Supplementary Material for: Anti-NMDA Receptor Encephalitis in a Patient with Tuberous Sclerosis-Related Brain Tumor: A Case Report

Anti-NMDA receptor (NMDAR) encephalitis (NMDARE) is an important treatable cause of autoimmune psychosis in all age-groups, which is sometimes associated with tumors, especially ovarian teratomas. Tuberous sclerosis complex (TSC) is an autosomal dominant inherited neurocutaneous disease predisposing for development of benign tumors. We present a case of a 35-year-old woman with recurrent episodes of schizophrenia-like symptoms. Accidentally, MRI revealed TSC-related brain tumors. NMDAR antibody titers were strongly positive in serum and cerebrospinal fluid. This is the first case describing an overlap of NMDARE and TSC-related brain tumors. A review of brain tumors and NMDARE is given in the supplementary material. Although a causal link seems interesting from a pathophysiological point of view, we are in favor of a coincidence.

抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎（NMDARE）是各年龄段人群中一类重要的可治疗性自身免疫性精神病病因，该病有时可伴发肿瘤，尤以卵巢畸胎瘤为常见。结节性硬化症（TSC）是一种常染色体显性遗传性神经皮肤疾病，易诱发良性肿瘤的发生。本文报告1例35岁女性患者，其反复出现类精神分裂症症状。磁共振成像（MRI）意外检出与TSC相关的脑肿瘤。患者血清及脑脊液（cerebrospinal fluid）中NMDAR抗体滴度均呈强阳性。本研究为首例报道NMDARE与TSC相关性脑肿瘤共现的病例。补充材料中附有脑肿瘤与NMDARE的相关综述。尽管从病理生理学角度来看，二者存在因果关联的假说颇具研究价值，但我们更倾向于认为该现象为偶然巧合。