Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jan 28, 2025; 17(1): 102579
Published online Jan 28, 2025. doi: 10.4329/wjr.v17.i1.102579
Rare mixed dementia: A case report
Xu-Hui Chen, Wen Xia, Jia-Bin Ma, Jiao Chen, Jun Hu, Xin Shi, Jing-Jing Yu, Jia Gong, Lu Liu, Yong-An Sun, Zhi-Gang Liu
Xu-Hui Chen, Yong-An Sun, Department of Neurology, Peking University First Hospital, Beijing 100034, China
Xu-Hui Chen, Wen Xia, Jiao Chen, Jun Hu, Xin Shi, Jing-Jing Yu, Jia Gong, Lu Liu, Department of Neurology, Peking University Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
Jia-Bin Ma, Zhi-Gang Liu, Laboratory of Functional Chemistry and Nutrition of Food, Northwest A&F University, Yangling 712100, Shanxi Province, China
Co-first authors: Xu-Hui Chen and Wen Xia.
Author contributions: Chen XH and Wen X conceptualized and designed the case report, drafted and revised the initial manuscript; Ma JB contributed to the conception and design of the manuscript; Chen J contributed to the formal analysis, visualization, and writing, review and editing of the manuscript; Hu J, Shi X, Yu JJ, Gong J, and Liu L were involved in data curation; Liu ZG contributed to the supervision, and writing, review and editing of the manuscript; Chen XH, Xia W, Ma JB, Chen J, Hu J, Shi X, Yu JJ, Gong J, Liu L, Sun YA, Liu ZG reviewed the results and approved the final version of the manuscript.
Supported by the Shenzhen Science and Technology Program, No. JCYJ20220818102810022; Shenzhen University Teaching Reform fund, No. JG2023166; National Natural Science Foundation of China, No. 12231018; and Science and Technology Innovation 2030-Major Project, No. 2021ZD0201805.
Informed consent statement: The informed consent form has been signed.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-An Sun, PhD, Professor, Department of Neurology, Peking University First Hospital, No. 8 Xishku Street, Xicheng District, Beijing 100034, China. sya@bjmu.edu.cn
Received: October 25, 2024
Revised: December 22, 2024
Accepted: January 14, 2025
Published online: January 28, 2025
Processing time: 90 Days and 22.9 Hours
Abstract
BACKGROUND

Autoimmune encephalitis (AE) is a rare and recently described neuroinflammatory disease associated with specific autoantibodies. Anti-leucine-rich glioma inactivated 1 (anti-LGI1) encephalitis is a rare but treatable type of AE discovered in recent years. Alzheimer’s disease (AD) is a degenerative brain disease and the most common cause of dementia. AD may undergo a series of pathological physiological changes in brain tissue 20 years before the onset of typical symptoms. The stage of mild cognitive impairment (MCI) that occurs during this process, known as MCI due to AD, is the earliest stage with clinical symptoms. MCI is typically categorized into two subtypes: Amnestic MCI (aMCI) and non-aMCI.

CASE SUMMARY

This report describes a patient with rapid cognitive impairment, diagnosed with anti-LGI1 antibody-mediated AE and aMCI, and treated at Peking University Shenzhen Hospital in March 2023. The patient was hospitalized with acute memory decline for more than 3 months. Both the cerebrospinal fluid and serum were positive for anti-LGI1 antibodies, biomarkers of AD coexisting in the patient’s cerebrospinal fluid. Following combination treatment with immunoglobulin therapy and glucocorticoid, plus inhibition of acetylcholinesterase, the patient’s cognitive function significantly improved. Throughout the 3-month follow-up period, a sustained improvement in cognitive function was observed. The results of serum anti-LGI1 antibody were negative.

CONCLUSION

This case has raised awareness of the possible interaction between AE and early AD (including MCI due to AD), and alerted clinicians to the possibility of concurrent rare and common diseases in patients presenting with cognitive impairment.

Keywords: Anti-leucine-rich glioma inactivated 1; Encephalitis; Alzheimer’s disease; Cognitive impairment; Case report

Core Tip: Here we present a case of simultaneous autoimmune encephalitis mediated by anti-leucine-rich glioma inactivated 1 antibody and amnestic mild cognitive impairment caused by Alzheimer’s disease. After active treatment, the patient’s symptoms significantly improved. This case report aims to remind clinical doctors to consider the possibility of rare and common diseases in patients with cognitive impairment.