Autoimmune Encephalitis Associated with Anti-N-methyl-D-aspartate Receptor and Anti-Hu Antibodies Successfully Treated with Carboplatin and Etoposide for Small-cell Lung Cancer

Intern Med. 2023 Feb 1;62(3):469-474. doi: 10.2169/internalmedicine.9707-22. Epub 2022 Jun 28.

Abstract

The coexistence of multiple autoantibodies associated with autoimmune encephalitis (AE) is rare. A 63-year-old woman developed psychosis and consciousness disorder. Her cerebrospinal fluid was positive for anti-N-methyl-D-aspartate receptor antibodies, and her serum was positive for anti-Hu antibodies. Enhanced computed tomography revealed a mass in the right pulmonary hilum. AE complicated with small-cell lung cancer was diagnosed. Immunotherapy (steroid therapy and intravenous immunoglobulin) and four courses of carboplatin-etoposide chemotherapy were required to improve her neurological symptoms. When the coexistence of multiple antibodies is detected, despite its rarity, aggressive detection and treatment of any underlying malignancy may be recommended.

Keywords: anti-Hu antibody; anti-NMDAR antibody; autoimmune encephalitis; carboplatin; etoposide; small-cell lung cancer.

Publication types

  • Case Reports

MeSH terms

  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis* / complications
  • Autoantibodies
  • Carboplatin / therapeutic use
  • Etoposide / therapeutic use
  • Female
  • Humans
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Middle Aged
  • Receptors, N-Methyl-D-Aspartate

Substances

  • Carboplatin
  • Etoposide
  • aspartic acid receptor
  • Autoantibodies
  • Receptors, N-Methyl-D-Aspartate

Supplementary concepts

  • Hashimoto's encephalitis