Details

Autor(en) / Beteiligte

• Desestret, Virginie
• Chefdeville, Aude
• Viaccoz, Aurélien
• Bost, Chloe
• Ducray, François
• Picard, Géraldine
• Rogemond, Veronique
• Chaffois, Marie-Oceane
• Blanc, Charlotte
• Bardel, Claire
• Treilleux, Isabelle
• Pascual, Olivier
• Antoine, Jean-Christophe
• Delattre, Jean-Yves
• Honnorat, Jerome

Titel

CSF IgA NMDAR antibodies are potential biomarkers for teratomas in anti-NMDAR encephalitis

Ist Teil von

• Neurology : neuroimmunology & neuroinflammation, 2015-12, Vol.2 (6), p.e166

Ort / Verlag

United States: American Academy of Neurology

Erscheinungsjahr

2015

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• OBJECTIVE:To evaluate the presence of immunoglobulin A (IgA) subtype of anti-NMDA receptor (NMDAR) antibodies (IgA-NMDAR-Abs) in the CSF of patients with immunoglobulin G (IgG)-NMDAR-Ab encephalitis and to describe the potential association with a specific clinical pattern. METHODS:The retrospective analysis for the presence of IgA-NMDAR-Abs in 94 CSF samples from patients with anti-NMDAR encephalitis diagnosed between October 2007 and February 2014 was conducted at the French Reference Centre on Paraneoplastic Neurological Syndrome. This observational study compared 39 patients with both IgA- and IgG-NMDAR-Abs to 55 patients with only IgG-NMDAR-Abs. RESULTS:In the retrospective cohort, 41% of the patients with NMDAR-Ab encephalitis had both CSF IgG- and IgA-NMDAR-Abs. Approximately half of the IgA-NMDAR-Ab-positive patients (18/38, 49%) definitively possessed associated tumors, primarily ovarian teratomas (17/18, 94%), compared with only 5% (3/55) of the patients in the IgA-NMDAR-Ab-negative group (p < 0.001). In the adult female population at risk for ovarian teratoma, the detection of CSF IgA-NMDAR-Ab positivity showed 85% sensitivity, 70% specificity, a 57% positive predictive value, and a 90% negative predictive value for the diagnosis of ovarian teratoma. No other specific clinical features or clinical outcome were associated with CSF IgA-NMDAR-Ab positivity. CONCLUSION:These results suggest that in patients with IgG-NMDAR-Ab encephalitis, CSF IgA-NMDAR-Abs could be used as a biological marker for the presence of an ovarian teratoma.