Autoimmune XXXX of adults and teenagers.

@entity1 @entity146 @entity3391 @entity8684 @entity9663 @entity10926 @entity159
OBJECTIVE: To report 14 @entity1 with immune-mediated relapsing symptoms @entity10926 ( @entity10926 ) and to compare the clinical and immunologic features of the teenage and adult group with those of young @entity1 . METHODS: Prospective observational study of @entity1 diagnosed between June 2013 and February 2015. Immunologic techniques have been reported previously. RESULTS: Among the teenage and adult group (8 @entity1 , median age 40 years, range 13-69; 5 male), 3 had an acute symptom presentation suggesting a viral relapse, and 5 a presentation contiguous with @entity10926 suggesting a recrudescence of previous deficits. Seven @entity1 developed severe @entity146 /behavioral symptoms disrupting all social interactions, and one refractory @entity159 . @entity9663 occurred in one @entity1 . Five @entity1 had CSF antibodies against @entity3391 receptor (NMDAR) and 3 against unknown neuronal cell surface proteins. In 5/6 @entity1 , the brain MRI showed new areas of contrast enhancement that decreased after immunotherapy and clinical improvement. Immunotherapy was useful in 7/7 @entity1 , sometimes with impressive recoveries, returning to their baseline @entity10926 residual deficits. Compared with the 6 younger @entity1 (median age 13 months, range 6-20, all with NMDAR antibodies), the teenagers and adults were less likely to develop @entity8684 (0/8 vs 6/6, p < 0.01) and decreased level of consciousness (2/8 vs 6/6, p < 0.01) and had longer delays in diagnosis and treatment (interval relapse/antibody testing 85 days, range 17-296, vs 4 days, range 0-33, p = 0.037). CONCLUSION: In teenagers and adults, the immune-mediated relapsing syndrome post- @entity10926 is different from that known in young @entity1 as @entity10926 and is underrecognized. Prompt diagnosis is important because immunotherapy can be highly effective.
