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Serum complement levels in anti‐ N ‐methyl‐ d ‐aspartate receptor encephalitis
Author(s) -
Shu Y.,
Chen C.,
Chen Y.,
Xu Y.,
Chang Y.,
Li R.,
Sun X.,
Peng L.,
Lu Z.,
Qiu W.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13495
Subject(s) - medicine , encephalitis , modified rankin scale , cerebrospinal fluid , gastroenterology , antibody , immunology , virus , ischemic stroke , ischemia
Background and purpose This study aimed to evaluate the relationship between serum complement and anti‐ N ‐methyl‐ d ‐aspartate receptor ( NMDAR ) encephalitis. Methods Serum complement (C3, C4 and CH 50), immunoglobulins (IgG, IgM and IgA) and C‐reactive protein ( CRP ) were evaluated in 40 patients with anti‐ NMDAR encephalitis and 40 controls. Follow‐up evaluations of 11 of the 40 patients with anti‐ NMDAR encephalitis were conducted 6 months after admission. Modified Rankin Scale ( mRS ) scores and clinical and cerebrospinal fluid parameters were evaluated in patients with anti‐ NMDAR encephalitis. Results Serum C4 levels were significantly higher in patients with anti‐ NMDAR encephalitis than in controls ( P = 0.003), especially in female patients ( P = 0.001) and those with severe impairment ( mRS ≥ 4; P < 0.001). Serum CH 50 levels were significantly higher in patients with severe impairment ( P = 0.007) and limited treatment responses ( P = 0.007). Serum C4 was associated with C3 ( r = 0.506, P = 0.001), CH 50 ( r = 0.478, P = 0.002) and mRS score ( r = 0.607, P < 0.001). Serum C3 was associated with CH 50 ( r = 0.339, P = 0.032) and cerebrospinal fluid white blood cells ( r = 0.351, P = 0.026). Serum CH 50 was associated with age, mRS score and CRP . Follow‐up evaluations revealed that mRS scores were significantly lower than those before treatment, and a significant negative correlation was observed between the change in C3 levels and the change in mRS score. Conclusion Our results demonstrated that serum C4 levels were elevated and associated with C3, CH 50 and CRP levels, and disease severity in patients with anti‐ NMDAR encephalitis.