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Heterogeneity of clinical features and corresponding antibodies in seven patients with anti-NMDA receptor encephalitis
Anti-N-methyl D-aspartate (NMDA) receptor encephalitis is the most common type of encephalitis in the spectrum of autoimmune encephalitis defined by antibodies targeting neuronal surface antigens. In the present study, the clinical spectrum of this disease is presented using instructive cases in cor...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
D.A. Spandidos
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577954/ https://www.ncbi.nlm.nih.gov/pubmed/26622479 http://dx.doi.org/10.3892/etm.2015.2689 |
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author | SÜHS, KURT-WOLFRAM WEGNER, FLORIAN SKRIPULETZ, THOMAS TREBST, CORINNA TAYEB, SAID BEN RAAB, PETER STANGEL, MARTIN |
author_facet | SÜHS, KURT-WOLFRAM WEGNER, FLORIAN SKRIPULETZ, THOMAS TREBST, CORINNA TAYEB, SAID BEN RAAB, PETER STANGEL, MARTIN |
author_sort | SÜHS, KURT-WOLFRAM |
collection | PubMed |
description | Anti-N-methyl D-aspartate (NMDA) receptor encephalitis is the most common type of encephalitis in the spectrum of autoimmune encephalitis defined by antibodies targeting neuronal surface antigens. In the present study, the clinical spectrum of this disease is presented using instructive cases in correlation with the anti-NMDA receptor antibody titers in the cerebrospinal fluid (CSF) and serum. A total of 7 female patients admitted to the hospital of Hannover Medical School (Hannover, Germany) between 2008 and 2014 were diagnosed with anti-NMDA receptor encephalitis. Among these patients, 3 cases were selected to illustrate the range of similar and distinct clinical features across the spectrum of the disease and to compare anti-NMDA antibody levels throughout the disease course. All patients received immunosuppressive treatment with methylprednisolone, intravenous immunoglobulin and/or plasmapheresis, followed in the majority of patients by second-line therapy with rituximab and cyclophosphamide. The disease course correlated with NMDA receptor antibody titers, and to a greater extent with the ratio between antibody titer and protein concentration. A favorable clinical outcome with a modified Rankin Scale (mRS) score of ≤1 was achieved in 4 patients, 1 patient had an mRS score of 2 after 3 months of observation only, whereas 2 patients remained severely impaired (mRS score 4). Early and aggressive immunosuppressive treatment appears to support a good clinical outcome; however, the clinical signs and symptoms differ distinctively and treatment decisions have to be made on an individual basis. |
format | Online Article Text |
id | pubmed-4577954 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | D.A. Spandidos |
record_format | MEDLINE/PubMed |
spelling | pubmed-45779542015-11-30 Heterogeneity of clinical features and corresponding antibodies in seven patients with anti-NMDA receptor encephalitis SÜHS, KURT-WOLFRAM WEGNER, FLORIAN SKRIPULETZ, THOMAS TREBST, CORINNA TAYEB, SAID BEN RAAB, PETER STANGEL, MARTIN Exp Ther Med Articles Anti-N-methyl D-aspartate (NMDA) receptor encephalitis is the most common type of encephalitis in the spectrum of autoimmune encephalitis defined by antibodies targeting neuronal surface antigens. In the present study, the clinical spectrum of this disease is presented using instructive cases in correlation with the anti-NMDA receptor antibody titers in the cerebrospinal fluid (CSF) and serum. A total of 7 female patients admitted to the hospital of Hannover Medical School (Hannover, Germany) between 2008 and 2014 were diagnosed with anti-NMDA receptor encephalitis. Among these patients, 3 cases were selected to illustrate the range of similar and distinct clinical features across the spectrum of the disease and to compare anti-NMDA antibody levels throughout the disease course. All patients received immunosuppressive treatment with methylprednisolone, intravenous immunoglobulin and/or plasmapheresis, followed in the majority of patients by second-line therapy with rituximab and cyclophosphamide. The disease course correlated with NMDA receptor antibody titers, and to a greater extent with the ratio between antibody titer and protein concentration. A favorable clinical outcome with a modified Rankin Scale (mRS) score of ≤1 was achieved in 4 patients, 1 patient had an mRS score of 2 after 3 months of observation only, whereas 2 patients remained severely impaired (mRS score 4). Early and aggressive immunosuppressive treatment appears to support a good clinical outcome; however, the clinical signs and symptoms differ distinctively and treatment decisions have to be made on an individual basis. D.A. Spandidos 2015-10 2015-08-19 /pmc/articles/PMC4577954/ /pubmed/26622479 http://dx.doi.org/10.3892/etm.2015.2689 Text en Copyright: © Sühs et al. This is an open access article distributed under the terms of a Creative Commons Attribution License. http://creativecommons.org/licenses/by/4.0 This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited. |
spellingShingle | Articles SÜHS, KURT-WOLFRAM WEGNER, FLORIAN SKRIPULETZ, THOMAS TREBST, CORINNA TAYEB, SAID BEN RAAB, PETER STANGEL, MARTIN Heterogeneity of clinical features and corresponding antibodies in seven patients with anti-NMDA receptor encephalitis |
title | Heterogeneity of clinical features and corresponding antibodies in seven patients with anti-NMDA receptor encephalitis |
title_full | Heterogeneity of clinical features and corresponding antibodies in seven patients with anti-NMDA receptor encephalitis |
title_fullStr | Heterogeneity of clinical features and corresponding antibodies in seven patients with anti-NMDA receptor encephalitis |
title_full_unstemmed | Heterogeneity of clinical features and corresponding antibodies in seven patients with anti-NMDA receptor encephalitis |
title_short | Heterogeneity of clinical features and corresponding antibodies in seven patients with anti-NMDA receptor encephalitis |
title_sort | heterogeneity of clinical features and corresponding antibodies in seven patients with anti-nmda receptor encephalitis |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577954/ https://www.ncbi.nlm.nih.gov/pubmed/26622479 http://dx.doi.org/10.3892/etm.2015.2689 |
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