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Case Reports
. 2021 Sep 28;13(4):487-496.
doi: 10.3390/neurolint13040048.

Lyme Disease and Associated NMDAR Encephalitis: A Case Report and Literature Review

Natalja Predkele  1   2   3 , Jānis Mednieks  1   2
Affiliations
Case Reports

Lyme Disease and Associated NMDAR Encephalitis: A Case Report and Literature Review

Natalja Predkele et al. Neurol Int. .

Abstract

We present a case of a patient with positive N-methyl-D-aspartate receptor (NMDAR) IgG antibodies in their serum and cerebrospinal fluid (CSF) associated with neuroborreliosis. Clinically, the patient presented with symptoms of confusion, as well as behavioral and speech impairments. Regardless of antibacterial treatment, no significant improvement was achieved. Methylprednisolone provided a marked improvement in the patient's clinical signs and CSF findings. The screening did not reveal any underlying neoplasm. Taking into account the marked clinical improvement after treatment with glucocorticosteroids, we suggest that NMDAR encephalitis is a possible autoimmune complication in neuroborreliosis patients requiring additional immunotherapy.

Keywords: Lyme disease; NMDAR antibodies; NMDAR encephalitis; autoimmune encephalitis; neuroborreliosis.

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Conflict of interest statement

The authors declare no conflict of interest.

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References

    1. Tanaka K., Kawamura M., Sakimura K., Kato N. Significance of Autoantibodies in Autoimmune Encephalitis in Relation to Antigen Localization: An Outline of Frequently Reported Autoantibodies with a Non-Systematic Review. Int. J. Mol. Sci. 2020;21:4941. doi: 10.3390/ijms21144941. - DOI - PMC - PubMed
    1. Dalmau J., Armangue T., Planaguma J., Radosevic M., Mannara F., Leypoldt F., Geis C., Lancaster E., Titulaer M.J., Rosenfeld M.R., et al. An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: Mechanisms and models. Lancet Neurol. 2019;18:1045–1057. doi: 10.1016/S1474-4422(19)30244-3. - DOI - PubMed
    1. Dalmau J., Lancaster E., Martinez-Hernandez E., Rosenfeld M.R., Balice-Gordon R. Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol. 2011;10:63–74. doi: 10.1016/S1474-4422(10)70253-2. - DOI - PMC - PubMed
    1. Titulaer M.J., McCracken L., Gabilondo I., Armangué T., Glaser C., Iizuka T., Honig L.S., Benseler S.M., Kawachi I., Martinez-Hernandez E., et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: An observational cohort study. Lancet Neurol. 2013;12:157–165. doi: 10.1016/S1474-4422(12)70310-1. - DOI - PMC - PubMed
    1. Dalmau J., Geis C., Graus F. Autoantibodies to Synaptic Receptors and Neuronal Cell Surface Proteins in Autoimmune Diseases of the Central Nervous System. Physiol. Rev. 2017;97:839–887. doi: 10.1152/physrev.00010.2016. - DOI - PMC - PubMed

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