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Clinical significan...
Clinical significance of IgM and IgA class anti-NMDAR antibodies in herpes simplex encephalitis
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- Westman, Gabriel, 1977- (författare)
- Uppsala University,Uppsala universitet,Infektionssjukdomar
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- Sohrabian, Azita (författare)
- Uppsala University,Uppsala universitet,Klinisk immunologi
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- Aurelius, E. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska University Hospital
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- Ahlm, Clas, 1956- (författare)
- Umeå University,Umeå universitet,Infektionssjukdomar,Umea Univ, Infect Dis, Dept Clin Microbiol, Umea, Sweden
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- Schliamser, Silvia (författare)
- Lund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Sund, Fredrik (författare)
- Uppsala University,Uppsala universitet,Infektionssjukdomar
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- Studahl, Marie, 1957 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine,Univ Gothenburg, Sahlgrenska Acad, Dept Infect Dis, Gothenburg, Sweden,Sahlgrenska Academy
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- Rönnelid, Johan (författare)
- Uppsala University,Uppsala universitet,Klinisk immunologi
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(creator_code:org_t)
- Elsevier BV, 2018
- 2018
- Engelska.
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Ingår i: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532 .- 1873-5967. ; 103, s. 75-80
- Relaterad länk:
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http://dx.doi.org/10...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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http://kipublication...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- Background: Herpes simplex encephalitis (HSE) is a devastating disease, often leaving patients with severe disabilities. It has been shown that IgG anti-N-methyl-o-aspartate receptor (NMDAR) antibodies appear in approximately 25% of HSE patients and could be associated with impaired recovery of cognitive performance. Objectives: To characterize the prevalence of IgM and IgA anti-NMDAR antibodies in HSE patients, in relation to subsequent development of IgG anti-NMDAR and correlation to cognitive performance. Study design: A total of 48 subjects were included from a previously described cohort of patients with HSE verified by HSV-1 PCR. Cerebrospinal fluid (CSF) and serum samples drawn close to onset of disease, after 14-21 days of iv aciclovir treatment and after 90 days of follow-up, were analyzed for the presence of IgM and IgA anti-NMDAR, and related to IgG anti-NMDAR. Antibody levels were correlated to the recovery of cognitive performance, as estimated by the Mattis Dementia Rating Scale (MDRS), for a total of 24 months. Results: In total, 27 of 48 (56%) study subjects were anti-NMDAR positive, defined as the presence of IgG (12/ 48, 25%), IgM (14/48, 29%) or IgA (13/48, 27%) antibodies in CSF and/or serum. IgM or IgA anti-NMDAR did not predict subsequent IgG autoimmunization and did not correlate to cognitive outcome. IgG anti-NMDAR serostatus, but not antibody titers, correlated to impaired recovery of cognitive performance. Conclusions: A majority of HSE patients develop IgG, IgM or IgA anti-NMDAR antibodies. However, the predictive value and clinical relevance of non-IgG isotypes remains to be shown in this setting.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Immunology in the medical area (hsv//eng)
Nyckelord
- Herpes simplex encephalitis
- HSV-1
- N-methyl-D-aspartate receptor antibodies
- NMDAR
- IgA
- IgM
- varicella-zoster-virus
- receptor encephalitis
- adult patients
- combination therapy
- prognostic-factors
- ovarian teratoma
- case series
- acyclovir
- pathogenesis
- diagnosis
- Virology
- Herpes simplex encephalitis
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Westman, Gabriel ...
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Sohrabian, Azita
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Aurelius, E.
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Ahlm, Clas, 1956 ...
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Schliamser, Silv ...
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Sund, Fredrik
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Studahl, Marie, ...
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Rönnelid, Johan
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- Av lärosätet
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Göteborgs universitet
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Umeå universitet
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Uppsala universitet
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Karolinska Institutet
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Lunds universitet