Maternal-fetal Transfer of Anti-N-methyl-D-aspartate Receptor Antibodies

Overview

Journal Obstet Gynecol

Specialty Gynecology & Obstetrics

Date 2015 Feb 25

PMID 25710615

Citations 11

Authors

Leah M Lamale-Smith

Gaea S Moore

Saketh R Guntupalli

Julie B Scott

Affiliations

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Abstract

Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a neuroautoimmune disease commonly associated with ovarian teratomas. It is characterized by neuropsychiatric symptoms, seizures, and autonomic instability. Few cases are described in pregnancy, and little is known about potential fetal effects.

Case: Anti-NMDA receptor encephalitis was diagnosed at 24 weeks of gestation. No improvement occurred with intravenous immunoglobulin, methylprednisolone, and plasmapheresis. Imaging was unremarkable. Cesarean delivery with concurrent bilateral oophorectomy resulted in prompt maternal improvement. Antibody titers were positive in cord blood.

Conclusion: Anti-N-methyl-D-aspartate receptor encephalitis in pregnancy can lead to NMDA receptor antibodies in the fetal circulation. Pregnancy interruption through early delivery with or without oophorectomy may accelerate maternal recovery.

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