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Case Reports
. 2022 Feb 23:13:754938.
doi: 10.3389/fpsyt.2022.754938. eCollection 2022.

Psychotic Symptoms as the Initial Presentation of a Long-Lasting Misdiagnosed Anti-GAD65 Autoimmune Encephalitis: An Emblematic Case and Literature Review

Jianjun Wang  1   2   3 , Shenglan Gong  1   4   5 , Fanxin Kong  1   2 , Dongbin Cai  1   2 , Binqing Huang  1   2 , Haotao Zheng  1   2 , Songjun Lin  1   2 , Jinfang Li  1   2 , Tianfeng Zhang  4   5
Affiliations
Case Reports

Psychotic Symptoms as the Initial Presentation of a Long-Lasting Misdiagnosed Anti-GAD65 Autoimmune Encephalitis: An Emblematic Case and Literature Review

Jianjun Wang et al. Front Psychiatry. .

Abstract

Objective: To present a long-lasting misdiagnosed case of anti-GAD65 autoimmune encephalitis (AE) and promote the early identification of reversible psychotic symptoms in AE.

Methods: The case report was generated through detailed assessment of clinical characteristics, cerebral magnetic resonance images, and laboratory results. Meanwhile, a literatures review related to the topic was conducted.

Results: Psychotic symptoms could be presented in the early stage of anti-GAD65 autoimmune encephalitis. Even though there exists a transdisciplinary gap that hinder the timely recognition of early psychiatric symptoms as components of organic disease, a few strategies could be introduced to enable the earlier recognition and appropriate treatment.

Conclusions: Our report intends to raise awareness to promote the early identification of immune-mediated "symptomatic" forms of psychosis.

Keywords: GAD65; autoantibodies; autoimmune; autoimmune hepatitis; encephalitis; psychosis; seizure (medical records).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The GAD65 antibody was diluted 1:10 in the serum (a) and 1:100 in the cerebrospinal fluid (b).
Figure 2
Figure 2
1H-magnetic resonance spectroscopy (MRS) images showing an increased Cho/Cr ratio (1.67) in the right hippocampus with a markedly elevated Cho peak.
See this image and copyright information in PMC

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