Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2023; 11(7): 1586-1592
Published online Mar 6, 2023. doi: 10.12998/wjcc.v11.i7.1586
Four kinds of antibody positive paraneoplastic limbic encephalitis: A rare case report
Pan Huang, Min Xu
Pan Huang, Department of Neurology, People’s Hospital of Deyang City, Deyang 618000, Sichuan Province, China
Min Xu, Department of Neurology, The Second People’s Hospital of Deyang City, Deyang 618000, Sichuan Province, China
Author contributions: Huang P and Xu M reviewed the literature, and contributed to manuscript drafting; Xu M reviewed and edited the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images. This study was approved by the Ethics Committee of People’s Hospital of Deyang City.
Conflict-of-interest statement: The authors declare that they have no conflicts 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: Min Xu, MS, Doctor, Department of Neurology, The second People’s Hospital of Deyang City, No. 340 Minjiang West Road Section, Deyang 618000, Sichuan Province, China. 782067723@qq.com
Received: October 27, 2022
Peer-review started: October 27, 2022
First decision: January 9, 2023
Revised: January 14, 2023
Accepted: February 15, 2023
Article in press: February 15, 2023
Published online: March 6, 2023
Processing time: 126 Days and 0.2 Hours
Abstract
BACKGROUND

It is not uncommon to develop autoimmune encephalitis and paraneoplastic neurological syndromes (PNS). 4 kinds of antibody-positive autoimmune paraneoplastic limbic encephalitis (PLE) have not been reported.

CASE SUMMARY

PNS are distant effects of cancer on the nervous system, rather than syndromes in which cancer directly invades and metastasizes to the nerves and/or muscle tissues. If the limbic lobe system of the brain is involved, this will result in PLE. The detection of patients with PNS is challenging since tumors that cause paraneoplastic neurologic disorders are often asymptomatic, obscure, and thus easily misdiagnosed or missed. Currently, single- or double-antibody-positive paraneoplastic marginal encephalitis has been reported. However, no cases of three or more-antibody-positive cases have been reported. Here, we report a case of PLE that is anti-collapsing response-mediator protein-5, anti-neuronal nuclear antibody-type 1, anti-aminobutyric acid B receptor, and anti-glutamate deglutase positive, and address relevant literature to improve our understanding of the disease.

CONCLUSION

This article reports on the management of a case of PLE with four positive antibodies, a review of the literature, in order to raise awareness among clinicians.

Keywords: Paraneoplastic limbic encephalitis; anti-collapsing response-mediator protein-5; anti-neuronal nuclear antibody-type 1; anti-aminobutyric acid B receptor; anti-glutamate deglutase; Case report

Core Tip: This patient mainly had persistent epilepsy as the main clinical manifestation, and a lumbar puncture examination showed anti-collapsing response mediator protein-5; anti-neuronal nuclear antibody-type 1; anti-aminobutyric acid B receptor; anti-glutamate deglutase positive, and further improvement of chest computed tomography and medical examination showed lung small cell carcinoma.