PMC10196045_01
Time course of the patient's symptoms and diagnostics. CARPVIII, Anti-carbonic anhydrase-related protein VIII; MRI, magnetic resonance imaging; NPT, neuropsychological testing; SAE, subcortical arteriosclerotic encephalopathy.
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fig1
A 75-year-old woman presented to the memory outpatient clinic of the Department of Psychiatry and Psychotherapy of the University Medical Center Gottingen because of concentration difficulties as well as memory and retentiveness disorders that had been gradually developing for 2 years (Table 1; Figure 1). Table 1) with a predominant pattern of lymphocytes (93%), elevated phosphorylated tau protein 181 (54.8 pg/mL, pathological: > 50 pg/mL, Table 1) and total tau protein (418 pg/mL, reference, <415 pg/mL), and anti-CARPVIII autoantibodies in the serum at 1:32 intensity (Table 1; Figure 1). The CSF analysis revealed no abnormalities in the beta amyloid peptides: amyloid beta 42 (Ass42), amyloid beta 40 (Ass40) and the amyloid beta 42/40 (Ass42/40) ratio were all in the normal range. In a repeated blood test 2 months later, we detected anti-CARPVIII autoantibodies again at a greater intensity of 1:32 (Figure 1).
Neuropsychological profile of patient. TMT part A, trial making test part A. The dotted red line indicates the level of the single standard deviation and the solid red line shows the level of the double standard deviation.
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Neuropsychological testing revealed impaired semantic and phonematic word fluency, reduced cognitive processing speed, faulty switching ability, a pathological clock test, and verbal memory deficits (encoding and delayed recall of verbal, non-associated information, encoding and delayed recall of complex verbal content) (Figure 2). Results from her thorough neuropsychological tests are in Figure 2.