Anti-endothelial serum antibodies in a patient with Susac's syndrome

J Neurol Sci. 2009 Oct 15;285(1-2):259-61. doi: 10.1016/j.jns.2009.07.002. Epub 2009 Jul 29.


Background: Susac's syndrome (SS) is a rare arteriopathy affecting the microvasculature of the brain, retina, and inner ear, resulting in encephalopathy, branch retinal artery occlusion and hearing loss. Anecdotal reports exist on SS being associated with a humoral immune response against endothelial cells. However, no original data has ever been published.

Objective: To analyze serum and CSF from a patient with SS for the presence of CNS auto-antibodies and, if present, to further characterize such antibodies immunologically.

Methods: Serum and CSF samples were examined by indirect immunofluorescence on adult mouse cerebrum, cerebellum, brain stem, and inner ear tissue sections, and IgG subclasses were determined.

Results: Anti-endothelial antibodies were found at a titre of 1:960 in serum but not CSF. Antibodies belonged to the complement activating IgG1 subclass. Glucocorticoid treatment resulted in a decrease of titres (1:480), though the antibodies remained clearly detectable.

Conclusion: Our finding of anti-endothelial cell antibodies in a patient with SS is important in the light of previous pathological data suggesting that SS is associated with endothelial damage. Larger serological studies are now warranted to assess systematically the frequency and relevance of auto-antibodies in SS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autoantibodies / blood*
  • Autoantibodies / cerebrospinal fluid
  • Autoantibodies / metabolism
  • Brain / metabolism
  • Brain / pathology
  • Ear, Inner / metabolism
  • Endothelium / immunology*
  • Endothelium / metabolism
  • Female
  • Fluorescent Antibody Technique
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulin G / metabolism
  • Intracranial Arterial Diseases / blood*
  • Intracranial Arterial Diseases / cerebrospinal fluid
  • Intracranial Arterial Diseases / drug therapy
  • Labyrinth Diseases / blood*
  • Labyrinth Diseases / cerebrospinal fluid
  • Labyrinth Diseases / drug therapy
  • Magnetic Resonance Imaging
  • Mice
  • Middle Aged
  • Retinal Diseases / blood*
  • Retinal Diseases / cerebrospinal fluid
  • Retinal Diseases / drug therapy
  • Syndrome
  • Treatment Outcome


  • Autoantibodies
  • Glucocorticoids
  • Immunoglobulin G