RSS-Feed abonnieren
DOI: 10.1055/s-0041-1740352
Rate of Anti-NMDA Receptor Encephalitis in Ovarian Teratomas
Funding This work was not funded.Abstract
Background The rate of anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) in ovarian teratomas is unknown. We aim to identify the prevalence of NMDARE as well as volumetric and histopathologic characteristics of ovarian teratomas in patients with versus without.
Methods We performed a retrospective cohort study to identify patients with confirmed ovarian teratomas and the characteristics of teratomas in NMDARE compared with non-NMDARE patients. Patients aged between 0 and 21 years with confirmed histopathological diagnosis of ovarian teratoma after resection were included. The rate of NMDARE in ovarian teratomas was identified. Moreover, volumes of ovarian teratomas and the frequency of neuronal glial elements on histopathology in NMDARE versus non-NMDARE patients were assessed.
Results Five out of one-hundred-and-sixty-three (3.07%) patients with histopathology confirmed ovarian teratomas were diagnosed with NMDARE. Age was not different between the NMDARE (mean: 13.8 years, standard deviation: 3.9) and non-NMDARE groups (median: 14, interquartile range [IQR]: 5). Teratoma volumes from NMDARE patients were smaller than those of non-NMDARE patients (median 28.3 cm3 with IQR of 431.2 and median 182.8 with IQR of 635.0, respectively). Both age and NMDARE diagnosis were statistically significant variables in the analysis of variance on a multiple linear regression model. Age (p = 0.013) had a positive correlation with teratoma size, whereas presence of NMDARE had a negative correlation (p = 0.008).
Conclusion The rate of NMDARE in ovarian teratomas is low and NMDARE patients have smaller teratomas than non-NMDARE. Further studies are needed to understand the timing of anti-NMDA receptor antibodies in teratomas and the development of NMDARE.
Keywords
autoimmune encephalitis - anti-NMDA receptor encephalitis - ovarian teratoma - paraneoplasticPublikationsverlauf
Eingereicht: 13. Juli 2021
Angenommen: 04. Oktober 2021
Artikel online veröffentlicht:
06. Dezember 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Dalmau J, Gleichman AJ, Hughes EG. et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol 2008; 7 (12) 1091-1098
- 2 Dalmau J, Tüzün E, Wu HY. et al. Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol 2007; 61 (01) 25-36
- 3 Titulaer MJ, McCracken L, Gabilondo I. et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol 2013; 12 (02) 157-165
- 4 Chefdeville A, Treilleux I, Mayeur ME. et al. Immunopathological characterization of ovarian teratomas associated with anti-N-methyl-D-aspartate receptor encephalitis. Acta Neuropathol Commun 2019; 7 (01) 38
- 5 Graus F, Titulaer MJ, Balu R. et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol 2016; 15 (04) 391-404
- 6 Howarth RA, Vova J, Blackwell LS. Early functional outcomes for pediatric patients diagnosed with anti-NMDA receptor encephalitis during inpatient rehabilitation. Am J Phys Med Rehabil 2018; 30 (Oct): •••
- 7 Day GS, Laiq S, Tang-Wai DF, Munoz DG. Abnormal neurons in teratomas in NMDAR encephalitis. JAMA Neurol 2014; 71 (06) 717-724
- 8 Chiu HC, Su YC, Huang SC, Chiang HL, Huang PS. Anti-NMDAR encephalitis with ovarian teratomas: review of the literature and two case reports. Taiwan J Obstet Gynecol 2019; 58 (03) 313-317
- 9 Rudnick E, Khakoo Y, Antunes NL. et al. Opsoclonus-myoclonus-ataxia syndrome in neuroblastoma: clinical outcome and antineuronal antibodies-a report from the Children's Cancer Group Study. Med Pediatr Oncol 2001; 36 (06) 612-622
- 10 Dahm L, Ott C, Steiner J. et al. Seroprevalence of autoantibodies against brain antigens in health and disease. Ann Neurol 2014; 76 (01) 82-94