CSF IgA NMDAR antibodies are potential biomarkers for teratomas in anti-NMDAR encephalitis - Archive ouverte HAL Access content directly
Journal Articles Neurology Neuroimmunology & Neuroinflammation Year : 2015

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

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1
V. Desestret
  • Function : Author
A. Chefdeville
  • Function : Author
A. Viaccoz
  • Function : Author
C. Bost
  • Function : Author
F. Ducray
  • Function : Author
G. Picard
V. Rogemond
  • Function : Author
M. O. Chaffois
  • Function : Author
C. Blanc
  • Function : Author
Claire Bardel
I. Treilleux
  • Function : Author
O. Pascual
  • Function : Author
J. C. Antoine
  • Function : Author
J. Y. Delattre
  • Function : Author
J. Honnorat
  • Function : Author

Abstract

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.

Dates and versions

hal-02044951 , version 1 (21-02-2019)

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V. Desestret, A. Chefdeville, A. Viaccoz, C. Bost, F. Ducray, et al.. CSF IgA NMDAR antibodies are potential biomarkers for teratomas in anti-NMDAR encephalitis. Neurology Neuroimmunology & Neuroinflammation, 2015, 2 (6), pp.e166. ⟨10.1212/NXI.0000000000000166⟩. ⟨hal-02044951⟩
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