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Frequent rhabdomyolysis in anti-NMDA receptor encephalitis

Jung-Ah Lim1, Soon-Tae Lee1, Tae-Joon Kim1

  • 1Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea.

Journal of Neuroimmunology
|September 10, 2016
PubMed

Insights

Rhabdomyolysis, a muscle-damaging condition, frequently occurs in anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, particularly after immunotherapy. Dopamine receptor blockers significantly increase this risk, necessitating careful administration in affected patients.

Area of Science:

  • Neurology
  • Immunology
  • Toxicology

Background:

  • Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a severe autoimmune neurological disorder.
  • Rhabdomyolysis, characterized by muscle breakdown, is a potential complication but its specific triggers in this context are not fully understood.

Purpose of the Study:

  • To investigate the clinical presentation and identify provocation factors for rhabdomyolysis in patients diagnosed with anti-NMDAR encephalitis.

Main Methods:

  • Retrospective analysis of a cohort of 16 patients with anti-NMDAR encephalitis.
  • Evaluation of clinical data, including creatine kinase (CK) levels, immunotherapy use, and medication history (specifically dopamine receptor blockers).

Main Results:

  • Nine out of 16 patients (56%) exhibited elevated CK levels and clinical signs of rhabdomyolysis.
  • Rhabdomyolysis was observed more frequently in patients who had undergone immunotherapy.
  • The use of dopamine receptor blockers (DRBs) was associated with a significantly increased risk of rhabdomyolysis; none of the patients without rhabdomyolysis received DRBs.

Conclusions:

  • Rhabdomyolysis is a common complication of anti-NMDAR encephalitis.
  • Immunotherapy and the administration of dopamine receptor blockers are identified as significant risk factors.
  • Caution is advised when prescribing DRBs to patients with anti-NMDAR encephalitis due to the elevated risk of rhabdomyolysis.
Keywords:
Autoimmune encephalitisEncephalitisNMDARhabdomyolysis

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