title: Maternal-fetal transfer of anti-N-methyl-D-aspartate receptor antibodies.
abstract: BACKGROUND
  Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a neuroautoimmune disease commonly associated with ovarian teratomas. It is characterized by neuropsychiatric symptoms, seizures, and autonomic instability. Few cases are described in pregnancy, and little is known about potential fetal effects.
  
  
  METHODS
  Anti-NMDA receptor encephalitis was diagnosed at 24 weeks of gestation. No improvement occurred with intravenous immunoglobulin, methylprednisolone, and plasmapheresis. Imaging was unremarkable. Cesarean delivery with concurrent bilateral oophorectomy resulted in prompt maternal improvement. Antibody titers were positive in cord blood.
  
  
  CONCLUSIONS
  Anti-N-methyl-D-aspartate receptor encephalitis in pregnancy can lead to NMDA receptor antibodies in the fetal circulation. Pregnancy interruption through early delivery with or without oophorectomy may accelerate maternal recovery.
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado, Denver, Colorado.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Lamale-Smith
authors.forename: Gaea S
authors.initials: GS
authors.lastname: Moore
authors.forename: Saketh R
authors.initials: SR
authors.lastname: Guntupalli
authors.forename: Julie B
authors.initials: JB
authors.lastname: Scott
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000276:immunology*; D000906:Antibodies / Q000032:analysis*; D005260:Female; D005333:Fetus / Q000276:immunology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange / Q000276:immunology*; D010052:Ovariectomy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000276:immunology*; D011256:Pregnancy Outcome
chemical_list: D000906:Antibodies