Anti-NMDAR encephalitis: a new, severe and challenging enduring entity.

Two girls, 15- and 17-year-old, were consecutively and involuntarily admitted to the local child and adolescent psychiatric hospital with severe first onset psychosis. Due to refractory agitation, ongoing psychosis and insomnia, catatonic features, autonomic instability and the need for one-on-one guidance, the first girl was transferred to the PICU of an academic tertiary hospital and anti-NMDA receptor encephalitis was diagnosed. Given this experience nursing staff suspected, due to similarities in the clinical presentation and course, anti-NMDA receptor encephalitis in the second girl also and this proved to be true.

[Toxic damage of kidney, liver and muscle attributed to the administration of germanium-lactate-citrate].

The case history is described of a woman aged 57 years with renal, hepatic and muscular damage attributed to intake of germanium lactate-citrate (a cumulative dose of 32.1 g germanium) over at least one year, as alternative treatment of metastatic breast cancer. Histological examination of biopsies showed highly vacuolated cytoplasm of the epithelial cells of the distal renal tubules and micro- and macrovesicular steatosis of centrilobular hepatocytes.