Association of antibodies against myelin and neuronal antigens with neuroinflammation in systemic lupus erythematosus

Rheumatology ◽  
2018 ◽  
Vol 58 (5) ◽  
pp. 908-913 ◽  
Author(s):  
Anne-Katrin Pröbstel ◽  
Madlaina Thanei ◽  
Barbara Erni ◽  
Anne-Catherine Lecourt ◽  
Léonore Branco ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Metabotropic Glutamate Receptor ◽  
Clinical Symptoms ◽  
Glycine Receptor ◽  
Gamma Aminobutyric Acid ◽  
Chi Square ◽  
Cross Sectional ◽  
Metabotropic Glutamate ◽  
Mog Antibodies

Abstract Objectives To determine frequency and syndrome specificity of novel and known nervous system (NS)-directed antibodies in a large, unbiased cohort of SLE patients in the Swiss SLE Cohort Study. Methods This retrospective pilot study included 174 patients in a cross-sectional and 102 in a longitudinal study. Antibodies against 12 NS antigens [myelin oligodendrocyte glycoprotein (MOG), neurofascin 186 (NF186), aquaporin-4 (AQP4), N-methyl-D-aspartate receptor (subunit NR1) (NMDAR-NR1), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (subunits 1 and 2) (AMPAR1/2), gamma-aminobutyric acid B receptor (subunits B1 and B2) (GABABR1/2), glutamate decarboxylase 65 (GAD65), glycine receptor (GlyR), contactin-associated protein-like 2 (CASPR2), leucine-rich glioma-inactivated 1 (LGI1), metabotropic glutamate receptor 5 (mGluR5) and dipeptidyl-peptidase-like protein 6 (DPPX)] were screened with validated cell-based assays and correlated with clinical and diagnostic findings. Results Twenty-three of one hundred and seventy-four (13.2%) patients harboured antibodies against MOG (n = 14), NF186 (n = 6), GAD65 (n = 2), AQP4 and GlyR (n = 1). Anti-MOG antibodies were most frequently found in the cohort (8%). Thirteen of the anti-NS antibody-positive patients showed clinical symptoms of NS involvement, a subgroup of which (n = 8) resembled the syndrome associated with the antibody. Nine patients harboured antibodies without neurological symptoms and one patient was lost to follow-up. The frequency of NPSLE was significantly higher in the anti-NS antibody-positive patients (13/23, 56.5%: MOG 6/14, 42.9%; NF186 5/6, 83.3%; GAD65 2/2, 100%; AQP4/GlyR 0/1, 0%) compared with the antibody-negative cohort (21/151, 13.9%) (chi-square test, P < 0.0001). Conclusion Anti-NS antibodies, most prevalently anti-MOG antibodies, are significantly associated with NPSLE and manifest with the distinct neurological syndrome associated with the antibody in a subgroup. Follow-up studies in large, independent cohorts will reveal whether these anti-NS antibodies could serve as a diagnostic and prognostic biomarker for NPSLE and enable tailored treatment decisions in this challenging and diverse patient cohort.

scholarly journals Autoimmune encephalitis associated with antibodies against the metabotropic glutamate receptor type 1: case report and review of the literature

2019 ◽  
Vol 12 ◽  
pp. 175628641984741 ◽  
Author(s):  
Monika Christ ◽  
Torsten Müller ◽  
Corinna Bien ◽  
Thomas Hagen ◽  
Markus Naumann ◽  
...  
Keyword(s):  
Cerebellar Ataxia ◽  
Glutamate Receptor ◽  
Metabotropic Glutamate Receptor ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Autoimmune Encephalitis ◽  
Receptor Type ◽  
Metabotropic Glutamate

Autoimmune encephalitis associated with antibodies against the metabotropic glutamate receptor type 1 is a rare autoimmune disease with only 18 cases being described in the literature so far. Most patients present with subacute cerebellar ataxia. In more than one third of cases a paraneoplastic aetiology has been suspected. Here we report a case of a 45-year-old man without known malignancy, who presented with progressive dysarthria and subsequently developed subacute cerebellar ataxia. Immunotherapy with glucocorticoids, i.v. immunoglobulins and rituximab improved clinical symptoms and resulted in a stable disease course up to the present. The article describes the clinical course of the patient with a follow-up-period of approximately 24 months and reviews the cases reported in the literature so far.

scholarly journals Thymoma and Autoimmune Encephalitis

2021 ◽  
Vol 8 (5) ◽  
pp. e1053
Author(s):  
Mar Guasp ◽  
Jon Landa ◽  
Eugenia Martinez-Hernandez ◽  
Lidia Sabater ◽  
Takahiro Iizuka ◽  
...  
Keyword(s):  
Metabotropic Glutamate Receptor ◽  
Glycine Receptor ◽  
Autoimmune Encephalitis ◽  
Japanese Patients ◽  
Gamma Aminobutyric Acid ◽  
Acid Receptor ◽  
Metabotropic Glutamate ◽  
Peripheral Nerve Hyperexcitability ◽  
Fluid Attenuated Inversion Recovery ◽  
Common Clinical Presentation

ObjectiveTo report the clinical, neuroimaging, and antibody associations in patients with autoimmune encephalitis (AE) and thymoma.MethodsA retrospective cohort study of 43 patients was conducted. Antibody determination and immunoprecipitation to characterize novel antigens were performed using reported techniques.ResultsPatients' median age was 52 years (range: 23–88 years). Forty (93%) had neuronal surface antibodies: gamma-aminobutyric acid receptor A (GABAAR) (15), amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) (13), contactin-associated protein-like 2 (CASPR2) (4), leucine-rich, glioma inactivated 1 (LGI1) (3), glycine receptor (GlyR) (3), and unknown antigens (2). Concurrent antibodies against intracellular antigens occurred in 13 (30%; 9 anti–collapsin response mediator protein 5 [CRMP5]) and were more frequent in anti-AMPAR encephalitis (54% vs 20%; p = 0.037). The most common clinical presentation was encephalitis with multiple T2/fluid-attenuated inversion recovery hyperintense lesions in 23 (53%) patients (15 GABAAR, 5 AMPAR, and 1 unknown neuropil antibody), followed by encephalitis with peripheral nerve hyperexcitability in 7 (16%; 4 CASPR2, 2 LGI1, and 1 unknown antibody), limbic encephalitis in 6 (14%; 4 AMPAR, 1 LGI1, and 1 antibody negative), progressive encephalomyelitis with rigidity and myoclonus in 4 (9%; 3 GlyR and 1 AMPAR antibodies), and encephalitis with normal MRI in 3 (7%; AMPAR antibodies). Anti-GABAAR encephalitis was more prevalent in Japanese patients compared with Caucasians and other ethnicities (61% vs 16%; p = 0.003). In anti-AMPAR encephalitis, 3/4 patients with poor and 0/6 with good outcome had concurrent CRMP5 antibodies (p = 0.033). Immunoprecipitation studies identified metabotropic glutamate receptor 3 antibodies that were additionally found in 5 patients (3 with and 2 without encephalitis).ConclusionsAE in patients with thymoma include several clinical-radiologic syndromes that vary according to the associated antibodies. Anti-GABAAR encephalitis was the most frequent AE and occurred more frequently in Japanese patients.

scholarly journals Outcomes of Endodontic Therapy Comparing Conventional Sodium Hypochlorite Irrigation with Passive Ultrasonic Irrigation Using Sodium Hypochlorite and Ethylenediaminetetraacetate. A Retrospective Analysis

2016 ◽  
Vol 10 (1) ◽  
pp. 375-381 ◽  
Author(s):  
Moritz Hertel ◽  
Katja Sommer ◽  
Eckehard Kostka ◽  
Sandra Maria Imiolczyk ◽  
Husam Ballout ◽  
...  
Keyword(s):  
Sodium Hypochlorite ◽  
Clinical Symptoms ◽  
Treatment Success ◽  
Success Rates ◽  
Chi Square ◽  
Passive Ultrasonic Irrigation ◽  
Ultrasonic Irrigation ◽  
Endodontic Irrigation ◽  
Group 2

The aim of the present study was to investigate the clinical outcomes of two different standardized endodontic irrigation protocols. It was assumed that the additional use of ethylenediaminetetraacetate (EDTA) and passive ultrasonic irrigation (PUI) would result in an increased rate of absence of symptoms and remission based on the periapical index (PAI) compared to passive irrigation using only sodium hypochlorite (NaOCl). Data and radiographs from 199 teeth retrieved from the institutional endodontic database were analyzed retrospectively. In 106 teeth irrigation was performed using only NaOCl (protocol 1). Ninety-three teeth were irrigated using NaOCl and EDTA (protocol 2). Chlorhexidine (CHX) was additionally used in revision treatments in both groups. All irrigants in group 2 were activated by PUI. Mean follow-up periods were: protocol 1 = 9.2 ± 4.4 and protocol 2 = 6.6 ± 2.5 months (p < 0.0001 (chi-square test). The frequencies of the PAImasterpoint and PAIfollow-up scores did not differ significantly between teeth, which received either protocol 1 or 2 (p = 0.555 and 0.138). Statistical analysis revealed no significant association between treatment success (absence of clinical symptoms and PAIfollow-up = I or PAImasterpoint > PAIfollow-up > I) and the applied protocol (success rates: protocol 1 = 72.6% vs. protocol 2 = 82.8%; p = 0.203). Furthermore, the frequency of extractions did not differ significantly between the two protocols (p = 0.102). No association was found between follow-up time and treatment success (p = 0.888). The hypothesis was not confirmed. Even though the obtained success rate was higher after supplementing the irrigation protocol with EDTA and PUI, no significance was recorded. Hence, protocol 2 was not superior to protocol 1 regarding therapy success, at least within the limited follow-up period. It may be cautiously concluded that sufficient mechanical debridement combined with passive NaOCl irrigation results in comparably high success rates compared to EDTA and PUI.

scholarly journals The Impact of T Cell Vaccination in Alleviating and Regulating Systemic Lupus Erythematosus Manifestation

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Liuye Huang ◽  
Yuan Yang ◽  
Yu Kuang ◽  
Dapeng Wei ◽  
Wanyi Li ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
T Cells ◽  
T Cell ◽  
Side Effects ◽  
Lupus Erythematosus ◽  
Clinical Symptoms ◽  
Systemic Lupus ◽  
T Cell Vaccination ◽  
Dna Antibodies

Objective. Systemic lupus erythematosus (SLE) is an autoimmune disease identified by a plethora of production of autoantibodies. Autoreactive T cells may play an important role in the process. Attenuated T cell vaccination (TCV) has proven to benefit some autoimmune diseases by deleting or suppressing pathogenic T cells. However, clinical evidence for TCV in SLE is still limited. Therefore, this self-controlled study concentrates on the clinical effects of TCV on SLE patients. Methods. 16 patients were enrolled in the study; they accepted TCV regularly. SLEDAI, clinical symptoms, blood parameters including complements 3 and 4 levels, ANA, and anti-ds-DNA antibodies were tested. In addition, the side effects and drug usage were observed during the patients’ treatment and follow-up. Results. Remissions in clinical symptoms such as facial rash, vasculitis, and proteinuria were noted in most patients. There are also evident reductions in SLEDAI, anti-ds-DNA antibodies, and GC dose and increases in C3 and C4 levels, with no pathogenic side effects during treatment and follow-up. Conclusions. T cell vaccination is helpful in alleviating and regulating systemic lupus erythematosus manifestation.

Screening for MOG-IgG and 27 other anti-glial and anti-neuronal autoantibodies in ‘pattern II multiple sclerosis’ and brain biopsy findings in a MOG-IgG-positive case

2016 ◽  
Vol 22 (12) ◽  
pp. 1541-1549 ◽  
Author(s):  
Sven Jarius ◽  
Imke Metz ◽  
Fatima Barbara König ◽  
Klemens Ruprecht ◽  
Markus Reindl ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Glutamate Receptors ◽  
Glutamate Receptor ◽  
Metabotropic Glutamate Receptor ◽  
Brain Biopsy ◽  
Acid Decarboxylase ◽  
Gamma Aminobutyric Acid ◽  
Serum Samples ◽  
Metabotropic Glutamate ◽  
Histopathological Studies

Background: Histopathological studies have revealed four different immunopathological patterns of lesion pathology in early multiple sclerosis (MS). Pattern II MS is characterised by immunoglobulin and complement deposition in addition to T-cell and macrophage infiltration and is more likely to respond to plasma exchange therapy, suggesting a contribution of autoantibodies. Objective: To assess the frequency of anti-myelin oligodendrocyte glycoprotein (MOG), anti-M1-aquaporin-4 (AQP4), anti-M23-AQP4, anti-N-methyl-d-aspartate-type glutamate receptors (NMDAR) and 25 other anti-neural antibodies in pattern II MS. Methods: Thirty-nine serum samples from patients with MS who had undergone brain biopsy ( n = 24; including 13 from patients with pattern II MS) and from histopathologically non-classified MS patients ( n = 15) were tested for anti-MOG, anti-M1-AQP4, anti-M23-AQP4, anti-NMDAR, anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor-type glutamate receptors (AMPAR), anti-gamma-aminobutyric acid receptors (GABABR), anti-leucine-rich, glioma-activated protein 1 (LGI1), anti-contactin-associated protein 2 (CASPR2), anti-dipeptidyl-peptidase-like protein-6 (DPPX), anti-Tr/Delta/notch-like epidermal growth factor–related receptor (DNER), anti-Hu, anti-Yo, anti-Ri, anti-Ma1/Ma2, anti-CV2/collapsin response mediator protein 5 (CRMP5), anti-glutamic acid decarboxylase (GAD), anti-amphiphysin, anti-Ca/RhoGTPase-activating protein 26 (ARHGAP26), anti-Sj/inositol-1,4,5-trisphosphate receptor 1 (ITPR1), anti-Homer3, anti-carbonic anhydrase–related protein (CARPVIII), anti-protein kinase gamma (PKCgamma), anti-glutamate receptor delta 2 (GluRdelta2), anti-metabotropic glutamate receptor 1 (mGluR1) and anti-mGluR5, as well as for anti-glial nuclei antibodies (AGNA) and Purkinje cell antibody 2 (PCA2). Results: Antibodies to MOG belonging to the complement-activating immunoglobulin G1 (IgG1) subclass were detected in a patient with pattern II MS. Detailed brain biopsy findings are shown. Conclusion: This is the largest study on established anti-neural antibodies performed in MS so far. MOG-IgG may play a role in a small percentage of patients diagnosed with pattern II MS.

scholarly journals Incidência de Interações Medicamentosas e Avaliação Clínica nos Pacientes de um Hospital Público Brasileiro

2020 ◽  
Vol 24 (3) ◽  
pp. 202-210
Author(s):  
Fabiana Cristina Furquim ◽  
Cristina Eunice Okuyama ◽  
Sandro Rostelato-Ferreira ◽  
Carla Leticia Rivero-Wendt ◽  
Helder Oliveira ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Positive Association ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Documentary Evidence ◽  
Potential Ddis ◽  
Cross Sectional ◽  
De Se ◽  
Clinical Interactions

Interações droga-droga (IDDs) são responsáveis por problemas terapêuticos e as principais causas de reações adversas a medicamentos que levam a hospitalização. O objetivo do trabalho foi analisar a incidência de IDDs em pacientes admitidos em hospital público no Brasil, em 2015. Em um estudo transversal, 351pacientes foram selecionados com IDDs utilizando-se o banco de dados da Micromedex®, e as interações foram classificadas de acordo com a severidade e documentação. Os potenciais IDDs foram avaliados durante o acompanhamento farmacoterapêutico diário por anamnese farmacêutica e a análise dos exames laboratoriais foi realizada. Um total de 2.937 potenciais IDDs foram identificados e 28,42% deles tinham sinais e sintomas clínicos confirmados em 87 pacientes (29%). Entre os pacientes que apresentaram interações, 62,07% tinham mais que 60 anos. Neste grupo de idade, 61,27% de todos os sinais e sintomas clínicos observados foram também identificados, demonstrando uma associação positiva entre interações clínicas e idade. Além disso, uma correlação positiva entre o número de drogas prescritas e a ocorrência de sinais clínicos também foram observados. Muitos IDDs observados foram de severidade moderada e estavam relacionados a alterações das pressões arteriais e níveis glicêmicos. Este estudo demonstrou que IDDs estão diretamente relacionados a idade e número de drogas prescritas. E a grande frequência de IDDs com documentação fraca alertam para a necessidade de se analisar esse tipo de interação. Sendo assim, este estudo mostrou que potenciais IDDs e sinais e sintomas clínicos significantes em pacientes só reforçam a necessidade de se apoiar a farmácia clínica.   Palavras-chave: Interação Droga-Droga (IDD). Pacientes Internados. Farmacoterapia, Poli Farmácia. Sinais e Sintomas.   Abstract Drug-drug interactions (DDIs) are responsible for therapeutic problems and the main causes of adverse drug reactions that require hospitalization. The aim of this study was to analyze the incidence of DDIs in patients admitted in a Public Hospital in Brazil, in 2015. In a cross-sectional study, DDIs were screened in 351 patients, using Micromedex® database, that classify interactions according to severity and documentary evidence. Potential DDIs were assessed at the daily pharmacotherapeutic follow-up through pharmaceutical anamnesis and analysis of laboratory tests were performed. A total of 2,937 potential DDIs were identified and 28.42% of these had confirmed signs and symptoms clinical in 87 patients (29%). Among the patients that presented interactions, 62.07% were older than 60 years. In this age group, 61.27% of all signs and symptoms clinical observed in the study were also identified, demonstrating a positive association between the occurrence of clinical interactions and age. In addition, a positive correlation between the number of drugs prescribed and the occurrence of signs clinicals was also observed. Most DDIs observed were of moderate severity and were related to imbalance of blood pressure and glycemic levels. This study demonstrated that DDIs are directly related to the age and number of drugs prescribed. And the greater frequency of DDIs with fair documentary evidence alerts to the need to consider all the possible interactions. Thereafter, this study showed that potential DDIs and sign and clinical symptoms  are significant in patients and reinforce the need to support Clinical Pharmacy.   Keywords: Drug-Drug Interaction (DDI). Inpatients. Pharmacotherapy. Poly Pharmacy. Sign and Symptom.    

scholarly journals Heart Involvement in Systemic Lupus Erythematosus

Medicinus ◽  
2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Andree Kurniawan ◽  
Nata Pratama Hardjo Lugito
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pericardial Effusion ◽  
Lupus Erythematosus ◽  
Clinical Symptoms ◽  
Capital City ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Cardiac Symptoms ◽  
Heart Involvement ◽  
Pericardial Effusions

Pericardial effusion is considered as one of criteria to diagnose systemic lupus erythematosus (SLE) based on American Rheumatism Association (ARA) criteria. There is limited data about the incidence and characteristic pericardial effusion in SLE patients in our country. The aim of this study is to report and assess the incidence of and characteristic heart involvement in SLE. This is cross-sectional study conducted in secondary referral hospital in Tangerang county, west part of Jakarta, capital city of Indonesia. We evaluated from medical record and echocardiogram data from 2013-2015 patients diagnosed with SLE according to ARA criteria. From 33 SLE medical records reviewed, we found 13 patients (40%) with pericardial effusions. All patients were in active stage. Clinical assessment and transthoracic echocardiogram were used to diagnose pericardial effusions. Eighty percent pericardial effusion positive patients had minimal effusion. The others had moderate effusion. No tamponade patients were recorded. Ninety six percent patients were female with median age 24(13-51) years old. Three patients were reported having pulmonary arterial hypertension. One patient had thrombus in left ventricle. All patients had clinical symptoms of cardiac such as heart failure and chest pain. For the conclusion, the incidence of pericardial effusion in SLE patient was 40 percent. Eighty percent patients had minimal effusion. All patients had cardiac symptoms related.

scholarly journals HUBUNGAN FAKTOR USIA DENGAN KELELAHAN PADA PASIEN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) DI KOMUNITAS LAMPUNG TAHUN 2019

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Firhat Esfandiari ◽  
Sandhy Arya Pratama ◽  
Resati Nando Panonsih ◽  
Resia Evel Roselen
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Chi Square ◽  
Cross Sectional

Systemic Lupus Erythematosus (SLE) terjadi karena produksi antibodi didalam tubuh berlebihan terhadap komponen inti sel, sehingga menyebabkan berbagai gejala klinis pada organ. Kelelahan merupakan penyebab utama morbiditas pada penderita SLE. Berdasarkan data dari komunitas odapus Lampung dan Rumah Sakit, setiap bulannya ada sekitar 5-6 orang meninggal karena penyakit lupus dari 150 anggota komunitas tersebut. Diketahui hubungan faktor usia dengan kelelahan pada pasien Systemic Lupus Erythematosus di Lampung Tahun 2019. Jenis penelitian kuantitatif, rancangan analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini sebanyak 140 orang penderita Systemic Lupus Erythematosus (SLE) di Komunitas Odapus Lampung Tahun 2019. Responden yang memenuhi persyaratan dan masuk pada kriteria inklusi yaitu 61 orang. Teknik analisis data menggunakan uji chi square. Distribusi frekuensi usia pada pasien systemic lupus erytematosus (SLE) di Komunitas Odapus Lampung (KOL) sebagian besar dengan kategori usia 26-35 tahun (dewasa awal) sebanyak 20 responden (32,8%), gambaran tingkat kelelahan sebagian besar dengan kategori kelelahan sebanyak 38 responden (62,3%).  Ada hubungan antara faktor usia dengan kelelahan pada pasien Systemic Lupus Erythematosus (SLE) di Komunitas Odapus Lampung (KOL) Tahun 2019 (p-valeu 0,019 ˂ α = 0,05). Ada hubungan antara faktor usia dengan kelelahan pada pasien Systemic Lupus Erythematosus (SLE) di Komunitas Odapus Lampung (KOL) Tahun 2019. Disarankan bagi petugas kesehatan untuk mengedukasi dan mengingatkan pasien dan keluarga pasien untuk mengurangi dan membatasi aktivitas yang bisa menyebabkan kelelahan.

scholarly journals Knowledge, Perception, Attitude, Practice, and Barriers towards COVID-19 Infection among Saudi Residents in the Period of Rapid Outbreak of the Disease: A Cross Sectional Survey

2021 ◽  
pp. 7-21
Author(s):  
Md Salahuddin Ansari ◽  
Faisal Al-Otaibi
Keyword(s):  
Global Economy ◽  
Online Survey ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Behavioral Parameters ◽  
Chi Square Test ◽  
Appropriate Practices

The adherences to protective actions are subjective to knowledge, perception, attitude, practice and barriers towards COVID-19 by Saudi residents. The self-design questionnaires were used as a cross-sectional online survey for assessed their social and behavioral parameters during the agonizing time. The cross-sectional study used data collected via an online self-reported questionnaire from 2216 Saudi residents. SPSS software and chi-square test were applied to analyze and categorize significant differences among sectional variables of the parameters. More than 95% of responders were well aware about the main clinical symptoms of COVID-19 infection and had sufficient knowledge about the protocols of five steps to stop the spread of coronavirus. Apositive perception towards COVID-19 was observed, about 55% participants strongly agreed that the coronavirus outbreak could impact the global economy and infection could be successfully controlled by imposing lockdown and by staying at home. The majority of respondents had good practices regarding COVID-19 infection. A high percentage of participants favored wearing masks, cleaning hands and frequently using hand sanitizer. A large number of participant (83.2%; n=1844) agreed that misinformation and rumors are spreading more quickly than the current outbreak of the new coronavirus. The findings suggested that Saudi residents are possessed good knowledge, optimistic attitudes, and appropriate practices towards COVID-19 during the rapid rise of the COVID-19 outbreak. Hopefully, under the combined efforts of WHO, Ministry of Health, Saudi Arabia, all Saudi residents surely will win the battle against COVID-19 very soon.

scholarly journals Encephalitis with mGluR5 antibodies

Neurology ◽  
2018 ◽  
Vol 90 (22) ◽  
pp. e1964-e1972 ◽  
Author(s):  
Marianna Spatola ◽  
Lidia Sabater ◽  
Jesús Planagumà ◽  
Eugenia Martínez-Hernandez ◽  
Thaís Armangué ◽  
...  
Keyword(s):  
Cell Surface ◽  
Clinical Features ◽  
Hippocampal Neurons ◽  
Metabotropic Glutamate Receptor ◽  
Brain Mri ◽  
Clinical Information ◽  
Partial Recovery ◽  
Metabotropic Glutamate ◽  
Referring Physicians

ObjectiveTo report the clinical features of 11 patients with metabotropic glutamate receptor 5 (mGluR5) antibody–associated encephalitis, immunoglobulin G (IgG) subclass, and effects of the antibodies on neuronal mGluR5 clusters.MethodsClinical information was retrospectively obtained from referring physicians. Antibodies to mGluR5 and IgG subclasses were determined with brain immunohistochemistry and cell-based assays. The effects of the antibodies were examined on rat hippocampal neurons with reported techniques.ResultsFrom January 2005 to May 2017, 11 patients (median age 29 years, range 6–75 years, 5 female) were identified. The main clinical features were psychiatric (10), cognitive (10), movement disorders (7), sleep dysfunction (7), and seizures (6). Median modified Rankin Scale score at the peak of the disease was 4; 4 patients required intensive care. Five patients had Hodgkin lymphoma, and 1 had small cell lung cancer. CSF showed pleocytosis (median white blood cell count 22 mm3) in all patients; brain MRI was abnormal in 5, involving limbic (1) or extralimbic (4) regions. Treatments included immunotherapy and/or oncologic therapy; at the last follow-up (median 48 months), 6 patients had complete and 5 had partial recovery. Neurologic relapse occurred in 2 patients. Antibodies were IgG1 alone (4 of 9) or in combination with IgG2 (1 of 9), IgG3 (3 of 9), or both (1). Patients' IgG caused a significant and specific decrease of cell-surface synaptic and extrasynaptic mGluR5 without altering the levels of postsynaptic density protein 95.ConclusionsAnti-mGluR5 encephalitis associates with a complex neuropsychiatric syndrome, not restricted to limbic encephalitis, and can occur without tumor. Patients respond to treatment, but relapses can occur. The antibodies have pathogenic effects altering the levels of cell-surface mGluR5.

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