Anti-N-methyl-aspartate receptor encephalitis in identical twin sisters: role for oophorectomy.

Abstract

BACKGROUND:

Anti-N-methyl-aspartate receptor encephalitis is a potentially fatal form of encephalitis and frequently associated with ovarian teratomas. Surgical removal of ovarian teratomas improves clinical outcome, but it is unclear whether bilateral salpingo-oophorectomy for normal-appearing ovaries is of clinical benefit.

CASE:

Our report describes a unique clinical scenario of identical twin sisters with anti-N-methyl-aspartate receptor encephalitis. Neither patient responded to immunosuppressive therapy. Imaging studies showed normal-appearing ovaries. The first twin continued on medical therapy only and died of the disease. The second twin underwent a bilateral salpingo-oophorectomy followed by gradual recovery.

CONCLUSION:

Based on our experience in two genetically identical individuals, we suggest considering the removal of normal-appearing ovaries in patients with anti-N-methyl-aspartate receptor encephalitis who fail to respond to medical treatment.

• Authors: Salome Masghati, Mana Nosratian, Oliver Dorigo
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 123 Issue 2 Pt 2 Suppl 2 Pg. 433-435 (Feb 2014) ISSN: 1873-233X [Electronic] United States
• PMID: 24413237 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunosuppressive Agents

Topics

• Adult
• Anti-N-Methyl-D-Aspartate Receptor Encephalitis (drug therapy, surgery)
• Fatal Outcome
• Female
• Humans
• Immunosuppressive Agents (therapeutic use)
• Ovariectomy
• Twins, Monozygotic