Abstracts

Rationale: Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a treatable autoimmune disease of the central nervous system (CNS) with prominent neurologic and psychiatric features at disease onset. The disease is associated with the production of autoantibodies to NMDAR; affected patients develop a multistage progressive illness with symptoms ranging from memory deficits, seizures and psychosis, to potentially lethal catatonia, and autonomic and breathing instability. The outcome can be much improved with accurate diagnosis and early treatment using adequate immunosuppressive therapy. However, since the neurological and psychiatric symptoms as well as the clinical examination results can be non-specific, the disease is probably under-recognized. Reliable and accurate clinical testing for the identification of NMDAR autoantibodies is crucial for diagnosis. Different techniques are available for its diagnosis; however it is necessary to have more diagnostic tools to help understand and identify this type of diseaseMethods: The present study included 14 patients: 4 children with motor disorders and seizures and 10 adults with psychiatric disorders and seizures (16-45 years), in whom studies were performed to identify antibodies against the NMDA receptor and flow cytometry, 3 ml of FSC and peripheral blood were used for flow cytometry, according to the protocol of Kraan et al (2008), and was analyzed with FACSDiva Software Version 5.0.3Results: Patients who were identified as NMDA autoantibodies IgG class (11) showed a large population of cells in CSF (mean 10344 ± 2843), which, according to size and granularity of cells, corresponds to lymphocytes of these cells a 54 ± 26% correspond to T cells in adults and 18 ± 13% in pediatric patients, with high proportion of B lymphocyte in pediatric patients. Both groups maintained the ratio 2:1 between T helper and T cytotoxic cells. Both types of population showed the early activation marker CD69+, helper T in both groups showed a higher percentage of activation. In both groups, B cells express the majority of HLA-DR molecule and is related to their capacity for antigen presenting cells; well, T lymphocytes expressing HLA-DR are related to the migration event CSF compartment.Conclusions: The results indicate that flow cytometry is an additional tool that shows us the immune condition of each patient and can help establish the diagnosis.