Five years of NMDA receptor antibody testing in a psychiatric hospital

Abstract

Antibodies to the N‐methyl‐D‐aspartate receptor have been recently described in psychiatric patients in the last decade, but uncertainty as to whom should be tested is common. Here, the authors describe the clinical characteristics of patients who have been tested over five years in a psychiatric hospital, and compare this with the current literature.

Antibodies against N-Methyl D-Aspartate Receptor in Psychotic Disorders: A Systematic Review

“…Forty studies used CBA, and 1 study did not state the method of AB detection but had qualitative results and thus was included in the “CBA” section [31]. The results are displayed in Table 1.…”

“…Two other studies did not even report what Ig class they looked for; however, it seems likely that they assessed IgG [31, 69]. Kelleher et al [69] published only a poster abstract, in which they noted that 1 of the 4 positive cases was confirmed as anti-NMDAR encephalitis and treated successfully with immunotherapy.…”

“…Other positive patients received psychiatric treatment as usual [69]. Sheldon et al [31] found only 1 positive patient, who had not developed encephalitis over 2.5 years.…”

“…Eight studies clearly stated that blood was taken from patients in acute phase of the disease, 2 studies acquired samples at admission, 3 during hospitalization, and 2 – “as soon as possible” after admission or contact for psychosis. In general, 12 of the 15 aforementioned studies found small numbers of participants with IgG ABs [31, 41, 44-46, 50, 51, 55, 57, 59, 61, 66], one with IgA or IgM ABs only [48], and no AB-positive patients were found in 2 studies (one of them had very small sample) [32, 53]. However, the only study that stated that patients were stable at the moment of blood withdrawal also revealed positive cases [49].…”