Thymoma-associated autoimmune encephalitis with positive Titin antibodies: A case report

We report a case of thymoma-associated autoimmune encephalitis with positive Titin antibodies. The patient had cognitive dysfunction, psychiatric symptoms and symptomatic epilepsy. PET-CT indicated space-occupied lesion at the thoracic entrance. The patient was diagnosed with paraneoplastic autoimmu...

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Bibliographic Details
Published in:Journal of neuroimmunology 2021-09, Vol.358, p.577670-577670, Article 577670
Main Authors: Yao, Yu, Li, Xiang, Lin, Jie, Zhang, Xu, Wang, Hanmin
Format: Article
Language:English
Subjects:
Adult
Autoimmune encephalitis
Connectin - blood
Encephalitis - blood
Encephalitis - complications
Encephalitis - diagnostic imaging
Hashimoto Disease - blood
Hashimoto Disease - complications
Hashimoto Disease - diagnostic imaging
Humans
Male
Thymoma
Thymoma - blood
Thymoma - complications
Thymoma - diagnostic imaging
Thymus Neoplasms - blood
Thymus Neoplasms - complications
Thymus Neoplasms - diagnostic imaging
Titin
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Summary:We report a case of thymoma-associated autoimmune encephalitis with positive Titin antibodies. The patient had cognitive dysfunction, psychiatric symptoms and symptomatic epilepsy. PET-CT indicated space-occupied lesion at the thoracic entrance. The patient was diagnosed with paraneoplastic autoimmune encephalitis. After immunotherapy, his condition improved and underwent thymectomy. Pathology revealed type A thymoma. The patient recurred 10 days after the operation. Thymoma is associated with AE. And Titin antibodies may be involved in the extensive immune response to antigens which the patient's thymoma ectopically expressed. This case reflects the complexity of the immune relationship among autoimmune encephalitis, Titin antibodises and thymoma. Titin antibody may have a certain guiding significance for the treatment and prognosis of autoimmune encephalitis. [Display omitted] •Anti-Titin may be involved in the extensive immune response to antigens which the thymoma ectopically expressed•Thymoma-associated autoimmune encephalitis with positive anti-Titin may relapse after thymectomy.•Titin may expose many different possible antigens / antibody sites for autoimmune reactions by molecular mimicry.
ISSN:0165-5728
1872-8421
DOI:10.1016/j.jneuroim.2021.577670