CASE REPORT article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1536740
Anti-NMDAR encephalitis associated with neurobrucellosis: causality or coexistence?
Provisionally accepted
- 1Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi Province, China
- 2Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
- 3Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
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Human brucellosis, caused by brucella, is an infectious disease with the specific endemic regions, especially in pastoral areas, and may affect multiple organ systems. Neurological involvement, namely neurobrucellosis occurs in very few of those patients. Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most frequent type of autoimmune encephalitis and is usually associated with tumors or herpes simplex virus infections. However, the link between the two disease entities is unknown. In this report, we present a rare case of a 29-year-old Chinese man with anti-NMDAR encephalitis associated with neurobrucellosis, given the detection of anti-NMDAR antibodies by cell-based assay and brucella melitensis by metagenomic next-generation sequencing in his cerebrospinal fluid sample. The patient improved after antimicrobial treatment and immunotherapies, including steroids and intravenous immunoglobulin. This case implicates Brucella infection as a possible trigger for the production of anti-NMDAR antibodies, and prospective studies should reveal whether there is a casual relationship between brucellosis and anti-NMDAR antibodies.
Keywords: Neurobrucellosis, anti-NMDAR antibodies, Encephalitis, Immunotherapy, causality
Received: 29 Nov 2024; Accepted: 23 Apr 2025.
Copyright: © 2025 YAO, Ma, Ma, Sun, Zhao, Li and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jun Guo, Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi Province, China
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