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Anti-NMDAR encephalitis

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https://www.readbyqxmd.com/read/28736276/b-cells-as-therapeutic-targets-in-neuro-inflammatory-diseases
#1
Reinhard Hohlfeld
B cells are an emerging therapeutic target in neuroinflammatory diseases. The anti-CD20 monoclonal antibody ocrelizumab was recently approved in the US as the first B-cell targeting immunomodulatory treatment for relapsing-remitting MS and primary progressive MS. In autoantibody-associated demyelinating syndromes such as neuromyelitis optica (NMO) and in myelin-oligodendrocyte-glycoprotein-(MOG)-autoantibody-associated encephalomyelitis, B-cells are a logical target based on the pathogenesis of these antibody-mediated disorders...
July 20, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28730861/comparative-outcomes-in-children-and-adults-with-anti-n-methyl-d-aspartate-anti-nmda-receptor-encephalitis
#2
Eliza Gordon-Lipkin, Anusha K Yeshokumar, Deanna Saylor, Ana Arenivas, John C Probasco
This study compared neurologic disability and adaptive function in children and adults >1 year following anti- N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis diagnosis. Retrospective record review identified 12 patients with anti-NMDAR encephalitis. At last follow-up, all surviving patients had "good" modified Rankin Score (0-2). Four children, 6 adults, and their families participated in a telephone interview. Median duration since diagnosis was similar for children (2.42 years, interquartile range 2...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28698711/anti-n-methyl-d-aspartate-receptor-encephalitis-a-severe-potentially-reversible-autoimmune-encephalitis
#3
REVIEW
Cai-Yun Liu, Jie Zhu, Xiang-Yu Zheng, Chi Ma, Xu Wang
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is potentially lethal, but it is also a treatable autoimmune disorder characterized by prominent psychiatric and neurologic symptoms. It is often accompanied with teratoma or other neoplasm, especially in female patients. Anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum are characteristic features of the disease, thereby suggesting a pathogenic role in the disease. Here, we summarize recent studies that have clearly documented that both clinical manifestations and the antibodies may contribute to early diagnosis and multidisciplinary care...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28683723/case-report-anaesthetic-management-of-radical-gastrectomy-for-gastric-cancer-associated-with-anti-n-methyl-d-aspartate-receptor-encephalitis
#4
Lei Ding, Hongyu Tan, Ziyu Li, Jiafu Ji, Xuejun Song
BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a rare neurological disorder that is caused by the production of antibodies against NMDARs. As many anaesthetic drugs interact with NMDARs and may worsen the disease and because the disease poses risks, such as cardiovascular events, hyperthermia and respiratory insufficiency, while under anaesthesia, administering anaesthesia to patients with this disorder is clinically challenging. CASE PRESENTATION: A 55-year-old man with gastric cancer associated with anti-NMDAR encephalitis who was diagnosed 8 months prior was admitted to Peking University Cancer Hospital for tumour resection...
July 6, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28644967/tramadol-may-increases-the-efficacy-of-therapeutic-plasma-exchange-in-anti-nmdar-encephalitis
#5
Bradley A Dengler, Deanna Kitchen, Ali Seifi
No abstract text is available yet for this article.
May 31, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28606234/-efficacy-and-safety-of-cyclophosphamide-as-a-sequential-immunotherapy-drug-for-anti-n-methyl-d-aspartate-receptor-encephalitis-in-children
#6
Wei-Wen Zhu, Wei-Ping Liao, Yong-Hong Yi, Xing-Wang Song
OBJECTIVE: To evaluate the efficacy and safety of cyclophosphamide as a second-line drug in the treatment of children with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. METHODS: Six children with anti-NMDAR encephalitis, who showed poor response to steroids and intravenous immunoglobulin, were given cyclophosphamide as a second-line immunotherapy. Follow-up was performed to evaluate the efficacy and safety of cyclophosphamide. RESULTS: After first-line immunotherapy for 1-4 weeks, the six patients had reduced psychiatric symptoms, seizures, and involuntary movements; three patients had an improved level of consciousness and were able to make simple conversations...
June 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28600040/anti-n-methyl-d-aspartate-receptor-nmdar-encephalitis-during-pregnancy-clinical-analysis-of-reported-cases
#7
Yan-Chao Shi, Xiu-Ju Chen, Hong-Mei Zhang, Zhen Wang, Da-Yong Du
OBJECTIVE: To analyze the clinical features of 13 pregnant patients with anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis. MATERIALS AND METHODS: Retrospective review of thirteen reported cases was conducted for anti-NMDAR encephalitis patients during pregnancy. The clinical data were collected from papers published in PubMed prior to 16 February 2016. Statistical analysis of the data was performed, which encompasses the patients' age, past medical history, onset of symptoms, concomitant with ovarian teratomas, immunotherapy, outcomes of mothers and newborns...
June 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28585453/cognitive-outcomes-following-anti-n-methyl-d-aspartate-receptor-encephalitis-a-systematic-review
#8
Gemma L McKeon, Gail A Robinson, Alexander E Ryan, Stefan Blum, David Gillis, Carsten Finke, James G Scott
INTRODUCTION: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an immune-mediated neurological disorder that (among other severe neuropsychiatric symptoms) affects cognition. This study aimed to summarize current knowledge regarding the rates, nature, and predictors of neuropsychological dysfunction in patients recovering from anti-NMDAR encephalitis. METHOD: A systematic review of studies describing neuropsychological outcomes following anti-NMDAR encephalitis was conducted...
June 6, 2017: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/28535637/-analysis-of-prodromal-phase-and-prodromal-events-in-anti-n-methyl-d-aspartate-receptor-encephalitis
#9
Y Yao, B Peng, X H Wang, F Fang, D Xu, X L Xu, H T Ren, Y C Zhu, L Y Cui, H Z Guan
Objective: To analyze prodromal phase and prodromal events of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods: Clinical data of 179 patients hospitalized and diagnosed during 2010-2016 including adults and children in Peking Union Medical College Hospital and Beijing Children's Hospital were collected.Patients with prodromal phase or prodromal events were selected.A retrospective analysis of clinical characteristics including prodromal phase or prodromal events, course of disease, brain imaging, laboratory results and therapeutic effect was performed...
May 23, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28527387/analysis-of-electroencephalogram-characteristics-of-anti-nmda-receptor-encephalitis-patients-in-china
#10
Yan Zhang, Gang Liu, Meng Di Jiang, Li Ping Li, Ying Ying Su
OBJECTIVE: To explore the characteristics of electroencephalogram (EEG) in patients with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. METHODS: Anti-NMDAR encephalitis patients admitted to the Department of Neurology between January 2012 and June 2016 were enrolled. All patients underwent electroencephalogram (EEG) at least once in the disease peak stage, and received tumor screening, symptomatic therapy, and immunotherapy. Patients received outcome evaluation every 6months after the immunotherapy, and modified Rankin scale (mRS) 0-2 was defined as favorable outcome...
July 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28503332/chronic-neuropsychological-sequelae-in-a-patient-with-nontumorous-anti-nmda-receptor-encephalitis
#11
Dong Y Han, Lisa M Koehl, Aarti Patel, Zhengqiu Zhou, Sarah Phillips, Siddharth Kapoor
Anti-N-methyl-D-aspartate receptor encephalitis is a neurological, autoimmune disorder tightly conceptualized only as recently as the mid-2000s. It presents itself in a combination of psychiatric, neurological, and autonomic features. We observe a unique case with probable earlier episode (prior to the mid-2000s conceptualization of the disease) and a later relapse, accompanying a comprehensive neuropsychological profile tracked after the relapse and subsequent improvement. Neurocognitive findings revealed residual frontal deficits with mood changes even in the state after plasmapheresis...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28470592/japanese-encephalitis-can-trigger-anti-n-methyl-d-aspartate-receptor-encephalitis
#12
Jiannan Ma, Ting Zhang, Li Jiang
Japanese encephalitis (JE) is usually a monophasic disease; however, in rare cases, patients with JE may have an early relapse after a partial recovery, giving rise to a biphasic pattern for the disease. In this study, we report three pediatric cases in which post-JE relapse was characterized by movement disorder and/or behavioral problems, and was related to anti-N-methyl-D-aspartate receptor (NMDAR) immunoglobulin G (IgG). Serum and cerebrospinal fluid were examined for anti-NMDAR IgG in three patients who had confirmed JE and then developed relapsing symptoms which were similar to those of anti-NMDAR encephalitis...
June 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28469537/rituximab-for-treatment-of-refractory-anti-nmda-receptor-encephalitis-in-a-pediatric-patient
#13
Sarah Hallowell, Esli Tebedge, Margaret Oates, Elizabeth Hand
Anti-N-methyl d-aspartate receptor (anti-NMDAR) encephalitis is a devastating disease that is increasingly being identified in both children and adults with psychosis, language disturbances, behavioral changes, and motor deficits. Currently no consensus guidelines exist for the optimal management of patients with this disease, although intravenous immune globulin (IVIG) therapy is often considered first-line pharmacotherapy. We present a case of an otherwise healthy 4 year-old-child who presented with seizures, loss of age-appropriate language skills, and behavioral changes, in whom anti-NMDAR was subsequently diagnosed...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28461116/anti-neuronal-anti-bodies-in-patients-with-early-psychosis
#14
O Mantere, M Saarela, T Kieseppä, T Raij, T Mäntylä, M Lindgren, E Rikandi, W Stoecker, B Teegen, J Suvisaari
It may be challenging to distinguish autoimmune encephalitis associated with anti-neuronal autoantibodies from primary psychiatric disorders. Here, serum was drawn from patients with a first-episode psychosis (n=70) or a clinical high-risk for psychosis (n=6) and controls (n=34). We investigated the serum prevalence of 24 anti-neuronal autoantibodies: IgG antibodies for anti-N-methyl-d-aspartate-type glutamate receptor (anti-NMDAR), glutamate and γ-aminobutyric acid alpha and beta receptors (GABA-a, GABA-b), alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPA), glycine receptor (GlyR), metabotropic glutamate receptor 1 and 5 (mGluR1, mGluR5), anti-Tr/Delta/notch-like epidermal growth factor-related receptor (DNER), contactin-associated protein-like 2 (CASPR2), myelin oligodendrocyte glycoprotein (MOG), glutamic acid decarboxylase-65 (GAD65), collapsin response mediator protein 5/crossveinless-2 (CV2), aquaporin-4 (AQP4), anti-dipeptidyl-peptidase-like protein-6 (DPPX), type 1 anti-neuronal nuclear antibody (ANNA-1, Hu), Ri, Yo, IgLON5, Ma2, zinc finger protein 4 (ZIC4), Rho GTPase-activating protein 26, amphiphysin, and recoverin, as well as IgA and IgM for dopamine-2-receptor (DRD2)...
April 28, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28445312/early-progression-of-brain-atrophy-in-patients-with-anti-n-methyl-d-aspartate-receptor-encephalitis-case-reports
#15
Hiroshi Kataoka, Nobuhiro Sawa, Yasuyo Tonomura, Satoshi Ueno
BACKGROUND: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis responds to immunnotherapy, and approximately 80% of patients with this disorder fully recover or have only minor sequelae. Brain magnetic resonance imaging (MRI) does not show a specific abnormality, but some patients have progressive cerebral atrophy. The cerebral atrophy can become reversible after clinical improvement. METHODS: We describe 3 patients with diffuse cerebral atrophy (DCA) on serial brain MRI...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28439892/cerebrospinal-fluid-cyto-chemokine-profile-during-acute-herpes-simplex-virus-induced-anti-n-methyl-d-aspartate-receptor-encephalitis-and-in-chronic-neurological-sequelae
#16
Kavitha Kothur, Deepak Gill, Melanie Wong, Shekeeb S Mohammad, Sushil Bandodkar, Susan Arbunckle, Louise Wienholt, Russell C Dale
AIM: To examine the cytokine/chemokine profile of cerebrospinal fluid (CSF) during acute herpes simplex virus-induced N-methyl-d-aspartate receptor (NMDAR) autoimmunity and in chronic/relapsing post-herpes simplex virus encephalitis (HSE) neurological syndromes. METHOD: We measured longitudinal serial CSF cyto-/chemokines (n=34) and a glial marker (calcium-binding astroglial protein, S100B) in one patient during acute HSE and subsequent anti-NMDAR encephalitis, and compared the results with those from two patients with anti-NMDAR encephalitis without preceding HSE...
August 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28439890/herpes-simplex-virus-induced-anti-n-methyl-d-aspartate-receptor-encephalitis-a-systematic-literature-review-with-analysis-of-43-cases
#17
REVIEW
Margherita Nosadini, Shekeeb S Mohammad, Francesco Corazza, Ezia Maria Ruga, Kavitha Kothur, Giorgio Perilongo, Anna Chiara Frigo, Irene Toldo, Russell C Dale, Stefano Sartori
AIM: To conduct a systematic literature review on patients with biphasic disease with herpes simplex virus (HSV) encephalitis followed by anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. METHOD: We conducted a case report and systematic literature review (up to 10 December 2016), focused on differences between herpes simplex encephalitis (HSE) and anti-NMDAR encephalitis phases, age-related characteristics of HSV-induced anti-NMDAR encephalitis, and therapy...
August 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28298911/autoantibodies-against-the-n-methyl-d-aspartate-receptor-subunit-nr1-untangling-apparent-inconsistencies-for-clinical-practice
#18
REVIEW
Hannelore Ehrenreich
This viewpoint review provides an integrative picture of seemingly contradictory work published on N-methyl-d-aspartate receptor 1 (NMDAR1) autoantibodies (AB). Based on the present state of knowledge, it gives recommendations for the clinical decision process regarding immunosuppressive treatment. Brain antigen-directed AB in general and NMDAR1-AB in particular belong to a preexisting autoimmune repertoire of mammals including humans. Specific autoimmune reactive B cells may get repeatedly (perhaps transiently) boosted by various potential stimulants (e...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28284352/raised-cerebrospinal-fluid-baff-and-april-levels-in-anti-n-methyl-d-aspartate-receptor-encephalitis-correlation-with-clinical-outcome
#19
Bo Deng, Xiao-Ni Liu, Xiang Li, Xiang Zhang, Chao Quan, Xiang-Jun Chen
In this study, we aimed to assess the levels of B cell activating factor from the tumor necrosis factor family (BAFF) and a proliferation-inducing ligand (APRIL) in cerebrospinal fluid (CSF) of patients with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis and determine their correlation with clinical outcome. BAFF and APRIL concentrations in CSF and serum from 40 patients with anti-NMDAR encephalitis and 20 controls were measured by enzyme-linked immunosorbent assay (ELISA). Compared with controls, the levels of both BAFF and APRIL in CSF were significantly increased in patients with anti-NMDAR encephalitis (p<0...
April 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28283100/antecedent-anti-nmda-receptor-encephalitis-in-two-patients-with-multiple-sclerosis
#20
A Baheerathan, W J Brownlee, D T Chard, K Shields, R Gregory, S A Trip
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder characterised by psychiatric symptoms, movement disorder and seizures often evolving into a severe encephalopathy. An overlap has recently been recognised between anti-NMDAR encephalitis and inflammatory demyelinating disorders, particularly neuromyelitis optical spectrum disorder (NMOSD). In this case report, we describe two patients with an initial presentation consistent with anti-NMDAR encephalitis who have subsequently developed relapsing-remitting multiple sclerosis (MS) and discuss the literature pertaining to potential overlap between NMDAR encephalitis and inflammatory demyelinating disorders...
February 2017: Multiple Sclerosis and related Disorders
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