Abstract Background Anti-dipeptidyl-peptidase-like-protein 6 (DPPX) encephalitis is a rare type of autoimmune encephalitis typically characterized with weight loss, Central nervous system (CNS) hyperexcitability symptoms, and cognitive symptoms. However, increasing case reports suggest a more diverse clinical presentation. We report a case of insidious onset anti-DPPX encephalitis with previous history of Epstein-Barr virus (EBV) meningitis, diagnosed with gastric cancer after 2 years follow-up. Case presentation: a 72-year-old emaciated male presented with recurrent seizures during the last 20 years, personality changes over 10 years and memory loss in recent 2 years, with a clear history of viral meningitis in his childhood. Laboratory tests showed CSF positive IgG antibody to EBV virus, and serum positive DPPX antibody, MRI showed no significant changes, which supported the diagnosis of anti-DPPX encephalitis and previous EBV meningitis combined with his medical history. Two years after discharge, he was diagnosed with gastric cancer with multiple metastases receiving palliative care. In this report, we reviewed the clinical manifestations and characteristics of anti-DPPX encephalitis and explored the correlation among EBV infection, anti-DPPX encephalitis and gastric cancer. Conclusions The case illustrates a rare circumstance of EBV meningitis in the childhood, a long-stand stable course of anti-DPPX encephalitis and subsequent gastric cancer. Through this case report, we want to raise the awareness among clinical neurologists of anti-DPPX encephalitis even in patients with chronic course and strengthen the screening for malignancy in these patients.
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Wu et al. (2024) studied this question.
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