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Autoimmune encephalitis with autoimmune myocarditis

Authors: Anuraag Gattu; Chirag Sunil Lalwani; Sudheeran Kannoth; Siby Gopinath; Vivek Nambiar; Udit Saraf; Anandkumar Anandakuttan; +1 Authors

Autoimmune encephalitis with autoimmune myocarditis

Abstract

Autoimmune encephalitis can be associated with other autoimmune disorders, but the concurrent presence of autoimmune encephalitis and autoimmune myocarditis is uncommon. A man in his 80s with type 2 diabetes mellitus, hypertension and hypothyroidism presented with altered mental status for 8 months. He was previously diagnosed with myasthenia gravis, but therapy was discontinued due to infection. On presentation, he was wheelchair-bound with disorientation, proximal weakness, hyporeflexia and bradykinesia. MRI brain showed atrophy, and cerebrospinal fluid analysis revealed mildly elevated protein (58.8 mg/dL) without pleocytosis. Despite treatment for urinary tract infection and septic encephalopathy, his sensorium did not improve. A diagnosis of possible autoimmune encephalitis was considered, though antibody studies were negative. Whole-body Positron Emission Tomography - Computerized Tomography (PET-CT) ruled out malignancy and showed global hypokinesia, while echocardiography showed severe left ventricular systolic dysfunction. Positive acetylcholine receptor antibody led to intravenous immunoglobulin therapy, which improved his sensorium and cardiac dysfunction suggesting a positive association.

Keywords

Male, Aged, 80 and over, Myocarditis, Echocardiography, Positron Emission Tomography Computed Tomography, Humans, Encephalitis, Immunoglobulins, Intravenous, Hashimoto Disease, Magnetic Resonance Imaging, Autoimmune Diseases

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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