Evidence map›Paper›PMID 31619447›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2020

Anti-NMDAR encephalitis: A single-center, longitudinal study in China.

Xiaolu Xu, Qiang Lu, Yan Huang, Siyuan Fan, Lixin Zhou, Jing Yuan, Xunzhe Yang, Haitao Ren, Dawei Sun, Yi Dai and 6 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Xiaolu XuFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Qiang LuFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Yan HuangFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Siyuan FanFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Lixin ZhouFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Jing YuanFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.ORCID 0000-0002-3923-925X
Xunzhe YangFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Haitao RenFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Dawei SunFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Yi DaiFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Huadong ZhuFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Yinan JiangFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Yicheng ZhuFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Bin PengFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Liying CuiFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
Hongzhi GuanFrom the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences. guanhz@263.net.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo describe the detailed clinical characteristics, immunotherapy, and long-term outcomes of patients with anti-NMDA receptor (NMDAR) encephalitis in China.

methodsA single-center, prospective study. Patients who met the diagnostic criteria were enrolled from 2011 to 2017 and followed up. The clinical features, treatment, and long-term outcomes were collected prospectively. Factors affecting the long-term prognosis were analyzed.

resultsThe study included 220 patients. The most common clinical presentations were psychosis (82.7%) and seizures (80.9%). Of the patients, 19.5% had an underlying neoplasm; of which ovarian teratoma was 100% of tumors in females and only one male had lung cancer. Most patients (99.5%) received first-line therapy (glucocorticoids, IV immunoglobulin, or plasmapheresis alone or combined), and only 7.3% received second-line immunotherapy (rituximab, cyclophosphamide alone, or combined). Long-term immunotherapy (mycophenolate mofetil or azathioprine >1 year) was administered to 53.2% of patients. During the first 12 months, 207 (94.1%) patients experienced improvement, and 5 (2.3%) died, whereas 38 (17.3%) experienced relapses. At 12-month follow-up, 92.7% had favorable clinical outcomes (modified Rankin Scale score ≤2).

conclusionsPatients in China present with psychosis and seizure frequently but have a low percentage of underlying neoplasms. Re-enforced first-line immunotherapy is effective in managing anti-NMDAR encephalitis in the acute phase. Although relapse is relatively common, with combined first-line and long-term immunotherapy, most patients reached favorable outcomes.

Indexed as

Anti-N-Methyl-D-Aspartate Receptor EncephalitisNeoplasmsPsychotic DisordersSeizuresAdolescentAdultAgedChildChild, PreschoolChinaFemaleHumansLongitudinal StudiesMaleMiddle AgedYoung Adult

Identifiers

PMID31619447
PMCPMC6857906

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