Anti-NMDA receptor autoimmune encephalitis associated with systemic lupus erythematosus. Case report

Introduction: Anti-NMDA autoimmune encephalitis is a severe neurological disorder characterized by autoantibodies targeting the N-methyl-D-aspartate receptor. Its diagnosis is challenging, and its coexistence with systemic lupus erythematosus is rare, posing significant clinical and therapeutic challenges. Objective: To describe a case of anti-NMDA autoimmune encephalitis associated with SLE, highlighting diagnostic challenges and response to immunomodulatory treatment. Case Presentation: Female patient, 26 years old, with a psychiatric history, admitted with altered level of consciousness and dystonic movements. Due to diagnostic suspicion, tests were performed and initially, anti-NMDA antibodies in cerebrospinal fluid were negative, which complicated the diagnosis. However, subsequent serum tests confirmed anti-NMDA encephalitis. At the same time, autoimmune activity consistent with neuro-lupus was identified according to the 2019 EULAR/ACR criteria, leading to treatment with methylprednisolone pulses and intravenous immunoglobulin, with significant improvement. Discussion: The coexistence of anti-NMDA encephalitis and SLE is rare and may delay diagnosis when initial tests yield false-negative results. This case underscores the importance of diagnostic re-evaluations and a multidisciplinary approach to optimize treatment.

• 1. autor: Tirape Castro, Hugo (author)
• Kolejni autorzy: Vélez, Jorge Washington (author), Pérez-Quiroga , Fausto Daniel (author), Andrade-Sánchez , William Ricardo (author)
• Format: article
• Język: spa
• Wydane: 2025
• Hasła przedmiotowe: lupus eritematoso sistémico; receptores de N-metil-D-aspartato; enfermedades autoinmunes del sistema nervioso; convulsiones; neurología; systemic, receptors; N-Methyl-D-Aspartate; lupus erythematosus; autoimmune diseases of the nervous system; seizures; neurology
• Dostęp online: https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/7667