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• W3048550181 abstract "Objective: To determine the frequency of anti-NMDAR encephalitis without detectable serum NMDAR antibodies (NMDAR-abs) and the potential changes in the syndrome presentation. Background: Some patients with anti-NMDAR encephalitis do not have detectable NMDAR-abs in serum. The clinical implications are unknown. Design/Methods: Retrospective assessment of patients with anti-NMDAR encephalitis and available paired serum/CSF samples examined at Hospital Clinic-IDIBAPS, Barcelona, between January 2007 and December 2017. NMDAR-abs were determined with (1) rat brain immunostaining, (2) in-house cell-based assay (CBA), and (3) a commercial CBA. Patients were considered seronegative if NMDAR-abs were undetectable in serum using the 3 indicated techniques (NMDAR-abs only present in CSF). Results: Among 578 patients with anti-NMDAR encephalitis, 75 (13%) were seronegative. Compared with seropositive patients, the seronegative were older (23.5 years [IQR: 17–43] vs 20.5 [IQR: 14–31]; p 2 at one year follow-up, 8 [19%] vs 60 [27%]; p=0.265). In multivariate analysis, older age at diagnosis, absence of tumor and less need for ICU admission were independent variables associated with seronegativity. No differences were observed in time from symptom onset to diagnosis (median days 30 [21–60] vs 35 [21–63]; p=0.3792), or frequency of relapses (one or more in 9 [16%] vs 28 [11%]; p=0.307). Conclusions: 13% of patients with anti-NMDAR encephalitis are seronegative. These patients are more likely to be male, with milder forms of the disease, and without tumors. Disclosure: Dr. Guasp has nothing to disclose. Dr. Modena-Ouarzi has nothing to disclose. Dr. Armangue has received research support from Mutua Madrilena Foundation. Dr. Dalmau has received personal compensation in an editorial capacity for Editor: Neurology, Neuroimmunology, Neuroinflammation; and UpToDate. Dr. Dalmau has received royalty, license fees, or contractual rights payments from Euroimmune. Dr. Dalmau has received research support from Sage therapeutics. Dr. Graus has nothing to disclose." @default.
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• W3048550181 date "2020-04-14" @default.
• W3048550181 modified "2023-10-07" @default.
• W3048550181 title "Frequency and clinical significance of seronegative anti-NMDAR encephalitis (2418)" @default.
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