Anti-septin complex positive autoimmune encephalitis after severe falciparum malaria: a case report

Abstract Background Post malaria neurologic syndrome (PMNS) is a rare complication of malaria, usually caused by Plasmodium falciparum. The clinical picture is highly variable and ranges from qualitative disturbances of consciousness and psychosis to damage to the peripheral nerves, usually occurrin...

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Main Authors: Sven Kalbitz, Friederike A. Arlt, Johannes Wolf, Merle Corty, Harald Prüss, Christoph Lübbert
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Malaria Journal
Subjects:
Online Access:https://doi.org/10.1186/s12936-024-05207-3
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author Sven Kalbitz
Friederike A. Arlt
Johannes Wolf
Merle Corty
Harald Prüss
Christoph Lübbert
author_facet Sven Kalbitz
Friederike A. Arlt
Johannes Wolf
Merle Corty
Harald Prüss
Christoph Lübbert
author_sort Sven Kalbitz
collection DOAJ
description Abstract Background Post malaria neurologic syndrome (PMNS) is a rare complication of malaria, usually caused by Plasmodium falciparum. The clinical picture is highly variable and ranges from qualitative disturbances of consciousness and psychosis to damage to the peripheral nerves, usually occurring three to eight weeks after treated malaria. Case presentation We report the case of a 54-year-old male who presented with recurrent clinical symptoms three and a half weeks after severe falciparum malaria. After ruling out recurrent malaria, autoimmune encephalitis was suspected. Corticosteroid therapy led to a rapid improvement of the clinical symptoms. The extended examinations (including cranial MRI and FDG-PET/CT) revealed no pathological findings. Routine serologic autoimmune diagnostics remained negative. However, anti-septin complex antibodies were detected in the serum in a cell-based and a tissue-based immunofluorescence assay. Twelve months after discontinuation of corticosteroid therapy, the patient was free of immunosuppressants and completely asymptomatic. Conclusion To our knowledge, this is the first case of septin complex autoimmunity with encephalitis associated with PMNS. All physicians treating malaria patients should therefore be aware of this rare condition and consider extended autoimmune diagnostics if routine panels remain unremarkable.
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institution Kabale University
issn 1475-2875
language English
publishDate 2024-12-01
publisher BMC
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series Malaria Journal
spelling doaj-art-f08d6cbc23354d3f9c1b1cb87a08ac5e2024-12-15T12:06:40ZengBMCMalaria Journal1475-28752024-12-012311710.1186/s12936-024-05207-3Anti-septin complex positive autoimmune encephalitis after severe falciparum malaria: a case reportSven Kalbitz0Friederike A. Arlt1Johannes Wolf2Merle Corty3Harald Prüss4Christoph Lübbert5Department of Infectious Diseases and Tropical Medicine, Hospital St. GeorgGerman Centre for Neurodegenerative Diseases (DZNE) BerlinDepartment of Laboratory Medicine, Hospital St. GeorgClinical Immunology Laboratory Prof. Dr. Winfried StöckerGerman Centre for Neurodegenerative Diseases (DZNE) BerlinDepartment of Infectious Diseases and Tropical Medicine, Hospital St. GeorgAbstract Background Post malaria neurologic syndrome (PMNS) is a rare complication of malaria, usually caused by Plasmodium falciparum. The clinical picture is highly variable and ranges from qualitative disturbances of consciousness and psychosis to damage to the peripheral nerves, usually occurring three to eight weeks after treated malaria. Case presentation We report the case of a 54-year-old male who presented with recurrent clinical symptoms three and a half weeks after severe falciparum malaria. After ruling out recurrent malaria, autoimmune encephalitis was suspected. Corticosteroid therapy led to a rapid improvement of the clinical symptoms. The extended examinations (including cranial MRI and FDG-PET/CT) revealed no pathological findings. Routine serologic autoimmune diagnostics remained negative. However, anti-septin complex antibodies were detected in the serum in a cell-based and a tissue-based immunofluorescence assay. Twelve months after discontinuation of corticosteroid therapy, the patient was free of immunosuppressants and completely asymptomatic. Conclusion To our knowledge, this is the first case of septin complex autoimmunity with encephalitis associated with PMNS. All physicians treating malaria patients should therefore be aware of this rare condition and consider extended autoimmune diagnostics if routine panels remain unremarkable.https://doi.org/10.1186/s12936-024-05207-3Septin complexAnti-septin antibodiesAutoimmunityAutoimmune encephalitisFalciparum malariaCerebral malaria
spellingShingle Sven Kalbitz
Friederike A. Arlt
Johannes Wolf
Merle Corty
Harald Prüss
Christoph Lübbert
Anti-septin complex positive autoimmune encephalitis after severe falciparum malaria: a case report
Malaria Journal
Septin complex
Anti-septin antibodies
Autoimmunity
Autoimmune encephalitis
Falciparum malaria
Cerebral malaria
title Anti-septin complex positive autoimmune encephalitis after severe falciparum malaria: a case report
title_full Anti-septin complex positive autoimmune encephalitis after severe falciparum malaria: a case report
title_fullStr Anti-septin complex positive autoimmune encephalitis after severe falciparum malaria: a case report
title_full_unstemmed Anti-septin complex positive autoimmune encephalitis after severe falciparum malaria: a case report
title_short Anti-septin complex positive autoimmune encephalitis after severe falciparum malaria: a case report
title_sort anti septin complex positive autoimmune encephalitis after severe falciparum malaria a case report
topic Septin complex
Anti-septin antibodies
Autoimmunity
Autoimmune encephalitis
Falciparum malaria
Cerebral malaria
url https://doi.org/10.1186/s12936-024-05207-3
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