Anti-NMDA receptor encephalitis: Recombinant immunofluorescence test for determination of antibodies against glutamate receptors

Anti-NMDA receptor encephalitis is a severe encephalopathic autoimmune disease, which affects mainly young women with ovarian teratoma, but also women without tumours, men and children. First described in 2007, it is a currently still widely underdiagnosed disease entity (J. Dalmau et al., 2008, Lancet Neurol 7(12): 1091-1098).
Diagnosis of anti-NMDA receptor encephalitis is based on the detection of highly specific autoantibodies directed against glutamate receptors of type NMDA in serum or cerebrospinal fluid. These autoantibodies are detected with high sensitivity and specificity in indirect immunofluorescence using a human recombinant cell line expressing the major target antigen (receptor subunit NR1). The determination of antibodies against glutamate receptors (type NMDA) is of high significance in patients with encephalitis where no pathogen has been detected, as well as in suspected cases of limbic encephalitis. The new cell substrate can be combined with various tissue substrates that are relevant for differential diagnostics (e.g. hippocampus and cerebellum) as BIOCHIP Mosaics, allowing the detection of further autoantibodies associated with limbic encephalitis (e.g. anti-VGKC antibodies, anti-AMPA receptor antibodies).

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