Autoimmune Encephalitis Concomitant with SARS-CoV-2 Infection: Insight from 18F-FDG PET Imaging and Neuronal Autoantibodies.
J Nucl Med
; 61(12): 1726-1729, 2020 Dec.
Article
in English
| MEDLINE | ID: covidwho-993173
ABSTRACT
We report the case of a 72-y-old man with concomitant autoimmune encephalitis and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patient presented with subacute cerebellar syndrome and myoclonus several days after general infectious symptoms began. Methods:
Clinical examination, CT, PET, MRI, and autoantibody testing were performed.Results:
The oropharyngeal swab test was positive for SARS-CoV-2. The brain MRI results were normal. Cerebrospinal fluid testing showed normal cell counts, a negative result on reverse-transcription polymerase chain reaction testing, and no oligoclonal banding. Brain 18F-FDG PET showed diffuse cortical hypometabolism associated with putaminal and cerebellum hypermetabolism, compatible with encephalitis and especially cerebellitis. The immunologic study revealed high titers of IgG autoantibodies in serum and cerebrospinal fluid directed against the nuclei of Purkinje cells, striatal neurons, and hippocampal neurons. Whole-body 18F-FDG PET and CT scans did not show neoplasia. Treatment with steroids allowed a rapid improvement in symptoms.Conclusion:
This clinical case argues for a possible relationship between SARS-CoV-2 infection and autoimmune encephalitis and for the use of 18F-FDG PET in such a context.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Autoantibodies
/
Fluorodeoxyglucose F18
/
Positron-Emission Tomography
/
Encephalitis
/
Hashimoto Disease
/
COVID-19
/
Neurons
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Topics:
Long Covid
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
J Nucl Med
Year:
2020
Document Type:
Article
Affiliation country:
Jnumed.120.249292
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