{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:06:14Z","timestamp":1781625974502,"version":"3.54.5"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Distinguishing altered consciousness owing to an underlying organic disorder from a psychiatric etiology can be challenging in patients presenting at the emergency department after a suicide attempt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>The patient was a 52-year-old woman who jumped from the third floor of her house. She sustained a small subdural hematoma in the left cerebellar tentorium and a fracture of the right first rib. She was admitted to our tertiary emergency and critical care center for further evaluation of the head injury and remained clinically stable. On hospital day 2, the patient was diagnosed with severe depression by a psychiatrist and was transferred to a psychiatric ward. However, she developed disturbances of consciousness and cognitive impairment that could not be explained by psychiatric illness thereafter. Further workup revealed anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis and autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy as the etiology. High-dose intravenous methylprednisolone therapy together with high-dose intravenous immunoglobulin was initiated. Disturbances of consciousness and cognitive impairment did not fully recover; however, she was transferred to another hospital on day 149.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Apart from psychiatric causes, organic etiologies should be considered in patients who have attempted suicide if psychiatric interventions cannot explain cognitive abnormalities. This approach facilitates timely diagnosis and management of treatable diseases such as coexisting anti-NMDAR encephalitis and autoimmune GFAP astrocytopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12245-025-01095-9","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T13:52:17Z","timestamp":1766238737000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti-NMDA receptor encephalitis with coexisting autoimmune GFAP astrocytopathy presenting with psychiatric symptoms leading to a suicide attempt: a case report"],"prefix":"10.1186","volume":"19","author":[{"given":"Soichiro","family":"Kano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Kamidani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahito","family":"Miyake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohide","family":"Ando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Tamaoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoya","family":"Ono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Shiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shozo","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayoshi","family":"Shimohata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideshi","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,20]]},"reference":[{"key":"1095_CR1","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1007\/s00068-025-02780-3","volume":"51","author":"R Rantala","year":"2025","unstructured":"Rantala R, Hein\u00e4nen M, Kuorikoski J, Brinck T, S\u00f6derlund T. Effect of pre-existing psychiatric treatment in suicidal jumpers on the need for in-hospital treatment following injury. Eur J Trauma Emerg Surg. 2025;51:102. https:\/\/doi.org\/10.1007\/s00068-025-02780-3.","journal-title":"Eur J Trauma Emerg Surg"},{"key":"1095_CR2","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1001\/jamaneurol.2016.2549","volume":"73","author":"B Fang","year":"2016","unstructured":"Fang B, McKeon A, Hinson SR, Kryzer TJ, Pittock SJ, Aksamit AJ, et al. Autoimmune glial fibrillary acidic protein astrocytopathy: A novel meningoencephalomyelitis. JAMA Neurol. 2016;73:1297\u2013307. https:\/\/doi.org\/10.1001\/jamaneurol.2016.2549.","journal-title":"JAMA Neurol"},{"key":"1095_CR3","doi-asserted-by":"publisher","first-page":"79","DOI":"10.3390\/antib13040079","volume":"13","author":"P Gklinos","year":"2024","unstructured":"Gklinos P, Athanasopoulos F, Giatrakou V, Arkoudis NA, Pournara D, Giagkou E, et al. 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Nonetheless, this case was reported in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects established by the Japanese Government.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s legal guardian for the publication of this case report and accompanying images. A copy of the consent form is available for review by the Editor-in-Chief.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23"}}