Predkele Natalja, Mednieks Jānis
Department of Neurology, Paul Stradins Clinical University Hospital, 13 Pilsonu St., LV-1002 Riga, Latvia.
Department of Neurology and Neurosurgery, Riga Stradins University, 16 Dzirciema St., LV-1007 Riga, Latvia.
Neurol Int. 2021 Sep 28;13(4):487-496. doi: 10.3390/neurolint13040048.
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.
我们报告一例血清和脑脊液（CSF）中N-甲基-D-天冬氨酸受体（NMDAR）IgG抗体阳性且与神经莱姆病相关的患者。临床上，该患者表现出意识模糊症状以及行为和言语障碍。尽管进行了抗菌治疗，但未取得显著改善。甲泼尼龙使患者的临床体征和脑脊液检查结果有了明显改善。筛查未发现任何潜在肿瘤。考虑到糖皮质激素治疗后临床症状明显改善，我们认为NMDAR脑炎可能是神经莱姆病患者需要额外免疫治疗的一种自身免疫性并发症。
