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Title:	Herpes simplex virus encephalitis is a trigger of brain autoimmunity
Author:	Armangué, Thaís; Leypoldt, Frank; Málaga, Ignacio; Raspall Chaure, Miquel; Marti, Itxaso; Nichter, Charles; Pugh, John; Vicente-Rasoamalala, Mónica; Lafuente-Hidalgo, Miguel; Macaya Ruiz, Alfons; Ke, Michael; Titulaer, Maarten J.; Höftberger, Romana; Sheriff, Heather; Glaser, Carol; Dalmau Obrador, Josep
Notes:	In 5 prospectively diagnosed patients with relapsing post-herpes simplex encephalitis (HSE), N-methyl-D-aspartate receptor (NMDAR) antibodies were identified. Antibody synthesis started 1 to 4 weeks after HSE, preceding the neurological relapse. Three of 5 patients improved postimmunotherapy, 1 spontaneously, and 1 has started to improve. Two additional patients with NMDAR antibodies, 9 with unknown neuronal surface antibodies, and 1 with NMDAR and unknown antibodies, were identified during retrospective assessment of 34 HSE patients; the frequency of autoantibodies increased over time (serum, p=0.004; cerebrospinal fluid, p=0.04). The 3 retrospectively identified NMDAR antibody-positive patients also had evidence of relapsing post-HSE. Overall, these findings indicate that HSE triggers NMDAR antibodies and potentially other brain autoimmunity.
Subject(s):	-Encefalitis -Herpes -Autoimmunitat -Malalties cerebrals -Encephalitis -Herpesvirus diseases -Autoimmunity -Brain diseases
Rights:	(c) American Neurological Association, 2013
Document type:	Article Article - Accepted version
Published by:	Wiley-Liss
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