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Herpes simplex virus encephalitis is a trigger of brain autoimmunity
Author(s) -
Armangue Thaís,
Leypoldt Frank,
Málaga Ignacio,
RaspallChaure Miquel,
Marti Itxaso,
Nichter Charles,
Pugh John,
VicenteRasoamalala Monica,
LafuenteHidalgo Miguel,
Macaya Alfons,
Ke Michael,
Titulaer Maarten J.,
Höftberger Romana,
Sheriff Heather,
Glaser Carol,
Dalmau Josep
Publication year - 2014
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.24083
Subject(s) - encephalitis , autoantibody , autoimmunity , antibody , medicine , immunology , herpes simplex virus , cerebrospinal fluid , nmda receptor , virology , virus , pathology , receptor
In 5 prospectively diagnosed patients with relapsing post–herpes simplex encephalitis (HSE), N‐methyl‐D‐aspartate receptor (NMDAR) antibodies were identified. Antibody synthesis started 1 to 4 weeks after HSE, preceding the neurological relapse. Three of 5 patients improved postimmunotherapy, 1 spontaneously, and 1 has started to improve. Two additional patients with NMDAR antibodies, 9 with unknown neuronal surface antibodies, and 1 with NMDAR and unknown antibodies, were identified during retrospective assessment of 34 HSE patients; the frequency of autoantibodies increased over time (serum, p = 0.004; cerebrospinal fluid, p = 0.04). The 3 retrospectively identified NMDAR antibody–positive patients also had evidence of relapsing post‐HSE. Overall, these findings indicate that HSE triggers NMDAR antibodies and potentially other brain autoimmunity. Ann Neurol 2014;75:317–323