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Autoimmune encephalitis

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https://www.readbyqxmd.com/read/28224486/human-herpes-virus-6-encephalitis-causing-severe-anterograde-amnesia-associated-with-rituximab-azathioprine-and-prednisolone-combination-therapy-for-dermatomyositis
#1
Thomas Baumer, Charlie Fry, Sebastian Luppe, Harsha Gunawardena, Kasia Sieradzan
Human herpes virus-6 (HHV-6) reactivation is a well-recognised complication following haematological stem cell transplantation, but it is novel in the context of combination immunomodulatory therapy for autoimmune disease. We report a case of severe anterograde amnesia caused by HHV-6 encephalitis in a young female patient on rituximab, azathioprine and prednisolone for dermatomyositis (DM). The use of targeted biologic treatments for systemic autoimmune connective tissue diseases (CTDs) is increasing, particularly when refractory to conventional management...
February 21, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28223808/n-methyl-d-aspartate-receptor-antibody-could-be-a-cause-of-catatonic-symptoms-in-psychiatric-patients-case-reports-and-methods-for-detection
#2
Ko Tsutsui, Takashi Kanbayashi, Manabu Takaki, Yuki Omori, Yumiko Imai, Seiji Nishino, Keiko Tanaka, Tetsuo Shimizu
The symptoms of catatonia have been reported to be similar to the initial symptoms of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Subsequently, this autoimmune limbic encephalitis has been noticed by many psychiatrists. For a differential diagnosis of catatonic state, it is important to detect anti-NMDAR encephalitis. This encephalitis is expected to be in remission by early detection and treatment. We should be more cautious about catatonic symptoms of schizophrenia. When a patient is suspected of having encephalitis, we should screen for anti-NMDAR antibodies in cerebrospinal fluid samples using a cell-based assay...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28222692/hashimoto-s-encephalitis-associated-with-ampar2-antibodies-a-case-report
#3
Mingqin Zhu, Xuefan Yu, Caiyun Liu, Chenchen Duan, Chunxiao Li, Jie Zhu, Ying Zhang
BACKGROUND: Hashimoto's encephalitis (HE) is a rare neurological complication of Hashimoto's thyroiditis (HT), while limbic encephalitis (LE) is an autoimmune inflammatory disorder frequently associated with anti-neuronal antibodies. The glutamate receptor α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor (AMPAR) is important for synaptic transmission, memory, and learning. The etiology of HE remains unclear. We present a case of HE with antibodies to AMPAR2 both in the serum and cerebrospinal fluid...
February 21, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28222511/evaluation-of-a-dna-a%C3%AE-42-vaccine-in-aged-nzw-rabbits-antibody-kinetics-and-immune-profile-after-intradermal-immunization-with-full-length-dna-a%C3%AE-42-trimer
#4
Doris Lambracht-Washington, Min Fu, Mary Wight-Carter, Matthew Riegel, Roger N Rosenberg
A pathological hallmark of Alzheimer's disease (AD) are amyloid plaques in the brain consisting of aggregated amyloid-β 42 peptide (Aβ42) derived from cellular amyloid-β protein precursor (AβPP). Based on successful experiments in mouse AD models, active immunization with Aβ42 peptide and passive immunizations with anti-Aβ42 antibodies were started in clinical trials. Active Aβ42 peptide immunization in humans had led to an inflammatory autoimmune response, and the trial was stopped. Passive immunizations had shown some effects in slowing AD pathology...
February 7, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28220082/synaptic-and-neuronal-autoantibody-associated-psychiatric-syndromes-controversies-and-hypotheses
#5
Adam Al-Diwani, Thomas A Pollak, Alexander E Langford, Belinda R Lennox
Autoimmune encephalitis (AE) mediated by antibodies against synaptic and neuronal surface targets frequently presents with a psychiatric syndrome. In these patients, removal of autoantibodies treats the disease and outcomes are closely linked to early intervention. The discovery of these autoantibodies in isolated psychiatric syndromes has raised the possibility that these patients may derive similar benefits from immunotherapy, a potentially transformational approach to the treatment of mental illness. Although open-label case series suggest impressive therapeutic outcomes, the pathological relevance of these autoantibodies outside of canonical presentations is debated...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28212177/neurocognitive-outcomes-for-acute-global-acquired-brain-injury-in-children
#6
Fenella J Kirkham
PURPOSE OF REVIEW: In children, acute global brain injury from traumatic brain injury (TBI) and nontraumatic coma has a substantial cost to the child, the family, and the society. There have historically been relatively few studies looking at long-term cognition and behavioural outcomes. RECENT FINDINGS: Long-term follow-up studies, population-based studies, and meta-analyses are now available for TBI in children as well as adults and suggest that there is a significant cognitive cost, particularly for processing speed, working memory, and intelligence quotient (IQ) in severe TBI...
February 15, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28209905/diagnostic-value-of-18-f-fdg-pet-ct-versus-mri-in-the-setting-of-antibody-specific-autoimmune-encephalitis
#7
Lilja B Solnes, Krystyna M Jones, Steven P Rowe, Puskar Pattanayak, Abhinav Nalluri, Arun Venkatesan, John C Probasco, Mehrbod Som Javadi
Introduction: Diagnosis of autoimmune encephalitis presents some challenges in the clinical setting due to varied clinical presentations and delay in obtaining antibody panel results. We examined the role of neuroimaging in the setting of autoimmune encephalitides comparing the utility (18)F-FDG PET/CT versus conventional brain imaging with MRI. Methods: A retrospective study was performed assessing the positivity rate of MRI versus (18)F-FDG PET/CT during the initial work-up of 23 patients proven to have antibody positive autoimmune encephalitis...
February 16, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28194064/therapeutic-plasma-exchange-in-patients-with-neurologic-disorders-review-of-63-cases
#8
Anil Tombak, Mehmet Ali Uçar, Aydan Akdeniz, Arda Yilmaz, Hakan Kaleagası, Mehmet Ali Sungur, Eyup Naci Tiftik
Therapeutic plasma exchange (TPE) is a procedure that reduces circulating autoantibodies of the patients. TPE is commonly used in neurological disorders where autoimmunity plays a major role. We report our experience with regard to the indications, adverse events and outcomes of plasma exchange in neurological disorders. Sixty-three patients were included to this retrospective study. Median age was 48 years (range 1-85), there was a predominance of males. Neurological indications included Guillain-Barrè syndrome (n = 22), myasthenia gravis (n = 21), chronic inflammatory demyelinating polyneuropathy (n = 7), polymyositis (n = 3), multifocal motor neuropathy (n = 2), acute disseminated encephalomyelitis (n = 2), neuromyelitis optica (n = 2), multiple sclerosis (n = 2), limbic encephalitis (n = 1) and transverse myelitis (n = 1)...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28192149/serum-uric-acid-and-anti-n-methyl-d-aspartate-receptor-encephalitis
#9
Yaqing Shu, Yuge Wang, Tingting Lu, Rui Li, Xiaobo Sun, Jing Li, Yanyu Chang, Xueqiang Hu, Zhengqi Lu, Wei Qiu
BACKGROUND: Uric acid (UA) levels are associated with autoimmune and neurodegenerative disorders, but their relationship with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is unknown. METHODS: UA levels were evaluated in 58 patients with anti-NMDAR encephalitis, and 58 age- and sex-matched healthy controls (CTLs). Follow-up evaluations of 30 out of the 58 patients with anti-NMDAR encephalitis were conducted 3 months after admission. Modified Rankin scale (mRS) scores and clinical and cerebrospinal fluid parameters were evaluated in all anti-NMDAR encephalitis patients...
February 9, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28187808/diagnosis-and-management-of-acute-encephalitis
#10
J J Halperin
Encephalitis is typically viral (approximately half of diagnosed cases) or autoimmune (about a quarter) with the remainder remaining undiagnosable at this time. All require general supportive care but only a minority requires intensive care admission - in these intubation, to protect the airway or to treat status epilepticus with anesthetic drugs, may be needed. In some dysautonomia with wide blood pressure fluctuations is the principal concern. Remarkably, in addition to supportive care, specific treatment options are available for the majority - immune-modulating therapy for those with autoimmune disorders, antiviral therapy for herpes simplex 1 and 2, and varicella-zoster encephalitis...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28183838/autoimmune-encephalitis-pathophysiology-and-imaging-review-of-an-overlooked-diagnosis
#11
REVIEW
B P Kelley, S C Patel, H L Marin, J J Corrigan, P D Mitsias, B Griffith
Autoimmune encephalitis is a relatively new category of immune-mediated disease involving the central nervous system that demonstrates a widely variable spectrum of clinical presentations, ranging from the relatively mild or insidious onset of cognitive impairment to more complex forms of encephalopathy with refractory seizure. Due to its diverse clinical features, which can mimic a variety of other pathologic processes, autoimmune encephalitis presents a diagnostic challenge to clinicians. Imaging findings in patients with these disorders can also be quite variable, but recognizing characteristic findings within limbic structures suggestive of autoimmune encephalitis can be a key step in alerting clinicians to the potential diagnosis and ensuring a prompt and appropriate clinical work-up...
February 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28179405/diagnostic-accuracy-of-cerebrospinal-fluid-procalcitonin-in-bacterial-meningitis-patients-with-empiric-antibiotic-pretreatment
#12
Wen Li, Xiaolong Sun, Fang Yuan, Qiong Gao, Yue Ma, Yongli Jiang, Xiai Yang, Fang Yang, Lei Ma, Wen Jiang
Accurate diagnosis of bacterial meningitis (BM) relies on cerebrospinal fluid (CSF) Gram stain and bacterial culture, which often present high false-negative rates because of the antibiotic abuse. Thus a novel and reliable diagnostic biomarker is highly required. Procalcitonin (PCT) is well demonstrated to be specifically produced from peripheral tissues by bacterial infection, which makes it a potential candidate. Here, we performed a prospective clinical study comprising a total of 143 patients to investigate the diagnostic value of CSF PCT, serum PCT and other conventional biomarkers for BM...
February 8, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28169274/armc5-deletion-causes-developmental-defects-and-compromises-t-cell-immune-responses
#13
Yan Hu, Linjiang Lao, Jianning Mao, Wei Jin, Hongyu Luo, Tania Charpentier, Shijie Qi, Junzheng Peng, Bing Hu, Mieczyslaw Martin Marcinkiewicz, Alain Lamarre, Jiangping Wu
Armadillo repeat containing 5 (ARMC5) is a cytosolic protein with no enzymatic activities. Little is known about its function and mechanisms of action, except that gene mutations are associated with risks of primary macronodular adrenal gland hyperplasia. Here we map Armc5 expression by in situ hybridization, and generate Armc5 knockout mice, which are small in body size. Armc5 knockout mice have compromised T-cell proliferation and differentiation into Th1 and Th17 cells, increased T-cell apoptosis, reduced severity of experimental autoimmune encephalitis, and defective immune responses to lymphocytic choriomeningitis virus infection...
February 7, 2017: Nature Communications
https://www.readbyqxmd.com/read/28166327/neurological-autoantibody-prevalence-in-epilepsy-of-unknown-etiology
#14
Divyanshu Dubey, Abdulradha Alqallaf, Ryan Hays, Matthew Freeman, Kevin Chen, Kan Ding, Mark Agostini, Steven Vernino
Importance: Autoimmune epilepsy is an underrecognized condition, and its true incidence is unknown. Identifying patients with an underlying autoimmune origin is critical because these patients' condition may remain refractory to conventional antiseizure medications but may respond to immunotherapy. Objective: To determine the prevalence of neurological autoantibodies (Abs) among adult patients with epilepsy of unknown etiology. Design, Setting, and Participants: Consecutive patients presenting to neurology services with new-onset epilepsy or established epilepsy of unknown etiology were identified...
February 6, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28154970/differences-in-treatment-of-anti-nmda-receptor-encephalitis-results-of-a-worldwide-survey
#15
Luca Bartolini, Eyal Muscal
The objective of the study was to identify differences in treatment strategies for anti-NMDA receptor encephalitis based on specialty of treating physicians, geographic location, and years in practice. We conducted an anonymous worldwide electronic survey through the Practice Current section of Neurology(®) Clinical Practice to appraise differences in decisions about first- and second-line treatment and timing for initiation of second-line treatment for anti-NMDA receptor encephalitis. 399 participants answered all questions of the survey and were included in the analysis...
February 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28152224/effect-of-plasmapheresis-on-the-antifactor-xa-activity-of-enoxaparin-in-an-obese-adolescent-patient
#16
K W Rahawi, K L Higgins, C Noda, J S Stultz
To our knowledge, the effect of plasmapheresis on the antifactor Xa activity of enoxaparin has never been reported. We describe a 13-year-old, obese (92-kg) adolescent female who was treated with enoxaparin for a pulmonary embolism while receiving plasmapheresis for suspected autoimmune encephalitis, and experienced clinically significant reductions in antifactor Xa activity following plasmapheresis. She received five courses of plasmapheresis, with the final two during treatment with enoxaparin. Her antifactor Xa concentrations were highly variable, and we hypothesized that plasmapheresis was affecting these levels...
February 2, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28126315/identification-of-cytochrome-p450-isoforms-involved-in-the-metabolism-of-syl930-a-selective-s1pr1-agonist-acting-as-a-potential-therapeutic-agent-for-autoimmune-encephalitis
#17
Jiaqi Mi, Manman Zhao, Shu Yang, Yufei Jia, Yan Wang, Baolian Wang, Jing Jin, Xiaojian Wang, Qiong Xiao, Jinping Hu, Yan Li
Syl930 is a novel sphingosine-1-phosphate receptor subtype 1 (S1PR1) agonist for the treatment of autoimmune encephalitis with promising receptor selectivity and little risk of bradycardia. Syl930 could be reversibly converted to its phosphorylated metabolite, acting as the active form to provide therapeutic effects, but eliminated principally in the form of oxidative metabolites. The aim of the present study was to identify the cytochrome P450 isoforms (CYPs) responsible for the oxidative metabolism of Syl930...
July 14, 2016: Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/28125651/the-association-of-specific-constituents-of-the-fecal-microbiota-with-immune-mediated-brain-disease-in-dogs
#18
Nick D Jeffery, Andrew K Barker, Cody J Alcott, Jon M Levine, Ilyssa Meren, Jane Wengert, Albert E Jergens, Jan S Suchodolski
Meningoencephalomyelitis of unknown origin (MUO) is a common, naturally-occurring, clinical disease of pet dogs. It is an immune-mediated condition that has many similarities with experimental autoimmune encephalitis (EAE) in rodents and so investigation of its pathogenesis may aid in understanding factors that contribute to development of multiple sclerosis in people. Gut microbiota are known to modulate immune responses that influence susceptibility to immune-mediated brain disease. In this study we aimed to compare abundance of specific constituents of the fecal microbiota, namely Faecalibacterium prausnitzii and Prevotellaceae, between dogs diagnosed with MUO and matched controls...
2017: PloS One
https://www.readbyqxmd.com/read/28109991/clinical-characteristics-treatments-and-outcomes-of-patients-with-anti-n-methyl-d-aspartate-receptor-encephalitis-a-systematic-review-of-reported-cases
#19
REVIEW
Le Zhang, Meng-Qian Wu, Zi-Long Hao, Siew Mun Vance Chiang, Kun Shuang, Min-Tao Lin, Xiao-Sa Chi, Jia-Jia Fang, Dong Zhou, Jin-Mei Li
Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a recently recognized autoimmune disorder which is responsive to immunotherapy. However, the outcomes of different immunotherapies have not been defined and there have been few studies that carried out a comparison among them. To provide an overview of the clinical characteristics, treatments, and outcomes of anti-NMDAR encephalitis, we systematically reviewed the literature in the PubMed, Medline, Embase, Cochrane Library, BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and Wan-fang databases...
January 18, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28106787/anti-nmda-receptor-encephalitis-and-vaccination
#20
Hsiuying Wang
Anti-N-methyl-d-aspartate (Anti-NMDA) receptor encephalitis is an acute autoimmune neurological disorder. The cause of this disease is often unknown, and previous studies revealed that it might be caused by a virus, vaccine or tumor. It occurs more often in females than in males. Several cases were reported to be related to vaccination such as the H1N1 vaccine and tetanus/diphtheria/pertussis and polio vaccines. In this study, we reported an anti-NMDA receptor encephalitis case that may be caused by Japanese encephalitis vaccination...
January 18, 2017: International Journal of Molecular Sciences
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