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This patient's symptoms are driven by elevated active T3 and T4, making thyroglobulin unlikely to be the mechanism

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The anti-NMDAR autoantibody is a typical synaptic protein that can bind to synaptic NMDA glutamate receptors, leading to dysfunctional glutamate neurotransmission in the brain that manifests as psychiatric symptoms (psychosis, hallucinations, and personality changes) [267]

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