Late-onset anti-N-methyl-d-aspartate receptor encephalitis in China

Zhang, Le; Liu, Xu; Jiang, Xinyue; Wang, Yunhui; Zhou, Dong

doi:10.1016/j.yebeh.2018.02.025

Cited by 10 publications

(9 citation statements)

References 26 publications

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“…Epidemiologic studies indicate that young patients with anti‐NMDARE are predominantly affected at a median age of 21 years 6 ; however, it can also occur in a wide age range with a mean age of 2 months to 85 years at presentation 7 . Early‐onset anti‐NMDARE differs from late‐onset anti‐NMDARE regarding clinical characteristics 7,8 . Despite the relatively low incidence in elderly patients, late‐onset anti‐NMDARE still causes longer hospitalization and higher costs, and thus presents a great public health burden to our society.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies showed that advancing age is typically associated with an increasing risk of poor prognosis, 9 while others demonstrated that poor prognosis occurs irrespective of age 10,11 . To reach a definitive conclusion, studies divided patients with anti‐NMDARE into old and young subgroups but still reached different conclusions 7,8 . In addition, the proportion of elder patients admitted to the intensive care unit (ICU) and relapse rate in China is different from the ratio in foreign countries 7,8 .…”

Section: Introductionmentioning

confidence: 99%

“…To reach a definitive conclusion, studies divided patients with anti‐NMDARE into old and young subgroups but still reached different conclusions 7,8 . In addition, the proportion of elder patients admitted to the intensive care unit (ICU) and relapse rate in China is different from the ratio in foreign countries 7,8 . Therefore, further studies are warranted to investigate the prognosis of late‐onset anti‐NMDARE.…”

Section: Introductionmentioning

confidence: 99%

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The prognosis of late‐onset anti‐N‐methyl‐D‐aspartate receptor encephalitis in China

Sun

Ren

et al. 2021

Acta Neuro Scandinavica

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Objectives Early‐onset anti‐N‐methyl‐D‐aspartate receptor encephalitis (anti‐NMDARE) differs from late‐onset anti‐NMDARE regarding clinical characteristics. Until recently, research focusing on prognosis of elder adults has been scarce and showed inconsistent results. This study aims to evaluate the prognosis of late‐onset anti‐NMDARE in China. Materials & Methods One hundred and twelve adults diagnosed as anti‐NMDARE in four hospitals in China were reviewed retrospectively. Outcome data were assessed using modified Rankin Scale (mRS) score in short term (3 months after discharge) and long term (≥12 months after discharge). The relapse rate was also computed. Multivariable logistic regression was used to evaluate whether there are substantial differences in functional outcomes and recurrence rate across two groups. Results Of the 112 patients with anti‐NMDARE, 81 (72.3%) were early‐onset disease and 31 (27.7%) were late‐onset disease. Of these, all had short‐term follow‐up and 70 completed long‐term follow‐up. Late‐onset anti‐NMDARE group showed better short‐term (OR 2.70, 95% CI 1.09–6.71) and long‐term prognoses (OR 10.25, 95% CI 1.90–55.15). Recurrence rates were statistically different between the groups (OR 4.25, 95% CI 1.22–14.75). Conclusion The prognosis for anti‐NMDARE in China was poorer for older adults relative to younger adults. The relapse rates were higher in late‐onset group compared to early‐onset group.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The prognosis of late‐onset anti‐N‐methyl‐D‐aspartate receptor encephalitis in China

Sun

Ren

et al. 2021

Acta Neuro Scandinavica

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“…Furthermore, a lower rate of neoplasms and a delay in the diagnosis and treatment were detected in older patients 4. The findings by Titulaer et al were confirmed by a recent study analysing Chinese patients with anti-NMDA receptor encephalitis 7…”

Section: Discussionmentioning

confidence: 81%

Anti-N-methyl-d-aspartate receptor encephalitis in an older patient presenting with a rapid onset of delusions and amnesia

Marinova¹,

Bausch-Becker²,

Savaskan³

2019

BMJ Case Rep

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“…), также были выделены идиопатические варианты NMDA-энцефалита [2][3][4][5]. Значительная встречаемость анти-NMDA-энцефалита среди женщин до 45 лет, половина из которых имеют тератому яичника, обусловлена наличием в структуре данной опухоли аномальных нейронов, экспрессирующих NMDA-рецепторы [6,7].…”

Section: Introductionunclassified

Therapeutic apheresis in the complex pathogenetic therapy of anti-NMDA encephalitis associated with ovarian teratoma at a late stage of the disease

Бардаков

Skulyabin

Мошникова

et al. 2021

Neuromuscular Diseases

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Anti‑NMDA encephalitis is a rare autoimmune disease of the central nervous system caused by the synthesis of autoantibodies to the NR1/NR2 subunits of the NMDA receptor, characterized by the development of acute mental, cognitive, motor, autonomic disorders, epileptic syndrome and central hypoventilation.The article presents a three‑year observation of patient 34 years old with anti‑NMDA ncephalitis associated with late‑ stage ovarian teratoma, accompanied by an increase titer of antibodies to NMDA receptors in serum to 1:640.Based on a detailed analysis of clinical, neurological, neuropsychological (MMSE, MoСA, FAB, 10 words test A.R. Luria) and laboratory‑instrumental characteristics of the disease (titer anti‑NMDA, level of IgG, IgM, IgA, lymphocyte subpopulations, EEG, MRI of the brain, pelvis) suggested a combination scheme of first and second line therapy. The sequential use of two cycles of medium‑volume membrane plasmapheresis (25–30 % of the circulating plasma volume, No. 5 + 5) was carried out in combination with pulse therapy with methylprednisolone 1.0 (No. 4 + 3) and cyclophasphamide 1.0 (No. 2 + 1) on background of persistent ovarian teratoma. Symptom regression was achieved by the end of the first cycle, and full recovery to the initial level of cognitive functions occurred after the second cycle, while maintaining the anti‑NMDA antibody titer to 1:160. After removal of ovarian teratoma, the level of anti‑NMDA decreased in a month to 1:40, and after 7 months it reached normal values (<1:10) against the background of basic pill therapy with methotrexate 12.5 mg/week.Thus, a rational combination and sequence of first and second line therapy and therapeutic apheresis, taking into account the pathogenetic features of each phase of the disease, can quickly achieve complete stable remission in patient with anti‑NMDA encephalitis.

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Late-onset anti-N-methyl-d-aspartate receptor encephalitis in China

Cited by 10 publications

References 26 publications

The prognosis of late‐onset anti‐N‐methyl‐D‐aspartate receptor encephalitis in China

The prognosis of late‐onset anti‐N‐methyl‐D‐aspartate receptor encephalitis in China

Anti-N-methyl-d-aspartate receptor encephalitis in an older patient presenting with a rapid onset of delusions and amnesia

Therapeutic apheresis in the complex pathogenetic therapy of anti-NMDA encephalitis associated with ovarian teratoma at a late stage of the disease

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