Anti-LGI1 autoimmune encephalitis in a patient with rheumatoid arthritis and MGUS
  • Lamprini Bounou
    Department of Neurology, Laiko General Hospital, Athens, Greece
  • Aimilios Kaklamanos
    Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  • Theodoros Androutsakos
    Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  • Elissavet Kemanetzoglou
    Department of Neurology, Laiko General Hospital, Athens, Greece
  • Ioanna Moustaka
    Department of Neurology, Laiko General Hospital, Athens, Greece
  • Athanasios Protogerou
    Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  • Athina Euthimiou
    Department of Neurology, Laiko General Hospital, Athens, Greece

Keywords

Anti-LGI1 autoimmune encephalitis, limbic encephalitis, rheumatoid arthritis, MGUS, hyponatraemia

Abstract

Background: Anti-leucine-rich glioma inactivated 1 limbic encephalitis (anti-LGI1 LE) is one of the most frequent autoimmune encephalitis, commonly coexisting with other autoimmune diseases. Rheumatoid arthritis (RA) and monoclonal gammopathy of unknown significance (MGUS) are commonly associated with autoimmune phenomena. However, neither RA nor MGUS have been described in the literature to date as coexisting with anti-LGI1 LE.
Case description: We present the case of anti-LGI1 LE in a male patient with rheumatoid arthritis, who was also found to have an MGUS. The patient was initially treated with corticosteroids and IV immunoglobulin. After a mild relapse, his treatment was complemented with rituximab, resulting in complete regression of the disease symptoms.
Conclusions: Our report provides evidence for the coexistence of anti-LGI1 LE with RA and/or MGUS, thus extending the differential diagnosis of patients suffering with these disease entities that present with neuropsychiatric symptoms suggestive of encephalitis. Moreover, this case raises challenges on the management of the coexistence of these diseases, given the lack of therapeutic guidelines and their potential interaction on a pathophysiological and a clinical level.

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    Published: 2024-06-18
    Issue: 2024: LATEST ONLINE (view)

    How to cite:
    1.
    Bounou L, Kaklamanos A, Androutsakos T, Kemanetzoglou E, Moustaka I, Protogerou A, Euthimiou A. Anti-LGI1 autoimmune encephalitis in a patient with rheumatoid arthritis and MGUS. EJCRIM 2024;11 doi:10.12890/2024_004572.