Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
Neurol Neuroimmunol Neuroinflamm. 2015 Aug 13;2(5):e141. doi: 10.1212/NXI.0000000000000141. eCollection 2015 Oct.
To analyze the frequency of NMDA receptor (NMDAR) antibodies in patients with various inflammatory demyelinating diseases of the CNS and to determine their clinical correlates.
Retrospective case-control study from 2005 to 2014 with the detection of serum IgG antibodies to NMDAR, aquaporin-4, and myelin oligodendrocyte glycoprotein by recombinant live cell-based immunofluorescence assays. Fifty-one patients with acute disseminated encephalomyelitis, 41 with neuromyelitis optica spectrum disorders, 34 with clinically isolated syndrome, and 89 with multiple sclerosis (MS) were included. Due to a known association of NMDAR antibodies with seizures and behavioral symptoms, patients with those clinical manifestations were preferentially included and are therefore overrepresented in our cohort. Nine patients with NMDAR encephalitis, 94 patients with other neurologic diseases, and 48 healthy individuals were used as controls.
NMDAR antibodies were found in all 9 patients with NMDAR encephalitis but in only 1 of 215 (0.5%) patients with inflammatory demyelination and in none of the controls. This patient had relapsing-remitting MS with NMDAR antibodies present at disease onset, with an increase in NMDAR antibody titer with the onset of psychiatric symptoms and cognitive deficits.
In demyelinating disorders, NMDAR antibodies are uncommon, even in those with symptoms seen in NMDAR encephalitis.
分析中枢神经系统各种炎症性脱髓鞘疾病患者中 NMDA 受体 (NMDAR) 抗体的频率，并确定其临床相关性。
这是一项回顾性病例对照研究，于 2005 年至 2014 年进行，采用基于活细胞的重组免疫荧光分析检测血清 IgG 抗体抗 NMDAR、水通道蛋白-4 和髓鞘少突胶质细胞糖蛋白。共纳入 51 例急性播散性脑脊髓炎患者、41 例视神经脊髓炎谱系疾病患者、34 例临床孤立综合征患者和 89 例多发性硬化症 (MS) 患者。由于 NMDAR 抗体与癫痫发作和行为症状有关，因此优先纳入具有这些临床表现的患者，因此我们的队列中这些患者的比例过高。9 例 NMDAR 脑炎患者、94 例其他神经系统疾病患者和 48 例健康个体作为对照组。
9 例 NMDAR 脑炎患者的所有患者中均发现了 NMDAR 抗体，但在 215 例炎症性脱髓鞘患者中仅 1 例（0.5%）和对照组中均未发现。该患者患有复发缓解型多发性硬化症，在疾病发作时存在 NMDAR 抗体，随着精神病症状和认知功能缺陷的出现，NMDAR 抗体滴度增加。
在脱髓鞘疾病中，NMDAR 抗体并不常见，即使在那些具有 NMDAR 脑炎症状的患者中也是如此。
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