Cerebrospinal fluid CD20 positive B-cell expansion in a case of anti-NMDAR encephalitis

Yiming Zheng; Jingjing Luo; Haiqiang Jin; Feng Gao; Hongjun Hao

doi:10.1016/j.jneuroim.2020.577365

Cerebrospinal fluid CD20 positive B-cell expansion in a case of anti-NMDAR encephalitis

J Neuroimmunol. 2020 Dec 15:349:577365. doi: 10.1016/j.jneuroim.2020.577365. Epub 2020 Aug 21.

Authors

Yiming Zheng¹, Jingjing Luo¹, Haiqiang Jin¹, Feng Gao², Hongjun Hao³

Affiliations

¹ Neurology Department, Peking University First Hospital, China.
² Neurology Department, Peking University First Hospital, China. Electronic address: gaofh2011@126.com.
³ Neurology Department, Peking University First Hospital, China. Electronic address: haohj1963@126.com.

PMID: 32971476
DOI: 10.1016/j.jneuroim.2020.577365

Abstract

Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a potentially fatal autoimmune encephalitis with a strong B-cell response. We measured the proportion of CD20 positive and CD19 positive B-cells in the CSF from a case of severe anti-NMDAR encephalitis. The proportion of CD20 positive B-cells in the CSF was 15.0%, higher than CD19 positive B cells (10.1%), and higher than that seen in non-inflammatory neurological disorders (<1%). After the treatments of steroids, intravenous immunoglobulin and rituximab to eliminate B-cells, she recovered. These findings further support the use of rituximab that targets CD20 positive B-cells in anti-NMDAR encephalitis.

Keywords: Anti-NMDAR encephalitis; CD19; CD20; Rituximab.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Anti-N-Methyl-D-Aspartate Receptor Encephalitis / cerebrospinal fluid*
Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis*
Antigens, CD20 / cerebrospinal fluid*
Autoantibodies / cerebrospinal fluid*
B-Lymphocytes / metabolism*
Biomarkers / cerebrospinal fluid
Female
Humans
Young Adult

Substances

Antigens, CD20
Autoantibodies
Biomarkers