Avin Dehbokri
Epsom and St Helier University Hospitals NHS Trust, United Kingdom.
Title: The devastating illness with an elusive source, A Case report: NMDAR encephalitis and microscopic ovarian teratoma
Biography
Biography: Avin Dehbokri
Abstract
This case study details the story of a previously fit and well 31-year-old woman who presented with progressive systemic and central nervous system symptoms. Initial investigations did not reveal any significant abnormalities, but she continued to deteriorate, developing seizures, and requiring ICU admission with intubation and ventilation. After weeks of diagnostic uncertainty and reviews by multiple specialties she was shown to have anti-NMDA encephalitis through antibody testing. She was treated with immunosuppression and recovered back to her normal baseline. As an outpatient she had follow-up investigations which revealed a very small right ovarian teratoma, thought to have been the source of the anti- NDMA antibodies, which were removed by the gynaecology team as a day case without complications. Subsequent histology report confirmed mature cystic teratoma with evidence of glial tissue. The case highlights that commonly used imaging can be unreliable when investigating for a causative ovarian teratoma in cases such as these, and details the further investigations that can be helpful when there is suspicion of a teratoma, such as PET/CT. The case also highlights how patients with this condition can improve significantly with targeted treatment. The condition is rare enough that most audience would likely be interested in about it, and the paper is written and will be presented in chronological order to allow the audience to think through what they may have done at each stepif they had been part of this woman’s medical team.