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High-throughput Flow Cytometry Cell-based Assay to Detect Antibodies to N-Methyl-D-aspartate Receptor or Dopamine-2 Receptor in Human Serum
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Anti-N-methyl-D-aspartate receptor encephalitis with concurrent human herpes virus-6A deoxyribonucleic acid

Sho Shimohama1, Takahiro Iizuka2, Tsubasa Takizawa1

  • 1Department of Neurology, Keio University School of Medicine, Tokyo, Japan.

Neuropathology : Official Journal of the Japanese Society of Neuropathology
|November 9, 2022
PubMed

Insights

This case study highlights anti-N-methyl-D-aspartate receptor encephalitis with concurrent human herpes virus-6 detection. Aggressive immunotherapy may be crucial even with HHV-6 DNA, as its role in autoimmune encephalitis remains unclear.

Area of Science:

  • Neurology
  • Immunology
  • Virology

Background:

  • Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a severe autoimmune neurological disorder.
  • Human herpes virus-6 (HHV-6) is a known neurotropic virus.
  • Concurrent detection of viral DNA and autoantibodies presents diagnostic and therapeutic challenges.

Observation:

  • A 38-year-old man presented with seizures and CSF pleocytosis.
  • HHV-6 DNA and NMDA receptor (GluN1) antibodies were detected in CSF.
  • Initial antiviral treatment for HHV-6 was ineffective, with rising viral load.

Findings:

  • The patient developed typical anti-NMDA receptor encephalitis symptoms.
  • Treatment with immunotherapy led to a decrease in GluN1 antibody titers.
  • Despite treatment, the patient experienced recurrent infections and died.

Implications:

  • The significance of concurrent HHV-6 DNA detection in anti-NMDA receptor encephalitis is unclear.
  • Early and aggressive immunotherapy might be necessary in refractory cases.
  • Further research is needed to understand the interplay between viral infections and autoimmune encephalitis.
Keywords:
N-methyl-d-aspartate (NMDA)autoimmune diseasesencephalitishuman herpes virus-6 (HHV-6)neuropathology

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