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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Ovarian teratoma related anti-N-methyl-D-aspartate receptor encephalitis: A case series and review of the literature
Shan-Ji Li, Min-Hua Yu, Jie Cheng, Wen-Xin Bai, Wen Di
Shan-Ji Li, Min-Hua Yu, Department of Obstetrics and Gynecology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Jie Cheng, Center for Reproductive Medicine, Shanghai Jiao Tong University, Shanghai 200135, China
Wen-Xin Bai, Department of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
Wen Di, Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Wen Di, Shanghai Key Laboratory of Gynecologic Oncology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Wen Di, State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
Author contributions: Li SJ and Yu MH contributed equally to this work; all authors contributed to the design and conduct of study, and approved the submission of this work for publication.
Supported by the Shanghai Municipal Commission of Health and Family Planning, No. 2017ZZ02016; the Funding from National Key Research and Development Program of China, No. 2021YFC2700400; the National Natural Science Foundation of China, No. 81974454; and the Shanghai Municipal Key Clinical Specialty, the Clinical Research Plan of SHDC, No. SHDC2020CR6009-002.
Institutional review board statement: The study was approved by the Ethic Committee of Shanghai Jiao Tong University.
Informed consent statement: Informed consent was obtained from all patients for participation in this study and the publication of results.
Conflict-of-interest statement: None of the authors have any conflict of interest to report.
Data sharing statement: Not available.
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: Wen Di, MD, PhD, Professor, Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Road, Pudong New Area, Shanghai 200127, China. diwen163@163.com
Received: July 12, 2021
Peer-review started: July 12, 2021
First decision: July 26, 2021
Revised: August 15, 2021
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: June 6, 2022
ARTICLE HIGHLIGHTS
Research background
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a rare complication of ovarian teratoma that remains poorly understood.
Research motivation
Anti-NMDAR encephalitis can be fatal and the pathogenesis involving association with ovarian teratoma needs to be better understood in order to improve diagnosis as well as patient outcome.
Research objectives
We aimed to better understand anti-NMDAR encephalitis through a thorough examination of six patients enrolled in our hospital in addition to survey of the literature.
Research methods
We evaluated six patients enrolled in our hospital and, additionally, surveyed PubMed and Scopus to evaluate 155 cases of anti-NMDAR encephalitis in 130 reports. Focus was on diagnosis, treatments, and patient outcomes.
Research results
In our patient cohort, five of six patients fully recovered while the 6th patient recovered with deficits. In the surveyed literature, the majority of patients, particularly those with surgical intervention, had positive outcome.
Research conclusions
Our evaluations revealed that surgical outcomes are favorable and early removal of tumor is critical. The importance of postoperative follow-up cannot be over-estimated.
Research perspectives
Early use of corticosteroids and IgG-depleting strategies may improve outcome. Postoperative follow-up is particularly important in case of recurrence.
