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Neuroimmunomodulation. 2018;25(4):206-214. doi: 10.1159/000494801. Epub 2018 Nov 29.

Serum Bilirubin and Albumin in Anti-N-Methyl-D-Aspartate Receptor Encephalitis.

Author information

1
Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
2
Department of Cardiovascular Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
3
Priority Area Asthma and Allergy, Research Center Borstel, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany.
4
Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, qiuwei120@vip.163.com.

Abstract

BACKGROUND AND OBJECTIVE:

Low serum levels of bilirubin and albumin are associated with multiple autoimmune diseases, but their role in anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is unknown.

METHODS:

Serum bilirubin and albumin levels were evaluated in 60 patients with anti-NMDAR encephalitis, 50 cryptococcal encephalitis, and 145 healthy controls (CTLs). Of the 60 anti-NMDAR encephalitis patients, 30 had a follow-up evaluation at 3 months after admission.

RESULTS:

Serum bilirubin and albumin levels were both significantly lower in anti-NMDAR encephalitis than in CTLs, and serum bilirubin levels were significantly lower in anti-NMDAR encephalitis than in cryptococcal encephalitis. Serum bilirubin levels were significantly lower in patients with psychiatric symptoms, with severe impairment, and with limited responses to treatment than those without psychiatric symptoms, with mild impairment, and with favorable responses to treatment, respectively. A follow-up evaluation of 30 patients revealed that the modified Rankin Scale scores were significantly decreased after treatment. Serum bilirubin significantly associated with serum albumin, and plasma hemoglobin.

CONCLUSIONS:

Our results revealed for the first time an association between the serum levels of bilirubin in the anti-NMDAR encephalitis. Further studies investigating the role of bilirubin and albumin in anti-NMDAR encephalitis are required.

KEYWORDS:

Albumin; Anti-N-methyl-D-aspartate receptor encephalitis; Antioxidant; Autoimmune disorders; Bilirubin

PMID:
30497071
DOI:
10.1159/000494801

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