The development of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is often associated with neoplasia or infectious diseases as antibodies against neurons or synaptic proteins surface. A 30-year-old male patient was admitted to our department because of neurocognitive symptoms, particularly memory difficulties which had appeared a year prior and since then had been increasing. He had a medical history of smoking and hypertension. On examination, there were no focal neurological deficits. However, neuropsychological tests confirmed a lack of concentration and short-term memory impairment. Brain magnetic resonance imaging (MRI) and electroencephalography (EEG) remained unremarkable. Cerebrospinal fluid (CSF) analysis revealed a low lymphocytic pleocytosis without oligoclonal bands. Serum testing for human immunodeficiency virus (HIV) was positive with 420,000 HIV-1-RNA copies/ml. On a more detailed physical examination, a large number of purple patches were found on the entire body, which a biopsy confirmed to be Kaposi sarcoma (KS). A positive serum and CSF NMDA receptor antibody titer (serum 1:280; CSF 1:8) confirmed the diagnosis of an AIDS-associated anti-NMDA receptor encephalitis; therefore, we treated him with antiretroviral and immunosuppressive therapy. After 12 months, the KS lesions faded and the cognitive deficits improved slightly. Our case highlights that a detailed clinical examination and searching for neoplasia and/or an infection are helpful, though often neglected, tools for detecting an anti-NMDA receptor encephalitis.

中文翻译：

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原发性艾滋病毒感染，表现为卡波济肉瘤和边缘性脑炎。

抗N-甲基-D-天冬氨酸（NMDA）受体脑炎的发展通常与瘤形成或传染性疾病有关，因为它们是针对神经元或突触蛋白的抗体。一名30岁的男性患者因神经认知症状而入院，尤其是一年前出现的记忆困难，此后一直在增加。他有吸烟和高血压的病史。经检查，没有局灶性神经功能缺损。然而，神经心理学测试证实缺乏专注力和短期记忆障碍。脑磁共振成像（MRI）和脑电图（EEG）仍然不明显。脑脊液（CSF）分析显示低淋巴细胞性胞吞作用，无寡克隆带。人体免疫缺陷病毒（HIV）的血清检测呈阳性，HIV / RNA拷贝数为420,000 / ml。在更详细的体格检查中，在整个身体上发现了大量紫色斑块，活检证实为紫色斑块状肉瘤（KS）。血清和CSF NMDA受体抗体滴度呈阳性（血清1：280； CSF 1：8）证实诊断为AIDS相关的抗NMDA受体脑炎；因此，我们用抗逆转录病毒和免疫抑制疗法治疗了他。12个月后，KS病变消退，认知缺陷略有改善。我们的病例强调，详细的临床检查和寻找瘤形成和/或感染是有用的工具，尽管通常被忽略，但它们是检测抗NMDA受体脑炎的工具。在全身发现大量紫色斑块，活检证实为卡波西肉瘤（KS）。血清和CSF NMDA受体抗体滴度呈阳性（血清1：280； CSF 1：8）证实诊断为AIDS相关的抗NMDA受体脑炎；因此，我们用抗逆转录病毒和免疫抑制疗法治疗了他。12个月后，KS病变消退，认知功能障碍略有改善。我们的病例强调，详细的临床检查和寻找瘤形成和/或感染是有用的工具，尽管通常被忽略，但它们是检测抗NMDA受体脑炎的工具。在全身发现大量紫色斑块，活检证实为卡波西肉瘤（KS）。血清和CSF NMDA受体抗体滴度呈阳性（血清1：280； CSF 1：8）证实诊断为AIDS相关的抗NMDA受体脑炎；因此，我们用抗逆转录病毒和免疫抑制疗法治疗了他。12个月后，KS病变消退，认知缺陷略有改善。我们的案例强调，详细的临床检查和寻找瘤形成和/或感染是有用的工具，尽管通常被忽略，但它们是检测抗NMDA受体脑炎的工具。8）证实诊断为艾滋病相关的抗NMDA受体脑炎；因此，我们用抗逆转录病毒和免疫抑制疗法治疗了他。12个月后，KS病变消退，认知缺陷略有改善。我们的病例强调，详细的临床检查和寻找瘤形成和/或感染是有用的工具，尽管通常被忽略，但它们是检测抗NMDA受体脑炎的工具。8）证实诊断为艾滋病相关的抗NMDA受体脑炎；因此，我们用抗逆转录病毒和免疫抑制疗法治疗了他。12个月后，KS病变消退，认知缺陷略有改善。我们的病例强调，详细的临床检查和寻找瘤形成和/或感染是有用的工具，尽管通常被忽略，但它们是检测抗NMDA受体脑炎的工具。