Create a free QxMD account to take advantage of the features offered by Read like saving your papers and creating collections. Get Started Unremitting diarrhoea in a girl diagnosed anti-N-methyl-D-aspartate-receptor encephalitis: A case report Norrapat Onpoaree, Montida Veeravigrom, Anapat Sanpavat, Narissara Suratannon, Palittiya Sintusek World Journal of Clinical Cases 2020 October 26, 8 (20): 4866-4875 BACKGROUND: Asymptomatic cytomegalovirus (CMV) infection is common in children; in contrast, in children with a weakened immune system, invasive CMV can occur. This is the first case report of a severe manifestation of CMV esophago-enterocolitis in a girl diagnosed with anti-N-methyl-D-aspartate-receptor (anti-NMDAR) encephalitis who received only a moderate dose of corticosteroid therapy. CASE SUMMARY: A 12-year-old-Thai girl presented with acute behavioural change and headache for 6 d. Electroencephalogram and positivity for NMDAR autoantibodies were compatible with anti-NMDAR encephalitis. Hence, she received pulse methylprednisolone 10 mg/kg per day for 4 d and continued with prednisolone 1.2 mg/kg per day. On day 42 of corticosteroid therapy, she developed unremitting vomiting and diarrhoea. Endoscopy showed multiple ulcers and erythaematous mucosa along the gastrointestinal tract. Tissue CMV viral load and viral-infected cells confirmed CMV esophago-enterocolitis. Therefore, the patient received ganciclovir 5 mg/kg per dose every 12 h for 3 wk and then 5 mg/kg per dose once daily for 3 wk. Unremitting diarrhoea slowly improved from stool output 1-4 L per day to 1-2 L per day after 3 wk of treatment. Pulse methylprednisolone 20 mg/kg for 5 d was initiated and continued with prednisolone 1 mg/kg per day. After this repeated pulse methylprednisolone treatment, surprisingly, diarrhoea subsided. Immunologic work-up was performed to rule out underlying immune deficiency with unremarkable results. CONCLUSION: Unremitting diarrhoea from CMV esophago-enterocolitis subsided with antiviral and methylprednisolone therapy, implying the immune and NMDAR dysregulation in anti-NMDAR encephalitis. Full Text Links We have located links that may give you full text access. Additional links Discussion You are not logged in. Sign Up or Log In to join the discussion. Trending Papers 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Steve R Ommen, Seema Mital, Michael A Burke, Sharlene M Day, Anita Deswal, Perry Elliott, Lauren L Evanovich, Judy Hung, José A Joglar, Paul Kantor, Carey Kimmelstiel, Michelle Kittleson, Mark S Link, Martin S Maron, Matthew W Martinez, Christina Y Miyake, Hartzell V Schaff, Christopher Semsarian, Sorajja Paul Circulation 2020 November 20, : CIR0000000000000938 Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers : A Randomized Controlled Trial. Henning Bundgaard, Johan Skov Bundgaard, Daniel Emil Tadeusz Raaschou-Pedersen, Christian von Buchwald, Tobias Todsen, Jakob Boesgaard Norsk, Mia M Pries-Heje, Christoffer Rasmus Vissing, Pernille B Nielsen, Ulrik C Winsløw, Kamille Fogh, Rasmus Hasselbalch, Jonas H Kristensen, Anna Ringgaard, Mikkel Porsborg Andersen, Nicole Bakkegård Goecke, Ramona Trebbien, Kerstin Skovgaard, Thomas Benfield, Henrik Ullum, Christian Torp-Pedersen, Kasper Iversen Annals of Internal Medicine 2020 November 18 How to ventilate obstructive and asthmatic patients. Alexandre Demoule, Laurent Brochard, Martin Dres, Leo Heunks, Amal Jubran, Franco Laghi, Armand Mekontso-Dessap, Stefano Nava, Lamia Ouanes-Besbes, Oscar Peñuelas, Lise Piquilloud, Theodoros Vassilakopoulos, Jordi Mancebo Intensive Care Medicine 2020 November 9 Volume overload in hemodialysis: diagnosis, cardiovascular consequences, and management. Charalampos Loutradis, Pantelis A Sarafidis, Charles J Ferro, Carmine Zoccali Nephrology, Dialysis, Transplantation 2020 November 13 Clinical Management of Hyperkalemia. Biff F Palmer, Juan Jesus Carrero, Deborah J Clegg, Gates B Colbert, Michael Emmett, Steven Fishbane, Debra J Hain, Edgar Lerma, Macaulay Onuigbo, Anjay Rastogi, Simon D Roger, Bruce S Spinowitz, Matthew R Weir Mayo Clinic Proceedings 2020 November 4 Comparing Laparoscopic Elective Sigmoid Resection With Conservative Treatment in Improving Quality of Life of Patients With Diverticulitis: The Laparoscopic Elective Sigmoid Resection Following Diverticulitis (LASER) Randomized Clinical Trial. Alexandre Santos, Panu Mentula, Tarja Pinta, Shamel Ismail, Tero Rautio, Risto Juusela, Aleksi Lähdesmäki, Tom Scheinin, Ville Sallinen JAMA Surgery 2020 November 18
