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Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater · 2026

Bilateral pulmonary embolism in anti-NMDA receptor encephalitis presenting as acute psychosis.

СтатьяНазвание и аннотация: Перевод в очереди
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Sorajja Natali, Alper Adir, Biavati Luca, Dhakal Rhea, Shah Priyansh, Desai Sudhamsh

Аннотация

BACKGROUND: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune disorder that frequently presents with prominent psychiatric manifestations, often leading to misdiagnosis as a primary psychiatric illness. Early recognition is critical, as timely immunotherapy significantly improves outcomes.

CASE PRESENTATION: A 26-year-old previously healthy man presented with acute psychosis following significant emotional stress and first-time marijuana use 3 days earlier. Initially diagnosed with brief psychotic disorder, he developed catatonia and fever. Cerebral spinal fluid (CSF) and serum anti-NMDA receptor antibodies confirmed the diagnosis. His course was complicated by bilateral pulmonary emboli and drug-induced liver injury. Treatment with intravenous immunoglobulin (IVIG) and high-dose corticosteroids resulted in marked improvement. Malignancy work-up was negative.

CONCLUSION: This case underscores the importance of considering autoimmune encephalitis in young patients presenting with new-onset psychosis, in the apparent absence of malignancy. A high index of suspicion and early CSF evaluation can prevent diagnostic delay and improve patient outcomes.

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

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