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Seroprevalence of anti-N-methyl-d-aspartate receptor antibodies in women with ovarian teratoma

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Abstract

Recently antibodies against neuronal receptors have been identified as cause of a new type of encephalitis. The anti-N-methyl-d-aspartate receptor (anti-NMDA-R) encephalitis is the prototype of these disorders. Patients have a high incidence of teratomata. Removal of teratoma is considered the essential treatment of anti-NMDA-R encephalitis. Here, we aimed to investigate whether neurologically asymptomatic individuals suffering from ovarian teratomata may have positive anti-NMDA-R antibodies to be detected by an established assay. Over a time period of 15 months, all patients suffering from ovarian teratomata without neurological symptoms were included in this prospective study. Twenty consecutive patients were pair matched to patients with other benign ovarian disease and healthy controls. Preoperatively, patients had a gynaecological examination, transvaginal ultrasound, neurological examination and determination of anti-NMDA-R antibodies. None of the patients or controls presented with neurological symptoms. All tumours could be removed completely by laparoscopy. Anti-NMDA-R antibodies were absent in the group of patients with teratomata as well as in patients with benign ovarian tumours and healthy controls. Testing for anti-NMDA-R antibodies revealed negative findings in well-characterised patients with ovarian teratomata lacking neurological symptoms. Our data support the current clinical practice that a systematic screening for anti-NMDA-R antibodies in teratoma patients is not indicated.

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Acknowledgments

The authors thank Dr. Julia Lange very much for providing the ultrasound picture of a teratoma. We would also like to thank Barbara Ingold-Heppner very much for kindly preparing the pathological figure.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gynecology, Charitéplatz 1, Charité Campus Mitte, 10117, Berlin, Germany

    Mandy Mangler, Isabel Trebesch de Perez, Achim Schneider, Jekaterina Vasiljeva & Dorothee Speiser

  2. Department of Neurology and Experimental Neurology, Charité Campus Mitte, 10117, Berlin, Germany

    Harald Prüss & Andreas Meisel

  3. Institute for Experimental Immunology, Affiliated to Euroimmun AG, Lübeck, Germany

    Bianca Teegen & Winfried Stöcker

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  1. Mandy Mangler
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  2. Isabel Trebesch de Perez
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  5. Harald Prüss
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Corresponding author

Correspondence to Mandy Mangler.

Electronic supplementary material

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415_2013_7074_Fig2_ESM.jpg

Typical ultrasound picture of ovarian teratoma 8.9 cm in size (provided by Dr. Julia Lange, Praxis Kurfürstendamm 199, 10719 Berlin) (JPEG 140 kb)

Histopathological pictures of teratoma in 500 μm solution (JPEG 280 kb)

Histopathological pictures of teratoma in 200 μm solution (JPEG 292 kb)

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Mangler, M., Trebesch de Perez, I., Teegen, B. et al. Seroprevalence of anti-N-methyl-d-aspartate receptor antibodies in women with ovarian teratoma. J Neurol 260, 2831–2835 (2013). https://doi.org/10.1007/s00415-013-7074-0

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  • DOI: https://doi.org/10.1007/s00415-013-7074-0

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