Y Shu1, C Chen1, Y Chen1,2, Y Xu3, Y Chang1, R Li1, X Sun1, L Peng1, Z Lu1, W Qiu1. 1. Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. 2. Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 3. Department of Cardiovascular Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Abstract
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 CH50), 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 CH50 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), CH50 (r = 0.478, P = 0.002) and mRS score (r = 0.607, P < 0.001). Serum C3 was associated with CH50 (r = 0.339, P = 0.032) and cerebrospinal fluid white blood cells (r = 0.351, P = 0.026). Serum CH50 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, CH50 and CRP levels, and disease severity in patients with anti-NMDAR encephalitis.
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 CH50), immunoglobulins (IgG, IgM and IgA) and C-reactive protein (CRP) were evaluated in 40 patients with anti-NMDARencephalitis and 40 controls. Follow-up evaluations of 11 of the 40 patients with anti-NMDARencephalitis were conducted 6 months after admission. Modified Rankin Scale (mRS) scores and clinical and cerebrospinal fluid parameters were evaluated in patients with anti-NMDARencephalitis. RESULTS: Serum C4 levels were significantly higher in patients with anti-NMDARencephalitis than in controls (P = 0.003), especially in female patients (P = 0.001) and those with severe impairment (mRS ≥ 4; P < 0.001). Serum CH50 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), CH50 (r = 0.478, P = 0.002) and mRS score (r = 0.607, P < 0.001). Serum C3 was associated with CH50 (r = 0.339, P = 0.032) and cerebrospinal fluid white blood cells (r = 0.351, P = 0.026). Serum CH50 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, CH50 and CRP levels, and disease severity in patients with anti-NMDARencephalitis.