of Two CasesManoj Mittal0Nancy Hammond1Sharon G. Lynch2Kansas University Medical Center, 5508 W 70th Street, Prairie Village, Kansas City, KS 66208, USAKansas University Medical Center, 5508 W 70th Street, Prairie Village, Kansas City, KS 66208, USAKansas University Medical Center, 5508 W 70th Street, Prairie Village, Kansas City, KS 66208, USAObjective. To describe the clinical characteristics and radiological findings in two patients with subacute encephalitis associated with elevated serum voltage-gated potassium channel antibody (VGKCAb) and antithyroperoxidase (TPO) antibody. Case Reports. Case 1: 63-year-old woman was admitted for altered mental status and possible seizure activity. MRI brain showed hyperintensity in the bilateral hippocampal areas. She was positive for VGKCAb and anti-TPO antibodies. She was treated with steroids, IVIG, plasma exchange and azathioprine. After 8 months, she had marked improvement in her memory and seizures. Case 2: 61-year-old woman was admitted for video EEG monitoring of unclassified seizure and cognitive function decline. MRI of the brain showed mild hyperintensity in bilateral hippocampal areas and significant atrophy in the frontotemporal lesion. Anti-TPO antibody and VGKCAb were positive. She was treated with steroids, plasma exchange and azathioprine. After 9 months, she had marked improvement in her memory and seizures. Conclusion. Autoimmune subacute encephalitis appears to be an underdiagnosed entity. It is important to screen patients with subacute encephalitis for anti-TPO antibody and VGKCAb, particularly in the presence of seizures. Immunosuppressive therapy appears to be effective in treating this entity.http://dx.doi.org/10.1155/2010/837371
spellingShingle Manoj Mittal
Nancy Hammond
Sharon G. Lynch
Immunotherapy Responsive Autoimmune Subacute Encephalitis: A Report of Two Cases
Case Reports in Medicine
title Immunotherapy Responsive Autoimmune Subacute Encephalitis: A Report of Two Cases
title_full Immunotherapy Responsive Autoimmune Subacute Encephalitis: A Report of Two Cases
title_fullStr Immunotherapy Responsive Autoimmune Subacute Encephalitis: A Report of Two Cases
title_full_unstemmed Immunotherapy Responsive Autoimmune Subacute Encephalitis: A Report of Two Cases
title_short Immunotherapy Responsive Autoimmune Subacute Encephalitis: A Report of Two Cases
title_sort immunotherapy responsive autoimmune subacute encephalitis a report of two cases
url http://dx.doi.org/10.1155/2010/837371
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AT nancyhammond immunotherapyresponsiveautoimmunesubacuteencephalitisareportoftwocases
AT sharonglynch immunotherapyresponsiveautoimmunesubacuteencephalitisareportoftwocases