Autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report

Autoimmune basal ganglia encephalitis causes neurological symptoms such as parkinsonism associated with basal ganglia lesions. Here, we report a case of autoimmune basal ganglia encephalitis without retinal lesions or malignancy harboring anti-recoverin antibodies. The patient was a 67-year-old Japa...

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Autores principales:	Yuki Kitazaki, Norimichi Shirafuji, Naoko Takaku, Tomohisa Yamaguchi, Soichi Enomoto, Masamichi Ikawa, Osamu Yamamura, Yasunari Nakamoto, Tadanori Hamano
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Autoimmune basal ganglia encephalitis Parkinsonism Autoimmune encephalitis High-dose immunoglobulin Anti-recoverin antibodies Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/433a536754e040c68ca4ac211ccd7fc8
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spelling	oai:doaj.org-article:433a536754e040c68ca4ac211ccd7fc82021-11-26T04:35:31ZAutoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report2405-650210.1016/j.ensci.2021.100382https://doaj.org/article/433a536754e040c68ca4ac211ccd7fc82021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2405650221000757https://doaj.org/toc/2405-6502Autoimmune basal ganglia encephalitis causes neurological symptoms such as parkinsonism associated with basal ganglia lesions. Here, we report a case of autoimmune basal ganglia encephalitis without retinal lesions or malignancy harboring anti-recoverin antibodies. The patient was a 67-year-old Japanese woman who developed anorexia, parkinsonism, and disturbance of consciousness 7 days before admission. Brain magnetic resonance imaging showed hyperintense bilateral basal ganglia lesions on fluid-attenuated inversion recovery images. 18F-fluorodeoxyglucose-positron emission tomography showed no malignancy in the trunk, and dopamine transporter single-photon emission computed tomography with dopamine transporters revealed reduced radiotracer uptake in the basal ganglia. Further, anti-recoverin IgG antibodies were detected in serum immunoblot. Based on the clinical and imaging findings, the patient was diagnosed with autoimmune basal ganglia encephalitis with anti-recoverin antibodies and administered high-dose immunoglobulins (HD-IVIG), which led to an improvement in clinical symptoms. Anti-recoverin antibodies are paraneoplastic antibodies that explicitly bind to Ca2+-binding proteins in the retina and cause retinopathy. This pathological sequence is defined as cancer-associated retinopathy (CAR). However, in our case, autoimmune basal ganglia encephalitis developed without CAR syndrome or malignancy. Clinicians should be aware of the possibility of autoimmune basal ganglia encephalitis showing anti-recoverin antibodies but no CAR syndrome or malignancy, which should be treated with HD-IVIG therapy.Yuki KitazakiNorimichi ShirafujiNaoko TakakuTomohisa YamaguchiSoichi EnomotoMasamichi IkawaOsamu YamamuraYasunari NakamotoTadanori HamanoElsevierarticleAutoimmune basal ganglia encephalitisParkinsonismAutoimmune encephalitisHigh-dose immunoglobulinAnti-recoverin antibodiesNeurology. Diseases of the nervous systemRC346-429ENeNeurologicalSci, Vol 25, Iss , Pp 100382- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Autoimmune basal ganglia encephalitis Parkinsonism Autoimmune encephalitis High-dose immunoglobulin Anti-recoverin antibodies Neurology. Diseases of the nervous system RC346-429
spellingShingle	Autoimmune basal ganglia encephalitis Parkinsonism Autoimmune encephalitis High-dose immunoglobulin Anti-recoverin antibodies Neurology. Diseases of the nervous system RC346-429 Yuki Kitazaki Norimichi Shirafuji Naoko Takaku Tomohisa Yamaguchi Soichi Enomoto Masamichi Ikawa Osamu Yamamura Yasunari Nakamoto Tadanori Hamano Autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report
description	Autoimmune basal ganglia encephalitis causes neurological symptoms such as parkinsonism associated with basal ganglia lesions. Here, we report a case of autoimmune basal ganglia encephalitis without retinal lesions or malignancy harboring anti-recoverin antibodies. The patient was a 67-year-old Japanese woman who developed anorexia, parkinsonism, and disturbance of consciousness 7 days before admission. Brain magnetic resonance imaging showed hyperintense bilateral basal ganglia lesions on fluid-attenuated inversion recovery images. 18F-fluorodeoxyglucose-positron emission tomography showed no malignancy in the trunk, and dopamine transporter single-photon emission computed tomography with dopamine transporters revealed reduced radiotracer uptake in the basal ganglia. Further, anti-recoverin IgG antibodies were detected in serum immunoblot. Based on the clinical and imaging findings, the patient was diagnosed with autoimmune basal ganglia encephalitis with anti-recoverin antibodies and administered high-dose immunoglobulins (HD-IVIG), which led to an improvement in clinical symptoms. Anti-recoverin antibodies are paraneoplastic antibodies that explicitly bind to Ca2+-binding proteins in the retina and cause retinopathy. This pathological sequence is defined as cancer-associated retinopathy (CAR). However, in our case, autoimmune basal ganglia encephalitis developed without CAR syndrome or malignancy. Clinicians should be aware of the possibility of autoimmune basal ganglia encephalitis showing anti-recoverin antibodies but no CAR syndrome or malignancy, which should be treated with HD-IVIG therapy.
format	article
author	Yuki Kitazaki Norimichi Shirafuji Naoko Takaku Tomohisa Yamaguchi Soichi Enomoto Masamichi Ikawa Osamu Yamamura Yasunari Nakamoto Tadanori Hamano
author_facet	Yuki Kitazaki Norimichi Shirafuji Naoko Takaku Tomohisa Yamaguchi Soichi Enomoto Masamichi Ikawa Osamu Yamamura Yasunari Nakamoto Tadanori Hamano
author_sort	Yuki Kitazaki
title	Autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report
title_short	Autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report
title_full	Autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report
title_fullStr	Autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report
title_full_unstemmed	Autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report
title_sort	autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: a case report
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/433a536754e040c68ca4ac211ccd7fc8
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_version_	1718409837904134144

Autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report

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