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May 20, 2026American Journal of Respiratory and Critical Care Medicine

A54-31 Serotonin Syndrome and Adalimumab-Associated Autoimmune Encephalitis: A Dual Diagnostic Challenge in the ICU

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Authors

MAM AbdullahSRS RocheMWM Walter

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Overview

Case demonstrates dual drug-induced encephalopathies in critical care, highlighting diagnostic challenges.

Key Points

  • The case aims to illustrate the complexities of diagnosing overlapping drug-induced encephalopathy in critically ill patients.
  • Detailed medication and supplement history was taken from a 21-year-old male with ankylosing spondylitis.
  • Cerebrospinal fluid analysis and autoimmune testing were conducted to assess neurological symptoms.
  • Treatments included cyproheptadine for serotonin syndrome and high-dose intravenous methylprednisolone for autoimmune encephalitis.
  • The patient initially presented with serotonin syndrome confirmed by symptoms and response to treatment.
  • Autoimmune testing revealed positive anti-histone antibodies, indicating an autoimmune reaction linked to adalimumab.
  • Rapid recovery occurred after discontinuation of adalimumab and corticosteroid therapy.

Cite This Study

Abdullah et al. (2026) studied this question.

synapsesocial.com/papers/6a0d4f34f03e14405aa9a759https://doi.org/10.1093/ajrccm/aamag162.4800
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1B53-21 Steroid-Responsive Undifferentiated Encephalopathy in Septic Shock: Navigating Autoimmune and Infectious Overlap in the ICU2026
  2. 2B48-28 From Psychosis to Seizures: Unmasking Anti-NMDA Receptor Encephalitis in a Young Woman2026
  3. 3Autoimmune encephalitis and axonal polyradiculoneuropathy following therapy with adalimumab and secukinumab: a case report and literature review2026
  4. 4Anti NMDA receptor encephalitis manifested as acute psychosis- case report2025
  5. 5Psychotic episode associated with autoimmune limbic encephalitis in a patient treated with checkpoint inhibitors: a case report2025