Abstract
BackgroundThe clinical significance of anti-neuronal antibodies in patients with psychiatric disorders, but without encephalitis, remains unknown. In patients admitted to acute psychiatric inpatient care we aimed to identify clinical features distinguishing anti-neuronal antibody positive patients from matched controls.ResultsPatients who were serum-positive to N-methyl d-aspartate receptor (NMDAR) (n = 21), contactin-associated protein 2 (CASPR2) (n = 14) and/or glutamic acid decarboxylase 65 (GAD65) (n = 9) antibodies (cases) were age and sex matched (1:2) with serum-negative patients from the same cohort (controls). The prevalence and severity of psychiatric symptoms frequently encountered in NMDAR, CASPR2 and GAD65 antibody associated disorders were compared in cases and controls. NMDAR, CASPR2 and GAD65 antibody positive patients did not differ in their clinical presentation from matched serum negative controls.ConclusionIn this cohort, patients with and without NMDAR, CASPR2 and GAD65 antibodies admitted to acute psychiatric inpatient care had similar psychiatric phenotypes. This does not exclude their clinical relevance in subgroups of patients, and studies further investigating the clinical significance of anti-neuronal antibodies in patients with psychiatric symptomatology are needed.
Highlights
The clinical significance of anti-neuronal antibodies in patients with psychiatric disorders, but without encephalitis, remains unknown
Anti-neuronal antibodies are associated with autoimmune encephalitis, which often presents with psychiatric symptoms [1]
We recently found serum anti-neuronal antibodies [Immunoglobulin (Ig) G, IgA and/or IgM] in 12% of 925 patients consecutively admitted to acute psychiatric inpatient care [N-methyl d-aspartate receptor (NMDAR) antibodies in 7.6%, contactin-associated protein 2 (CASPR2) antibodies in 2.5%, and glutamic acid decarboxylase 65 (GAD65) antibodies in 1.9%] [2]
Summary
The clinical significance of anti-neuronal antibodies in patients with psychiatric disorders, but without encephalitis, remains unknown. In patients admitted to acute psychiatric inpatient care we aimed to identify clinical features distinguishing anti-neuronal antibody positive patients from matched controls. We recently found serum anti-neuronal antibodies [Immunoglobulin (Ig) G, IgA and/or IgM] in 12% of 925 patients consecutively admitted to acute psychiatric inpatient care [N-methyl d-aspartate receptor (NMDAR) antibodies in 7.6%, contactin-associated protein 2 (CASPR2) antibodies in 2.5%, and glutamic acid decarboxylase 65 (GAD65) antibodies in 1.9%] [2]. The. IgG isotype of NMDAR, CASPR2 and GAD65 antibodies has been associated with autoimmune encephalitis with prominent psychiatric features [1]. The role of any of these antibodies in psychiatric patients without evidence of autoimmune encephalitis is, not clear This is an important issue to address because these patients might benefit from immunotherapy [7]
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