Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies

Anti-LGI1 encephalitis is an autoimmune encephalitis with antibodies against leucine-rich glioma-inactivated 1 (LGI1), first described in 2010. It is a non-frequent and poorly understood entity that represents the second most frequent cause of autoimmune encephalitis. This entity is characterized by...

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Autores principales: Otiniano-Sifuentes, Ricardo, Cuba Antezana, Anali, De La Cruz Ramirez, Walter F., Pacheco-Barrios, Kevin, Segura Chavez, Darwin A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843919/
https://www.ncbi.nlm.nih.gov/pubmed/33519701
http://dx.doi.org/10.3389/fneur.2020.620483
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author Otiniano-Sifuentes, Ricardo
Cuba Antezana, Anali
De La Cruz Ramirez, Walter F.
Pacheco-Barrios, Kevin
Segura Chavez, Darwin A.
author_facet Otiniano-Sifuentes, Ricardo
Cuba Antezana, Anali
De La Cruz Ramirez, Walter F.
Pacheco-Barrios, Kevin
Segura Chavez, Darwin A.
author_sort Otiniano-Sifuentes, Ricardo
collection PubMed
description Anti-LGI1 encephalitis is an autoimmune encephalitis with antibodies against leucine-rich glioma-inactivated 1 (LGI1), first described in 2010. It is a non-frequent and poorly understood entity that represents the second most frequent cause of autoimmune encephalitis. This entity is characterized by the presence of limbic encephalitis, hyponatremia, and faciobrachial dystonic seizures. Herein, we present the case of a male patient with an onset of epileptic seizures (generalized tonic-clonic seizure), and involuntary dystonic movements that affect the right side of his face and right upper limb associated with mental disorder, and affectation of higher functions. The electroencephalogram showed continuous generalized slowing of the background activity. The brain magnetic resonance imaging showed signal hyperintensity at the level of both mesial temporal lobes and hippocampi and in the head of the right caudate nucleus. Anti-thyroglobulin antibodies were positive, and he was initially diagnosed as Hashimoto's encephalopathy (HE). However, the response to corticosteroids was not completed as it is usually observed in HE. For that, antibodies for autoimmune encephalitis were tested, and the anti-LGI1 antibodies were positive in serum and cerebrospinal fluid. HE is an important differential diagnosis to consider. Furthermore, the presence of Anti-thyroglobulin antibodies should not be taken as the definitive diagnostic criteria, since these antibodies could be associated with other autoimmune encephalopathies, which include in addition to anti-LGI1, anti-NMDA and anti-Caspr2.
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spelling pubmed-78439192021-01-30 Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies Otiniano-Sifuentes, Ricardo Cuba Antezana, Anali De La Cruz Ramirez, Walter F. Pacheco-Barrios, Kevin Segura Chavez, Darwin A. Front Neurol Neurology Anti-LGI1 encephalitis is an autoimmune encephalitis with antibodies against leucine-rich glioma-inactivated 1 (LGI1), first described in 2010. It is a non-frequent and poorly understood entity that represents the second most frequent cause of autoimmune encephalitis. This entity is characterized by the presence of limbic encephalitis, hyponatremia, and faciobrachial dystonic seizures. Herein, we present the case of a male patient with an onset of epileptic seizures (generalized tonic-clonic seizure), and involuntary dystonic movements that affect the right side of his face and right upper limb associated with mental disorder, and affectation of higher functions. The electroencephalogram showed continuous generalized slowing of the background activity. The brain magnetic resonance imaging showed signal hyperintensity at the level of both mesial temporal lobes and hippocampi and in the head of the right caudate nucleus. Anti-thyroglobulin antibodies were positive, and he was initially diagnosed as Hashimoto's encephalopathy (HE). However, the response to corticosteroids was not completed as it is usually observed in HE. For that, antibodies for autoimmune encephalitis were tested, and the anti-LGI1 antibodies were positive in serum and cerebrospinal fluid. HE is an important differential diagnosis to consider. Furthermore, the presence of Anti-thyroglobulin antibodies should not be taken as the definitive diagnostic criteria, since these antibodies could be associated with other autoimmune encephalopathies, which include in addition to anti-LGI1, anti-NMDA and anti-Caspr2. Frontiers Media S.A. 2021-01-15 /pmc/articles/PMC7843919/ /pubmed/33519701 http://dx.doi.org/10.3389/fneur.2020.620483 Text en Copyright © 2021 Otiniano-Sifuentes, Cuba Antezana, De La Cruz Ramirez, Pacheco-Barrios and Segura Chavez. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Otiniano-Sifuentes, Ricardo
Cuba Antezana, Anali
De La Cruz Ramirez, Walter F.
Pacheco-Barrios, Kevin
Segura Chavez, Darwin A.
Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies
title Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies
title_full Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies
title_fullStr Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies
title_full_unstemmed Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies
title_short Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies
title_sort case report: anti-lgi1 limbic encephalitis associated with anti-thyroid autoantibodies
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843919/
https://www.ncbi.nlm.nih.gov/pubmed/33519701
http://dx.doi.org/10.3389/fneur.2020.620483
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