[Case of acute limbic encephalitis associated with SLE accompanied with anti-glutamate receptor antibodies].

A 23-year-old woman was admitted to our hospital because of consciousness disturbance and convulsion, preceded by high fever, headache and erythema multiforme. Her brain magnetic resonance images showed hyperintense lesions in the left medial temporal lobe and the left pulvinar nucleus of the thalamus on fluid attenuated inversion recovery images. Analysis of cerebrospinal fluid showed mild pleocytosis, but DNA of herpes simplex or herpes type 6 viruses was negative on PCR. Laboratory investigations showed the presence of anti-nuclear antibodies, anti-RNP antibodies and lupus anticoagulant. The clinical diagnosis was made as acute limbic encephalitis associated with SLE, and subsequent administration of prednisolone improved her conditions. In her serum and cerebrospinal fluid, anti-glutamate receptor (ε2, δ2, ζ1) antibodies were detected, and the titers of the antibodies decreased as the symptoms improved. Although the mechanism underlying limbic encephalitis associated with SLE remains unclear, at least in some cases, the anti-glutamate antibodies may play an important role in the pathogenesis of limbic encephalitis with SLE.