Striational Muscle Antibody Positivity Heralding a Diagnosis of Autoimmune Encephalitis associated with Epiglottic Squamous Cell Carcinoma: A Case Report

Arun Swaminathan

Striational Muscle Antibody Positivity Heralding a Diagnosis of Autoimmune Encephalitis associated with Epiglottic Squamous Cell Carcinoma: A Case Report

Arun Swaminathan * §

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§ University of Nebraska Medical Center

Striational Muscle Antibody Positivity Heralding a Diagnosis of Autoimmune Encephalitis associated with Epiglottic Squamous Cell Carcinoma: A Case Report

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Abstract

A 59 yo woman presented to our emergency room with confusion, spells of loss of awareness over four weekswith malaise, weakness, gait difficulties, and 30 lb weight loss over one year. Brain imaging was unremarkable. EEGs revealed diffuse slowing, triphasic GPDs, and left temporal epileptiform discharges. Spinal fluid showed an elevated protein count. She received a working diagnosis of autoimmune encephalitis and received steroids and antiepileptic medications. She experienced an improvement in symptoms and went home. Follow up revealed elevated striational muscle antibodies and enhancement of spinal nerve roots suggesting an autoimmune neurological syndrome. She received intravenous immune globulin (IVIg) therapy and had periods of improvement followed by worsening a few months later with each dose of IVIg. She presented to the hospital a year with worsening dysphagia and an endoscopy showing an epiglottic mass. Pathology confirmed squamous cell carcinoma, and she received chemotherapy and radiation. We wish to share this rare case of autoimmune encephalitis presenting with only striational antibodies as a heralding sign of a tumor. We postulate that, in the correct context, the presence of striational antibodies alone, despite low titers, may support a diagnosis of autoimmune encephalitis from underlying malignancy.

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Funding

No external funding was declared for this work.

Conflict of Interest

The authors declare no conflict of interest.

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No ethics committee approval was required for this article type.

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Not applicable for this article.

How to Cite This Article

Arun Swaminathan. 2020. "Striational Muscle Antibody Positivity Heralding a Diagnosis of Autoimmune Encephalitis associated with Epiglottic Squamous Cell Carcinoma: A Case Report". Global Journal of Medical Research - F: Diseases GJMR-F Volume 20 (GJMR Volume 20 Issue F8).

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GJMR Volume 20 Issue F8

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Journal Specifications

Crossref Journal DOI 10.17406/gjmr

Print ISSN 0975-5888

e-ISSN 2249-4618

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Classification

GJMR-F Classification NLMC Code: WP 460

Submission ReceivedDecember 7, 2019
Peer Review Double Blind
Handling Editor
Accepted January 2, 2020
Published January 15, 2020

Version of record

v1.2

Issue date

August 20, 2020

Language

English

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