Teen’s year-long case of depression and seizures caused by brain-injuring autoimmune disease

bright orange antibodies depicted attacking a purple neuron — On this specific kind of autoimmune illness, the mind turns into infected as immune cells begin attacking wholesome cells and tissue. (Picture credit score: Shutterstock)

A teenage woman instantly started experiencing melancholy, seizures and involuntary episodes wherein she’d hit her head or scratch her arms after which not recall doing so. Docs found that her signs truly stemmed from mind irritation brought on by a typical autoimmune illness, a brand new case report reveals.

The 15-year-old woman, from Taiwan, was hospitalized after experiencing a year-long decline in temper, repeated seizures and sudden bursts of those involuntary, self-injuring behaviors, as much as thrice a day. After many checks, her docs concluded she had Sjögren’s syndrome (SS), an autoimmune illness that mostly impacts the tear and salivary glands however also can influence the central nervous system (CNS), which incorporates the mind and spinal twine.

In accordance with the case report, printed June 29 within the journal Frontiers in Immunology, lastly getting an correct prognosis and applicable therapy meant the teenager was capable of get well and get her life “again on monitor,” as she reportedly phrased it to her docs.

Associated: Girl who spontaneously vomited as much as 30 instances a day seemingly had rogue antibodies

SS happens when the physique’s immune system assaults fluid-producing glands, like those who make tears and saliva, resulting in signs of dry mouth and eyes, fatigue and joint ache, based on the Nationwide Institute of Arthritis and Musculoskeletal and Pores and skin Illnesses. Estimated to have an effect on as much as 3% of adults worldwide, the illness is often identified in individuals age 40 or older, and it impacts primarily ladies. SS can generally result in neuropsychiatric signs in adults by damaging the CNS. Nonetheless, comparable problems have not often been studied in younger individuals.

Within the new case, the woman had a historical past of epilepsy associated to a previous bacterial an infection that had been efficiently handled. One yr previous to being identified with SS, the teenager observed her confidence had dropped, her temper worsened, and she or he struggled to sleep and bear in mind issues.

After experiencing three seizures, docs prescribed her antiepileptic treatment that originally improved her signs, however the results did not final. She began to have “episodes” the place she would instantly turn out to be agitated and begin unconsciously harming herself. Generally, simply earlier than her temper or habits modified, the affected person skilled a sudden shift in notion, referred to as an “aura,” which in her case concerned flashes of sunshine or machine sounds. Scans confirmed that these temper and habits shifts have been linked to bursts of seizure-inducing electrical exercise within the mind.

Nonetheless, regardless of this dangerous electrical exercise, additional mind scans discovered no proof of structural injury on her mind, and there have been no abnormalities in her cerebrospinal fluid (CSF), the clear fluid that cushions the mind and spinal twine. Docs additionally dominated out viral an infection, thyroid points and most cancers as potential causes. Believing that the affected person was seemingly experiencing mind irritation, the staff prescribed anti-inflammatory medicine, which partially improved her temper, however her agitation and self-injuring episodes returned.

At this level, the docs screened the affected person’s blood and CSF once more and found particular autoantibodies — antibodies that assault the physique somewhat than overseas invaders. The affected person additionally had a dry mouth and eyes, main the staff to conclude that she had SS. Extra particularly, SS was inflicting a sort of mind irritation ensuing from an immune assault on the organ’s cells, often called autoimmune encephalitis. After beginning an immune-suppressing remedy, the woman’s temper improved and her self-injuring episodes stopped.

Though SS is most prevalent in adults, the staff hopes that the case will elevate consciousness of the situation in youngsters.

“We emphasize the crucial significance of physicians remaining vigilant concerning the potential of underlying bodily situations when encountering sudden cases of self-harm habits that seem like out of context,” senior creator Dr. Chun-Hao Liu, a psychiatrist from the Chang Gung Memorial Hospital at Linkou, advised Reside Science in an e-mail. “It’s crucial to think about varied encephalopathies [brain damage or disease], alongside psychiatric problems, as potential underlying components in people displaying abrupt behavioral modifications, as overlooking these medical situations might result in misdiagnoses.”

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