Anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis during pregnancy: Clinical analysis of reported cases
Objective: To analyze the clinical features of 13 pregnant patients with anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis. Materials and methods: Retrospective review of thirteen reported cases was conducted for anti-NMDAR encephalitis patients during pregnancy. The clinical data were collect...
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| Format: | Article |
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Elsevier
2017-06-01
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| Series: | Taiwanese Journal of Obstetrics & Gynecology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1028455917300797 |
| _version_ | 1818591987598622720 |
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| author | Yan-Chao Shi Xiu-Ju Chen Hong-Mei Zhang Zhen Wang Da-Yong Du |
| author_facet | Yan-Chao Shi Xiu-Ju Chen Hong-Mei Zhang Zhen Wang Da-Yong Du |
| author_sort | Yan-Chao Shi |
| collection | DOAJ |
| description | Objective: To analyze the clinical features of 13 pregnant patients with anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis.
Materials and methods: Retrospective review of thirteen reported cases was conducted for anti-NMDAR encephalitis patients during pregnancy. The clinical data were collected from papers published in PubMed prior to 16 February 2016. Statistical analysis of the data was performed, which encompasses the patients' age, past medical history, onset of symptoms, concomitant with ovarian teratomas, immunotherapy, outcomes of mothers and newborns.
Results: Thirteen cases were reported in 11 articles with a median age of 23 (interquartile range, 19–27) years old. There were eight cases in which the onset periods of gestation happened in the first trimester and five cases in the second trimester. Among 13 cases, five patients had a past medical history, one concomitant with autoimmune Graves' hyperthyroidism, one with bilateral ovarian teratomas removed history, one with anti-NMDAR encephalitis five years before pregnancy and two with psychiatric symptoms. Five patients were found with ovarian teratomas. Seven patients responded to first-line immunotherapy whereas all of two patients responded to second-line immunotherapy when the first-line immunotherapy failed. Following up all the 13 patients, most experienced a substantial recovery, except one had spasticity and dystonia in one hand, and one died of a superimposed infection. Three fetuses were miscarried or aborted in total. Most newborns were healthy, except two cases (2/10) with abnormal neurologic signs.
Conclusions: Clinical analysis of the data indicates that most patients respond to first-line immunotherapy. A second-line immunotherapy is effective when first-line immunotherapy fails. It has also been found that most mothers and newborns can have good outcomes. |
| first_indexed | 2024-12-16T10:21:10Z |
| format | Article |
| id | doaj.art-92611130584045b3a5b339916ee90cfb |
| institution | Directory Open Access Journal |
| issn | 1028-4559 |
| language | English |
| last_indexed | 2024-12-16T10:21:10Z |
| publishDate | 2017-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Taiwanese Journal of Obstetrics & Gynecology |
| spelling | doaj.art-92611130584045b3a5b339916ee90cfb2022-12-21T22:35:19ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592017-06-0156331531910.1016/j.tjog.2017.04.009Anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis during pregnancy: Clinical analysis of reported casesYan-Chao Shi0Xiu-Ju Chen1Hong-Mei Zhang2Zhen Wang3Da-Yong Du4Department of Neurology, Tianjin Port Hospital, Tianjin, ChinaDepartment of Neurology, Tianjin Nankai Hospital, Tianjin, ChinaDepartment of Neurology, Tianjin Port Hospital, Tianjin, ChinaDepartment of Cardiology, Tianjin Nankai Hospital, Tianjin, ChinaDepartment of Neurology, Tianjin Port Hospital, Tianjin, ChinaObjective: To analyze the clinical features of 13 pregnant patients with anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis. Materials and methods: Retrospective review of thirteen reported cases was conducted for anti-NMDAR encephalitis patients during pregnancy. The clinical data were collected from papers published in PubMed prior to 16 February 2016. Statistical analysis of the data was performed, which encompasses the patients' age, past medical history, onset of symptoms, concomitant with ovarian teratomas, immunotherapy, outcomes of mothers and newborns. Results: Thirteen cases were reported in 11 articles with a median age of 23 (interquartile range, 19–27) years old. There were eight cases in which the onset periods of gestation happened in the first trimester and five cases in the second trimester. Among 13 cases, five patients had a past medical history, one concomitant with autoimmune Graves' hyperthyroidism, one with bilateral ovarian teratomas removed history, one with anti-NMDAR encephalitis five years before pregnancy and two with psychiatric symptoms. Five patients were found with ovarian teratomas. Seven patients responded to first-line immunotherapy whereas all of two patients responded to second-line immunotherapy when the first-line immunotherapy failed. Following up all the 13 patients, most experienced a substantial recovery, except one had spasticity and dystonia in one hand, and one died of a superimposed infection. Three fetuses were miscarried or aborted in total. Most newborns were healthy, except two cases (2/10) with abnormal neurologic signs. Conclusions: Clinical analysis of the data indicates that most patients respond to first-line immunotherapy. A second-line immunotherapy is effective when first-line immunotherapy fails. It has also been found that most mothers and newborns can have good outcomes.http://www.sciencedirect.com/science/article/pii/S1028455917300797Anti-NMDAR encephalitisPregnancyPathogenesisImmunotherapyPrognosis |
| spellingShingle | Yan-Chao Shi Xiu-Ju Chen Hong-Mei Zhang Zhen Wang Da-Yong Du Anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis during pregnancy: Clinical analysis of reported cases Taiwanese Journal of Obstetrics & Gynecology Anti-NMDAR encephalitis Pregnancy Pathogenesis Immunotherapy Prognosis |
| title | Anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis during pregnancy: Clinical analysis of reported cases |
| title_full | Anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis during pregnancy: Clinical analysis of reported cases |
| title_fullStr | Anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis during pregnancy: Clinical analysis of reported cases |
| title_full_unstemmed | Anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis during pregnancy: Clinical analysis of reported cases |
| title_short | Anti-N-Methyl-d-Aspartate receptor (NMDAR) encephalitis during pregnancy: Clinical analysis of reported cases |
| title_sort | anti n methyl d aspartate receptor nmdar encephalitis during pregnancy clinical analysis of reported cases |
| topic | Anti-NMDAR encephalitis Pregnancy Pathogenesis Immunotherapy Prognosis |
| url | http://www.sciencedirect.com/science/article/pii/S1028455917300797 |
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