Lentiform fork sign mimicking uremic encephalopathy in an atypical case of autoimmune limbic encephalitis

Radiology Case Reports 2026 Open access

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Authors: Chaimaa Jabbari, Ihssane Laasri, Aya Laridi, Meryem Fikri, Najwa Ech-cherif Kettani, Mohamed Jiddane, Firdaous Touarsa
DOI: 10.1016/j.radcr.2026.01.001
Cited by: 1
References: 5

Abstract

The lentiform fork sign (LFS) on MRI is often associated with uremic encephalopathy but is not pathognomonic. We present a case of autoimmune limbic encephalitis initially suspected as uremic encephalopathy despite normal renal function. A 58-year-old woman presented with seizures and altered mental status. MRI showed bilateral basal ganglia hyperintensities with the classic LFS. Normal renal parameters prompted cerebrospinal fluid analysis, which revealed anti-NMDA receptor antibodies, confirming autoimmune encephalitis. The patient improved markedly after immunotherapy. This case emphasizes the need to consider autoimmune causes of LFS and the importance of early diagnosis and treatment in preventing adverse outcomes.

Fields of Study & Subjects

Autoimmune Neurological Disorders and Treatments Neurological and metabolic disorders Glycogen Storage Diseases and Myoclonus

Publication details

Journal / source
Radiology Case Reports
Publisher
Elsevier BV
Volume
21
Issue
4
Pages
1741–1744
Publication date
6 February 2026
Language
EN