GABAA receptor and anti-titin antibody encephalitis in a patient with thymoma.

Abstract

Autoimmune encephalitis (AE) associated to antibodies against GABA A R is a rare form of encephalitis. On the other hand, thymoma has been linked to antibodies against both muscular and neuronal epitopes, even if concurrent positivity for more than one antibody is exceptional, and their contribution to the clinical course and treatment decision is unclear. We report a case of a 73-year-old male with AE associated with thymoma secreting both anti-GABAaR and anti-titin antibodies. Clinical presentation included status epilepticus, behavioural changes and cognitive decline. While the status was stopped with lacosamide, AE treatment included first- and second-line immunomodulation, in addition to thymoma's removal. Nonetheless, the patient experienced a worsening in cognitive and behavioural status.

• Authors: Maria Tappatà, Maria Pia Giannoccaro, Michele Romoli, Stefania Testoni, Giorgia Arnone, Laura Piccolo, Piergiorgio Solli, Anna Zaniboni, Federica Naldi, Keivan Kaveh Moghadam, Nazarena Nannini, Stefania Damiani, Rocco Liguori, Andrea Zini
• Journal: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (Neurol Sci) Vol. 43 Issue 9 Pg. 5633-5636 (Sep 2022) ISSN: 1590-3478 [Electronic] Italy
• PMID: 35708792 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2022. Fondazione Società Italiana di Neurologia.

Chemical References

• Autoantibodies
• Receptors, GABA-A

Topics

• Aged
• Autoantibodies
• Encephalitis
• Hashimoto Disease
• Humans
• Male
• Receptors, GABA-A
• Thymoma (complications)
• Thymus Neoplasms (complications)