Autoimmune Encephalitis Induced by SARS-CoV-2 Infection Treated with Thymectomy
Thymomas have been associated with the generation of paraneoplastic autoantibodies to neurogenic epitopes, collapsin-response-mediator protein-5 receptor (CRMP-5) and alpha-amino-3-hydroxyl-5methyl-4isoxazolepropionic acid receptor (AMPAR), in patients with acute viral infection. We report a patient with thymoma and myasthenia gravis, with SARS-CoV-2 infection, who became comatose secondary to autoimmune encephalitis. Plasmapheresis, high-dose steroids, pyridostigmine, eculizumab, and rituximab did not restore neurologic function. Robotic thymectomy with thymoma resection rendered CRMP-5 and AMPAR antibody titers undetectable and restored neurologic function. Thoracic surgeons should be aware of this rare condition and know that thymectomy is a potential cure for autoimmune-induced encephalitis in patients with thymoma.
