PT  - JOURNAL ARTICLE
AU  - Barbadillo, April Faye Pamillaran
AU  - Quimpo, Rhea Angela Salonga
AU  - Sanchez-Gan, Benilda
TI  - Case of anti-NMDA receptor encephalitis in a female adolescent with favourable response to second-line treatment with cyclophosphamide
AID  - 10.1136/bcr-2022-249991
DP  - 2022 Aug 01
TA  - BMJ Case Reports
PG  - e249991
VI  - 15
IP  - 8
4099  - http://casereports.bmj.com/content/15/8/e249991.short
4100  - http://casereports.bmj.com/content/15/8/e249991.full
SO  - BMJ Case Reports2022 Aug 01; 15
AB  - We report the case of a female adolescent who presented with behavioural changes. She was admitted to our institution due to worsening psychiatric and neurological symptoms, subsequently diagnosed with anti-N-methyl-D-aspartate receptor encephalitis. Additional workup was facilitated to rule out a possible underlying teratoma, but all tests turned out unremarkable. First-line treatment with methylprednisolone pulse therapy and intravenous immunoglobulin was started, to which she showed marked improvement from baseline. One month after discharge, a decision for readmission was made because of persistent episodes of hallucinations, agitation and dyskinesias. In this case report, we highlight the use of cyclophosphamide over rituximab as second-line treatment in a resource-limited setting, owing to its greater availability and lesser cost. Cyclophosphamide treatment was given resulting in a more sustained clinical improvement with return to baseline function.