Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2023; 11(6): 1379-1384
Published online Feb 26, 2023. doi: 10.12998/wjcc.v11.i6.1379
Epidemic Japanese B encephalitis combined with contactin-associated protein-like 2 antibody-positive autoimmune encephalitis: A case report
Pan Huang
Pan Huang, Department of Neurology, People’s Hospital of Deyang City, Deyang 618000, Sichuan Province, China
Author contributions: Huang P was the patient’s surgeon and drafted the manuscript.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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Corresponding author: Pan Huang, MD, Doctor, Department of Neurology, People’s Hospital of Deyang City, No. 173 TaiShan North Road, Deyang 618000, Sichuan Province, China. 1032857970@qq.com
Received: October 30, 2022
Peer-review started: October 30, 2022
First decision: December 13, 2022
Revised: December 19, 2022
Accepted: February 7, 2023
Article in press: February 7, 2023
Published online: February 26, 2023
Processing time: 116 Days and 20.4 Hours
Abstract
BACKGROUND

It is not uncommon to develop viral encephalitis. Epidemic Japanese B encephalitis infection combined with contactin-associated protein-like 2 (CASPR-2) antibody-positive autoimmune encephalitis has not been reported at present. In clinical work, we need to consider more options.

CASE SUMMARY

A 32-year-old male worker presented with headache, fever and call-unresponsive presentation. Complete cranial magnetic resonance image showed symmetrical abnormal signals in bilateral medial temporal lobe, bilateral thalamus and basal ganglia. Improved lumbar puncture showed that cerebrospinal fluid protein and cell count increased significantly. Viral encephalitis was considered, and the patient's consciousness still increased rapidly after antiviral treatment. Further detection of Cerebrospinal fluid Japanese B encephalitis virus Polymerase Chain Reaction positive, serum autoimmune encephalitis antibody showed CASPR-2 antibody positive (1:320), the patient's condition gradually improved after plasma exchange treatment. 3 mo later, the serum CASPR-2 antibody was negative and the patient's condition was stable.

CONCLUSION

This article reports the world’s first case of Epidemic Japanese B encephalitis infection combined with CASPR-2 antibody-positive autoimmune encephalitis, with a view to raising awareness.

Keywords: Epidemic Japanese B encephalitis; Contactin-associated protein-like 2 antibody; Autoimmune encephalitis

Core Tip: For viral encephalitis in summer, there is no significant improvement after antiviral treatment, so the possibility of Japanese B encephalitis and autoimmune encephalitis should be considered.