Abstract | CONTEXT: OBJECTIVES: To compare the specificity and prevalence of NMDA-R antibodies in schizophrenia (DSM-IV criteria) with those of other psychiatric diagnoses and to determine whether antibody subtypes characterize overlap with and distinction from those in NMDA-R encephalitis. DESIGN: PARTICIPANTS: Two hundred thirty matched healthy controls were compared with patients (unmedicated for at least 6 weeks) with schizophrenia (n = 121), MD (n = 70), or BLPD (n = 38). MAIN OUTCOME MEASURES: RESULTS: Diverse NMDA-R antibodies were identified in 15 subjects, primarily those with an initial schizophrenia diagnosis (9.9%), opposed to MD (2.8%), BLPD (0), and controls (0.4%). Retrospectively, 2 patients initially classified as having catatonic or disorganized schizophrenia were reclassified as having misdiagnosed NMDA-R encephalitis (presence of specific serum and cerebrospinal fluid IgG NR1a antibodies). In all other seropositive cases, the antibodies consisted of classes IgA and/or IgM or were directed against NR1a/NR2b (not against NR1a alone). None of the patients or controls had antibodies against AMPA-R. CONCLUSIONS: Acutely ill patients with an initial schizophrenia diagnosis show an increased prevalence of NMDA-R antibodies. The repertoire of antibody subtypes in schizophrenia and MD is different from that with NMDA-R encephalitis. The latter disorder should be considered as a differential diagnosis, particularly in young females with acute disorganized behavior or catatonia.
|
Authors | Johann Steiner, Martin Walter, Wenzel Glanz, Zoltán Sarnyai, Hans-Gert Bernstein, Stefan Vielhaber, Andrea Kästner, Martin Skalej, Wolfgang Jordan, Kolja Schiltz, Christine Klingbeil, Klaus-Peter Wandinger, Bernhard Bogerts, Winfried Stoecker |
Journal | JAMA psychiatry
(JAMA Psychiatry)
Vol. 70
Issue 3
Pg. 271-8
(Mar 2013)
ISSN: 2168-6238 [Electronic] United States |
PMID | 23344076
(Publication Type: Journal Article)
|
Chemical References |
- Autoantibodies
- Immunoglobulin G
- Immunoglobulins
- NR1A protein, human
- NR2B NMDA receptor
- Receptors, AMPA
- Receptors, N-Methyl-D-Aspartate
- glutamate receptor ionotropic, AMPA 2
- glutamate receptor ionotropic, AMPA 1
|
Topics |
- Adult
- Autoantibodies
(blood)
- Borderline Personality Disorder
(diagnosis, immunology)
- Case-Control Studies
- Depressive Disorder, Major
(diagnosis, immunology)
- Encephalitis
(diagnosis, immunology)
- Female
- Humans
- Immunoglobulin G
(blood)
- Immunoglobulins
(blood)
- Male
- Middle Aged
- Receptors, AMPA
(immunology)
- Receptors, N-Methyl-D-Aspartate
(immunology)
- Schizophrenia
(diagnosis, immunology)
- Sensitivity and Specificity
|