Frequent rhabdomyolysis in anti-NMDA receptor encephalitis

Jung-Ah Lim; Soon-Tae Lee; Tae-Joon Kim; Jangsup Moon; Jun-Sang Sunwoo; Jung-Ick Byun; Keun-Hwa Jung; Ki-Young Jung; Kon Chu; Sang Kun Lee

doi:10.1016/j.jneuroim.2016.08.002

Frequent rhabdomyolysis in anti-NMDA receptor encephalitis

J Neuroimmunol. 2016 Sep 15:298:178-80. doi: 10.1016/j.jneuroim.2016.08.002. Epub 2016 Aug 2.

Authors

Affiliations

¹ Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea.
² Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea; Department of Neurology, Soonchunhyang University School of Medicine, Seoul, South Korea.
³ Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea; Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.
⁴ Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address: stemcell.snu@gmail.com.
⁵ Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address: sangkun2923@gmail.com.

PMID: 27609293
DOI: 10.1016/j.jneuroim.2016.08.002

Abstract

The aim of this study was to analyze the clinical presentation and provocation factors of rhabdomyolysis in anti-NMDAR encephalitis. Among the 16 patients with anti-NMDAR encephalitis in our institutional cohort, nine patients had elevated CK enzyme levels and clinical evidence of rhabdomyolysis. Rhabdomyolysis was more frequent after immunotherapy. The use of dopamine receptor blocker (DRB) increased the risk of rhabdomyolysis. None of the patients without rhabdomyolysis received DRBs. Rhabdomyolysis is a frequent complication in anti-NMDAR encephalitis and more common after immunotherapy and the use of DRBs increases the risk. Therefore, DRBs should be administered carefully in patients with anti-NMDAR encephalitis.

Keywords: Autoimmune encephalitis; Encephalitis; NMDA; Rhabdomyolysis.

Publication types

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

MeSH terms

Adolescent
Adult
Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications*
Anti-N-Methyl-D-Aspartate Receptor Encephalitis / epidemiology*
Anti-N-Methyl-D-Aspartate Receptor Encephalitis / therapy
Child
Child, Preschool
Cohort Studies
Creatine Kinase
Female
Humans
Immunotherapy / adverse effects
Infant
Male
Receptors, N-Methyl-D-Aspartate
Rhabdomyolysis / epidemiology*
Rhabdomyolysis / etiology*
Young Adult

Substances

Receptors, N-Methyl-D-Aspartate
Creatine Kinase