Autoimmune Case Study

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TERMINOLOGY CLINICAL CLARIFICATION z • An autoimmune condition {with serum or CSF(cerebrospinal fluid) antibodies found against the N-methyl-D-aspartate {NMDA) receptor} associated with neurological, psychiatric, and autonomic symptoms. • Generally found in young women and often linked with ovarian teratomas. • High index of suspicion is required to diagnose. DIAGNOSIS CLINICAL PRESENTATION • History o Disease symptoms are preceded by generalized symptoms such as fever, fatigue, headaches, nausea, vomiting etc. o Initially in the disease process, the symptoms can be behavioral, psychiatric, or neurologic {confusion, agitation, anxiety, depression, hallucinations, seizures, memory problems, movement disorders etc.) - Children {s family - Regarding…show more content…
• At the 2 year mark, a mortality of 7% is reported. 1 • The reported potential for relapse is 12-24% 1 SYNOPSIS KEY POINTS • Common in young females, this disorder starts off with a prodrome of generalized symptoms. • Due to a wide variety of neurologic, psychiatric, and autonomic symptoms associated, a high index of suspicion is required to diagnose. • Presence of antibodies (in serum or CSF) against the GluN1 subunit of NMDA receptor confirms the diagnosis. • Treatment options include immunotherapy and/or plasmapharesis in addition to symptomatic control and removal of associated tumor (if present). • ICU admission may be required due to findings resulting from autonomic instability. • Good prognostic indicators include: tumor removal, early initiation of immunotherapy, and no need of ICU treatment during disease course. • Multidisciplinary team approach is important and can include specialists from neurology, psychiatry, oncology, critical care, medicine, and physiatry. URGENT ACTION • Patients with autonomic instability, affecting their pulmonary and cardiovascular systems require ICU

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