title: Persistent intrathecal antibody synthesis 15 years after recovering from anti-N-methyl-D-aspartate receptor encephalitis.
abstract: BACKGROUND
  Anti- N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune disorder characterized by high intrathecal antibody synthesis. Little is known about the long-term follow-up of the cerebrospinal fluid antibody status.
  
  
  OBJECTIVE
  To describe persistent intrathecal antibody synthesis in a clinically healthy person 15 years after recovering from anti-NMDAR encephalitis.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  A 40-year-old woman who had been diagnosed as having encephalitis of unknown origin in 1995.
  
  
  METHODS
  Clinical evaluation and NMDAR antibody testing.
  
  
  RESULTS
  On reexamination in 2011, the patient had fully recovered. Investigation of archived as well as follow-up serum and cerebrospinal fluid samples revealed intrathecal synthesis of NMDAR antibodies.
  
  
  CONCLUSIONS
  This is the longest follow-up on a patient with anti-NMDAR encephalitis. Our findings emphasize that intrathecal antibody synthesis does not necessarily reflect disease activity and that the significance of NMDAR antibody titers needs to be interpreted for each patient according to the clinical context.
authors: Department of Neurology and Psychiatry, Friedrich-Ebert-Hospital, Neumünster, Germany.
authors: Hans-Christian
authors: HC
authors: Hansen
authors: Christine
authors: C
authors: Klingbeil
authors: Josep
authors: J
authors: Dalmau
authors: Wenhan
authors: W
authors: Li
authors: Benedikt
authors: B
authors: Weissbrich
authors: Klaus-Peter
authors: KP
authors: Wandinger
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000134:cerebrospinal fluid / Q000276:immunology* / Q000503:physiopathology; D001323:Autoantibodies / Q000096:biosynthesis* / Q000134:cerebrospinal fluid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*; D013997:Time Factors
chemical_list: D001323:Autoantibodies; D016194:Receptors, N-Methyl-D-Aspartate