Anti-thyroid antibodies and thyroid function in anti-N-methyl- d -aspartate receptor encephalitis

Lin, Yinyao; Tan, Sha; Wang, Yuge; Shen, Xianru; Shu, Yaqing; Shan, Yingchun; Wang, Yanqiang; Li, Haiyan; Zhang, Lei; Cai, Wei; Sun, Xiaobo; Liu, Zhengqi

doi:10.1016/j.neuint.2017.11.019

Cited by 11 publications

(22 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, anti-thyroid antibodies abnormalities and elevated complement levels are frequent in patients with anti-NMDAR encephalitis, which are associated with the short-term prognosis (7)(8)(9). Furthermore, in our present study, only 9 in 39 of anti-NMDAR encephalitis were positive for serum systemic autoantibodies (7 ANA, 1 ANCA, and 1 centromere antibody).…”

Section: Discussionsupporting

confidence: 57%

“…Previous reports have demonstrated the intertwining relationships between systemic immune abnormalities and immune-mediated neurological disorders, such as neuromyelitis optica spectrum disorder (NMOSD), and multiple sclerosis (5,6). Recently, several studies have revealed anti-thyroid antibodies abnormalities and elevated complement levels are frequent in patients with anti-NMDAR encephalitis, which are associated with the outcomes (7)(8)(9). Serum systemic autoantibodies that are indicative of systemic immune diseases, such as antinuclear antibodies (ANAs), extractable nuclear antigen autoantibodies (ENAs), rheumatoid factors (RFs), and anti-neutrophil cytoplasmic antibodies (ANCAs), have also been detected in patients with AE, but the literature in this regard is limited (8,10).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Serum Systemic Autoantibodies in Anti-N-Methyl-D-Aspartate Receptor Encephalitis

et al. 2020

Self Cite

View full text Add to dashboard Cite

The aim of this retrospective study was to investigate the relationship between serum systemic autoantibodies and anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods: Thirty-nine patients with anti-NMDAR encephalitis were examined for serum systemic autoantibodies (antinuclear antibodies, extractable nuclear antigen autoantibodies, rheumatoid factors, and anti-neutrophil cytoplasmic antibodies), in comparison with 39 neuromyelitis optica spectrum disorder (NMOSD) and 78 healthy controls. Clinical features, cerebrospinal fluid characteristics, and outcomes were compared between the two subgroups of anti-NMDAR patients with positive and negative systemic autoantibodies, respectively. Results: Anti-NMDAR encephalitis patients had higher frequency of positive serum systemic autoantibodies than healthy controls (23.1 vs. 2.6%, p = 0.001) and lower frequency than NMOSD (23.1 vs. 48.7%, p = 0.018). No patients were diagnosed comorbidities with non-organ-specific autoimmune diseases. Consciousness disturbance was more frequent in autoantibodies positive group than in the negative group (88.9 vs. 40.0%, p = 0.02). Autoantibody positive group had a poorer outcome than autoantibody negative group (55.6 vs. 86.7%, p = 0.043). There was a negative correlation between serum autoantibodies and outcomes in anti-NMDAR encephalitis patients (r = −0.325, p = 0.044). Conclusion: Our data demonstrated serum systemic autoantibodies were more frequent in anti-NMDAR encephalitis patients than in healthy controls and less frequent than NMOSD, which were associated with higher severity of disease.

show abstract

Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Serum Systemic Autoantibodies in Anti-N-Methyl-D-Aspartate Receptor Encephalitis

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…It is plausible that the fT3 might also play a detrimental effect on outcome in patients with anti-NMDAR encephalitis, however, few studies have addressed this issue. Lin et al evaluated 42 patients with anti-NMDAR encephalitis and discovered that those with positive anti-thyroid antibodies had a higher mRS score at discharge 13 . Ma et al examined 43 patients with anti-NMDAR encephalitis and found that those with low T3 syndrome had a signi cantly longer hospital stay and higher mRS scores at discharge.…”

Section: Discussionmentioning

confidence: 99%

“…The reference intervals of our laboratory were as follows: 3.28-6.47 pmol/L for fT3, 7.9-18.4 pmol/L for fT4, and 0.34-5.6 µIU/ml for TSH. A small number of patients also received tests of thyroid autoantibodies, including anti-thyroglobulin antibodies (TGAb), anti-thyroid peroxidase antibodies (TPOAb), and anti-thyroid receptor antibodies (TRAb) 13,14 . "Clinical hyperthyroidism" was de ned as suppressed TSH and elevated fT4 levels with relevant clinical symptoms, and "subclinical hyperthyroidism" was de ned as a suppressed TSH level, fT3 and fT4 levels within the normal ranges, and the absence of symptoms.…”

Section: Clinical Information and Thyroid Function Measurementsmentioning

confidence: 99%

“…This constitutes the bases for evaluation of the potential association between thyroid hormones and the prognosis of anti-NMDAR encephalitis. To date, there are only a few data on this issue 13,14 , and its predictive value of functional outcome remains to be determined. Herein, we aimed to investigate the association between the thyroid hormones and functional outcome in patients with anti-NMDAR encephalitis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Anti-N-methyl-D-aspartate receptor encephalitis: a prospective study focused on thyroid hormones and functional outcome

Ji¹,

Huang²,

Lian³

et al. 2020

Preprint

View full text Add to dashboard Cite

We aimed to investigate the association between thyroid hormones and functional outcome in patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. 137 consecutive inpatients (2016-2019) were registered prospectively and followed up for 12 months. 96 eligible patients were included in the study. The modified Rankin scale (mRS) score of 3-6 was defined as poor functional outcome. Logistic regression analysis was performed. The patients were classified into 3 subgroups based on their free triiodothyronine (fT3) levels, and the subgroup differences were analyzed by parametric or nonparametric tests as appropriate. We found that the fT3 value upon admission was correlated with functional outcome (P=0.004), and this effect remained significant after adjustment for age, gender, tumor presence and consciousness declination. Patients in the low-fT3 subgroup had a higher disease severity during the acute phase, represented by greater maximum mRS scores during hospitalization (P=0.011) and higher percentages of intense care unit admission (p<0.001). In Conclusion,the relatively low fT3 value is associated with a poor functional outcome. Besides, patients with relatively low fT3 tend to have a higher disease severity during the acute phase. Our preliminary data suggest that the fT3 value might serve as a potential predictor of functional outcome in patients with anti-NMDAR encephalitis.

show abstract

The detection of up-regulated anti-thyroid antibodies and autoimmune thyroid diseases in patients with autoimmune encephalitis: a retrospective study of 221 patients

Lin

Wang

et al. 2022

Neurol Sci

View full text Add to dashboard Cite

Objective To investigate the potential detection rate of anti-thyroid antibodies' (ATAbs) positivity, thyroid dysfunctions, and autoimmune thyroid diseases (AITDs) in autoimmune encephalitis (AE) and to analyze whether thyroid autoimmunity/ dysfunction can affect the clinical course of AE. Methods Two hundred twenty-one AE patients and 229 age-and sex-matched controls were included in this study. We measured the levels of ATAbs (anti-thyroglobulin antibodies [TgAb], anti-thyroid peroxidase anti-bodies [TPOAb]) and thyroid hormones in all the individuals. In addition, the association of thyroid autoimmunity/dysfunctions with functional outcomes of AE was identified by using logistic regression and Kaplan-Meier analyses. ResultsThe prevalence of TPOAb-positive and TgAb-positive was significantly higher in AE patients (16.3% and 16.7%, respectively) as compared with controls (9.6% and 7.4%, respectively; P = 0.034 and P = 0.002, respectively). In addition, the free triiodothyronine (fT3) level was significantly lower in AE patients as compared to the controls (P < 0.001). However, the frequency of AITDs (Hashimoto's thyroiditis and Graves' disease) did not significantly differ between AE patients and control subjects. Importantly, low fT3 was found to be associated with poor functional outcomes at the 3-month follow-up in AE. Adjustment of potential confounders did not change the association. However, the presence of ATAbs did not significantly alert the disease course of AE. Conclusions ATAbs-positive and/or AITD patients with symptomatic encephalopathy should undergo proper surveillance for AE. Moreover, low fT3 could serve as a possible predictor of poor short-term outcome in AE, thereby suggesting that monitoring of thyroid function in AE may be necessary.

show abstract

Anti-thyroid antibodies and thyroid function in anti-N-methyl- d -aspartate receptor encephalitis

Cited by 11 publications

References 24 publications

Serum Systemic Autoantibodies in Anti-N-Methyl-D-Aspartate Receptor Encephalitis

Serum Systemic Autoantibodies in Anti-N-Methyl-D-Aspartate Receptor Encephalitis

Anti-N-methyl-D-aspartate receptor encephalitis: a prospective study focused on thyroid hormones and functional outcome

The detection of up-regulated anti-thyroid antibodies and autoimmune thyroid diseases in patients with autoimmune encephalitis: a retrospective study of 221 patients

Contact Info

Product

Resources

About