• Autoimmunity reviews · Oct 2012

    Review

    Anti-NMDA receptor encephalitis. The disorder, the diagnosis and the immunobiology.

    • Harry E Peery, Gregory S Day, Shannon Dunn, Marvin J Fritzler, Harald Prüss, Claire De Souza, Asif Doja, Karen Mossman, Lothar Resch, Chenjie Xia, Boris Sakic, Larry Belbeck, and Warren G Foster.
    • Department of Obstetrics and Gynecology, Division of Reproductive Biology, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5. peeryh@mcmaster.ca
    • Autoimmun Rev. 2012 Oct 1; 11 (12): 863-72.

    AbstractAnti-NMDAR encephalitis is a newly characterized syndrome with a progressive, predictable clinical course and the possibility of effective treatment. Accurate and timely diagnosis is critical to selection and implementation of treatments, and optimal patient outcomes. Outcomes are improved with early diagnosis via indirect immunofluorescence or cell-based assays, and the rapid and appropriate administration of immunosuppressant and anti-psychotic therapies. Three possible scenarios accounting for the immunopathogenesis of anti-NMDAR encephalitis are presented, with the most probable one being that of paraneoplastic autoimmunity. Future efforts in this disorder should focus on elucidating the mechanisms that contribute to initiation of this antibody response, as well as exploring the role of tumors, infectious triggers and immune-reactivation. Finally, accessible tools need to be developed that allow for reliable identification of specific antibody markers against synaptic proteins.Copyright © 2012 Elsevier B.V. All rights reserved.

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