TY - JOUR
T1 - Anti-Ma2-associated encephalitis in a patient with testis carcinoma
AU - Suwijn, Sven R.
AU - Klieverik, Lars P.
AU - Odekerken, Vincent J. J.
PY - 2016
Y1 - 2016
N2 - A 30-year-old man presented with 3 months of alternating hyper- and hypothermia, libido loss, hypersomnia, and headache. Neurologic examination was unremarkable. Laboratory tests revealed low serum testosterone and hypocortisolism. MRI showed hypothalamic T2 hyperintensity and contrast enhancement (figure, A). CSF analysis showed moderate lymphocytosis. Cerebral infections and malignancies were excluded. Methylprednisolone was started based on a working-diagnosis of lymphocytic hypothalamitis. After initial improvement, the patient relapsed, with MRI showing limbic involvement (figure, B). Serum and CSF screening was positive for anti-MA2. Ultrasonography showed microcalcification of the right testicle, which was resected. Histology showed focal germ cell neoplasia
AB - A 30-year-old man presented with 3 months of alternating hyper- and hypothermia, libido loss, hypersomnia, and headache. Neurologic examination was unremarkable. Laboratory tests revealed low serum testosterone and hypocortisolism. MRI showed hypothalamic T2 hyperintensity and contrast enhancement (figure, A). CSF analysis showed moderate lymphocytosis. Cerebral infections and malignancies were excluded. Methylprednisolone was started based on a working-diagnosis of lymphocytic hypothalamitis. After initial improvement, the patient relapsed, with MRI showing limbic involvement (figure, B). Serum and CSF screening was positive for anti-MA2. Ultrasonography showed microcalcification of the right testicle, which was resected. Histology showed focal germ cell neoplasia
U2 - https://doi.org/10.1212/WNL.0000000000002574
DO - https://doi.org/10.1212/WNL.0000000000002574
M3 - Editorial
C2 - 27163661
SN - 0028-3878
VL - 86
SP - 1461
JO - Neurology
JF - Neurology
IS - 15
ER -