Pearls & Oy-sters: DPPX Antibody-Associated Encephalitis in a Patient With Diarrhea, Tremor, Ocular Flutter, and Cognitive-Psychiatric Changes.
Santiago Martinez Sosa, Lauren M Webb, Anna Thomsen et al.
✦ AI-curated · Sources linked
Case in brief
A 57-year-old man presented with a 2-month history of progressive gastrointestinal symptoms, followed by neurological manifestations including tremor, myoclonus, and cognitive changes. Examination revealed ocular flutter and ataxia, while MRI showed hyperintensities in the brainstem and limbic regions. Diagnosis of DPPX antibody-associated encephalitis was confirmed through serological testing. Treatment with intravenous methylprednisolone and plasma exchange, followed by rituximab, resulted in significant symptom improvement.
Diagnostic / clinical pearl
Clinicians should consider DPPX antibody-associated encephalitis in patients with gastrointestinal symptoms followed by neurological changes, as early diagnosis and treatment can lead to significant recovery.
Why it matters
This case emphasizes the importance of recognizing the gastrointestinal prodrome and the utility of panel-based antibody screening in diagnosing autoimmune encephalitides.