Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: SÜHS, KURT-WOLFRAM, WEGNER, FLORIAN, SKRIPULETZ, THOMAS, TREBST, CORINNA, TAYEB, SAID BEN, RAAB, PETER, STANGEL, MARTIN
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2015
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
_version_ 1782391042996174848
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
work_keys_str_mv AT suhskurtwolfram heterogeneityofclinicalfeaturesandcorrespondingantibodiesinsevenpatientswithantinmdareceptorencephalitis
AT wegnerflorian heterogeneityofclinicalfeaturesandcorrespondingantibodiesinsevenpatientswithantinmdareceptorencephalitis
AT skripuletzthomas heterogeneityofclinicalfeaturesandcorrespondingantibodiesinsevenpatientswithantinmdareceptorencephalitis
AT trebstcorinna heterogeneityofclinicalfeaturesandcorrespondingantibodiesinsevenpatientswithantinmdareceptorencephalitis
AT tayebsaidben heterogeneityofclinicalfeaturesandcorrespondingantibodiesinsevenpatientswithantinmdareceptorencephalitis
AT raabpeter heterogeneityofclinicalfeaturesandcorrespondingantibodiesinsevenpatientswithantinmdareceptorencephalitis
AT stangelmartin heterogeneityofclinicalfeaturesandcorrespondingantibodiesinsevenpatientswithantinmdareceptorencephalitis