A 24-year-old nulligravida who presented with seizures and behavioral changes with prodrome of flu-like symptoms was initially treated as a case of viral encephalitis. Neurologic diagnostic tests including electroencephalogram, cerebrospinal fluid analysis (CSF), and cranial magnetic resonance imaging were done and inconclusive. Patient's seizure attacks persisted and her neurologic status was deteriorating despite giving appropriate anti-epileptic medications, hence an autoimmune disease was highly considered. The CSF was positive for N-methyl-D-aspartate receptor antibodies. This prompted a search for an associated teratoma and revealed a diagnostic dilemma between presence of an ovarian new growth versus a normal enlarged ovary. Laparoscopy which is both diagnostic and therapeutic was utilized. This report highlights prompt recognition of a rare case and prevented its progression to a potentially fatal condition as resection of the tumor dramatically relieved the symptoms. The significance of minimally invasive surgery in managing this case, effect in fertility, and possible association with pelvic inflammatory disease are also discussed.
Laparoscopy ; N-Methylaspartate ; Teratoma

The case of a pregnant woman initially presenting with low platelets and low haemoglobin and subsequently diagnosed as a case of Evans Syndrome is presented. Owing to its extremely low incidence, little research exists investigating pregnancies complicated by Evans Syndrome. Although diagnosis is simple and straightforward, management of a pregnancy of this nature has proven to be complex and challenging. Further complicating the case and its management is the concurrent diagnosis of Chronic Hypertension with Superimposed Pre-eclampsia, in complete HELLP Syndrome. Pre-eclampsia in the background of Evans Syndrome makes this case a truly interesting case. The individual effects of the two disease entities in a single patient are discussed in this report.

Human ; Female ; Adult ; Pregnancy ; Hellp Syndrome ; Pre-eclampsia ; Evans Syndrome ; Thrombocytopenia ; Anemia, Hemolytic, Autoimmune ; Blood Platelet Disorders ; Hematologic Diseases ; Hypertension

The case of a pregnant woman initially presenting with low platelets and low haemoglobin and subsequently diagnosed as a case of Evans Syndrome is presented. Owing to its extremely low incidence, little research exists investigating pregnancies complicated by Evans Syndrome. Although diagnosis is simple and straightforward, management of a pregnancy of this nature has proven to be complex and challenging. Further complicating the case and its management is the concurrent diagnosis of Chronic Hypertension with Superimposed Pre-eclampsia, in complete HELLP Syndrome. Pre-eclampsia in the background of Evans Syndrome makes this case a truly interesting case. The individual effects of the two disease entities in a single patient are discussed in this report.

Human ; Female ; Adult ; Pregnancy ; Hellp Syndrome ; Pre-eclampsia ; Evans Syndrome ; Thrombocytopenia ; Anemia, Hemolytic, Autoimmune ; Blood Platelet Disorders ; Hematologic Diseases ; Hypertension