Zhang Bingjun, Yang Yu, Lin Yinyao, Ai Lulu, Men Xuejiao, Lu Zhengqi
Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Neurol. 2020 Feb 28;11:117. doi: 10.3389/fneur.2020.00117. eCollection 2020.
The aim of this retrospective study was to investigate the relationship between serum systemic autoantibodies and anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. 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. Anti-NMDAR encephalitis patients had higher frequency of positive serum systemic autoantibodies than healthy controls (23.1 vs. 2.6%, = 0.001) and lower frequency than NMOSD (23.1 vs. 48.7%, = 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%, = 0.02). Autoantibody positive group had a poorer outcome than autoantibody negative group (55.6 vs. 86.7%, = 0.043). There was a negative correlation between serum autoantibodies and outcomes in anti-NMDAR encephalitis patients ( = -0.325, = 0.044). 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.
这项回顾性研究的目的是调查血清系统性自身抗体与抗 N-甲基-D-天冬氨酸受体（NMDAR）脑炎之间的关系。对 39 例抗 NMDAR 脑炎患者检测血清系统性自身抗体（抗核抗体、可提取核抗原自身抗体、类风湿因子和抗中性粒细胞胞浆抗体），并与 39 例视神经脊髓炎谱系障碍（NMOSD）患者及 78 例健康对照进行比较。分别比较抗 NMDAR 患者系统性自身抗体阳性和阴性的两个亚组的临床特征、脑脊液特征及预后。抗 NMDAR 脑炎患者血清系统性自身抗体阳性率高于健康对照（23.1%对 2.6%，P = 0.001），低于 NMOSD（23.1%对 48.7%，P = 0.018）。未诊断出合并非器官特异性自身免疫性疾病的患者。自身抗体阳性组意识障碍比阴性组更常见（88.9%对 40.0%，P = 0.02）。自身抗体阳性组预后比自身抗体阴性组差（55.6%对 86.7%，P = 0.043）。抗 NMDAR 脑炎患者血清自身抗体与预后呈负相关（r = -0.325，P = 0.044）。我们的数据表明，抗 NMDAR 脑炎患者血清系统性自身抗体比健康对照更常见，比 NMOSD 少见，且与疾病严重程度较高相关。
