Herpes Simplex Encephalitis Relapse With Chorea Is Associated With Autoantibodies to N-Methyl-D-Aspartate Receptor or Dopamine-2 Receptor

被引：154
作者：
Mohammad, Shekeeb S. [1 ,2 ,3 ,4 ]
Sinclair, Kate [2 ,3 ]
Pillai, Sekhar [1 ,4 ]
Merheb, Vera [1 ]
Aumann, Tim D. [5 ]
Gill, Deepak [4 ]
Dale, Russell C. [1 ,4 ]
Brilot, Fabienne [1 ]
机构：
[1] Univ Sydney, Neuroimmunol Grp, Inst Neurosci & Muscle Res, Kids Res Inst,Childrens Hosp Westmead, Westmead, NSW 2145, Australia
[2] Royal Childrens Hosp, Dept Neurosci, Brisbane, Qld, Australia
[3] Univ Queensland, Sch Med, Brisbane, Qld, Australia
[4] Childrens Hosp Westmead, TY Nelson Dept Neurol & Neurosurg, Westmead, NSW 2145, Australia
[5] Univ Melbourne, Florey Inst Neurosci & Mental Hlth, Parkville, Vic 3052, Australia
来源：
MOVEMENT DISORDERS | 2014年 / 29卷 / 01期
关键词：
herpes simplex encephalitis; NMDA receptor; dopamine-2; receptor; chorea; autoantibody; ANTIBODIES; CHOREOATHETOSIS; MOVEMENT; CHILDREN;
D O I：
10.1002/mds.25623
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
BackgroundMovement disorder relapses after herpes simplex virus 1 (HSV1) encephalitis have been hypothesized to be secondary to postviral autoimmunity. Recently, a proportion of patients with HSV1 encephalitis (HSE) were shown to produce autoantibodies against N-methyl-D-aspartate receptor (NMDAR). MethodsWe measured autoantibodies against NMDAR and dopamine-2 receptor (D2R) expressed at the cell surface in the stored acute serum of 9 children with HSE, 3 of whom had a relapsing course with chorea. ResultsThe 3 patients with chorea had elevated autoantibodies against NMDAR (n=1), D2R (n=1), or both (n=1), whereas patients without chorea were negative (n=6). The prospectively identified patient with chorea and NMDAR autoantibodies improved after early treatment with steroids, intravenous immunoglobulin, and cyclophosphamide, with reduction in serum NMDAR antibody titers. ConclusionsThese autoantibody findings lend support to the autoimmune hypothesis and the early use of immune suppression in post-HSE chorea. (c) 2013 International Parkinson and Movement Disorder Society
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页码：117 / 122
页数：6
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