Background and purpose: This study aimed to evaluate the relationship between serum complement and anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis.
Methods: Serum complement (C3, C4 and CH50), immunoglobulins (IgG, IgM and IgA) and C-reactive protein (CRP) were evaluated in 40 patients with anti-NMDAR encephalitis and 40 controls. Follow-up evaluations of 11 of the 40 patients with anti-NMDAR encephalitis were conducted 6 months after admission. Modified Rankin Scale (mRS) scores and clinical and cerebrospinal fluid parameters were evaluated in patients with anti-NMDAR encephalitis.
Results: Serum C4 levels were significantly higher in patients with anti-NMDAR encephalitis than in controls (P = 0.003), especially in female patients (P = 0.001) and those with severe impairment (mRS ≥ 4; P < 0.001). Serum CH50 levels were significantly higher in patients with severe impairment (P = 0.007) and limited treatment responses (P = 0.007). Serum C4 was associated with C3 (r = 0.506, P = 0.001), CH50 (r = 0.478, P = 0.002) and mRS score (r = 0.607, P < 0.001). Serum C3 was associated with CH50 (r = 0.339, P = 0.032) and cerebrospinal fluid white blood cells (r = 0.351, P = 0.026). Serum CH50 was associated with age, mRS score and CRP. Follow-up evaluations revealed that mRS scores were significantly lower than those before treatment, and a significant negative correlation was observed between the change in C3 levels and the change in mRS score.
Conclusion: Our results demonstrated that serum C4 levels were elevated and associated with C3, CH50 and CRP levels, and disease severity in patients with anti-NMDAR encephalitis.
Keywords: anti-N-methyl-d-aspartate receptor encephalitis; immune effects; serum complement.
© 2017 EAN.