Expanding the Spectrum of Autoimmune Encephalitis — A Rare Anti-Recoverin Case

Clinical Presentation and Diagnostic Features

The report describes a 33-year-old woman presenting with a subacute syndrome characterized by temporal lobe seizures, progressive cognitive dysfunction, and insomnia. Neuroimaging demonstrated bilateral hippocampal and thalamic signal abnormalities, while EEG confirmed bilateral temporal epileptiform activity.

Importantly, both serum and cerebrospinal fluid were strongly positive for anti-recoverin antibodies—classically associated with cancer-associated retinopathy but rarely implicated in central nervous system autoimmunity.

After excluding malignancy and alternative etiologies, the patient fulfilled criteria for definite autoimmune limbic encephalitis.

Therapeutic Course and Outcome

The patient was treated with high-dose corticosteroids and intravenous immunoglobulin, alongside antiseizure therapy. Over a two-year follow-up period, she demonstrated sustained clinical and radiologic improvement, with partial persistence of antibody titers.

Broader Implications

This case offers several important contributions to the literature:

It expands the phenotypic spectrum of anti-recoverin–associated disease beyond retinopathy
It reinforces the need to consider intracellular neuronal antibodies in atypical or seronegative AE presentations
It highlights the potential reversibility of rare autoimmune syndromes with timely immunotherapy
It underscores the enduring value of carefully documented case reports in identifying novel or underrecognized disease associations


Knowledge Check

Which statement best reflects the clinical significance of anti-recoverin antibodies in this context?

A. They are exclusively associated with retinal disease
B. They are common markers of anti-NMDA receptor encephalitis
C. They may rarely be associated with autoimmune encephalitis, even in the absence of malignancy
D. They are surface antibodies directly targeting synaptic receptors

Correct answer: C

Closing Perspective

As the landscape of autoimmune neurology continues to expand, recognition of rare antibody-mediated syndromes remains essential. This case exemplifies how individual observations—carefully reported—can meaningfully shape clinical understanding and patient care.

Journal of Medical Case Reports is the world’s first international, PubMed-listed, medical journal devoted to publishing case reports from all medical disciplines and will consider any original case report that expands the field of general medical knowledge, and original research relating to case reports.