Anti-NMDAR antibodies, watch the company they keep

Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis is the most common and best described of autoimmune syndromes associated with neuronal cell surface or synaptic autoantibodies. It typically characterised by a progressive clinical course involving confusion, psychosis, seizures, dysautonomia altered consciousness has increasingly been diagnostic consideration for clinicians given greater awareness its serious nature potential response to immunosuppressive therapy. Since anti-NMDAR’s characterisation, there vast expansion in number recognised autoantibodies spectrum neurological disorders association them. Increasingly, it realised that may be multiple present simultaneously anti-NMDA-R antibodies distinction between these entities can difficult. Here we describe outcomes anti-NMDAR antibody testing over 12 months state-wide immunopathology laboratory focus on their concurrence other Through three contrasting cases, highlight considerations pitfalls when faced this scenario emphasise importance correlation.