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Anti-NMDA receptor encephalitis is a treatment-responsive inflammatory encephalopathic autoimmune disease associated with anti-NMDA receptor antibodies. The disease is mostly associated with teratomas of the ovaries, and is thus considered a paraneoplastic neurologic syndrome (PNS). However, there are a significant number of cases with no detectable tumor.
Tests generally appear in the order most useful for common clinical situations
| Test name: CBC with Platelet Count & Automated Differential |
| ARUP #: 0040003 |
| Methodology: Automated Cell Count with Flow Cell Differential |
| Use: May be helpful in diagnosing infectious etiology |
| Test name: Electrolyte Panel |
| ARUP #: 0020410 |
| Methodology: Quantitative Ion-Selective Electrode/Enzymatic |
| Use: Aid in ruling out metabolic encephalopathy |
| Test name: Hepatic Function Panel |
| ARUP #: 0020416 |
| Methodology: Refer to individual components. |
| Use: Aid in ruling out metabolic encephalopathy |
| Test name: CSF Bacterial Culture (Includes Gram Stain 0060101) |
| ARUP #: 0060106 |
| Methodology: Standard reference procedures for bacterial stain, aerobic culture, and identification |
| Use: Rule out meningitis |
| Test name: Cell Count, CSF |
| ARUP #: 0095018 |
| Methodology: Cell Count/Differential |
| Use: Rule out infection |
| Test name: Glucose, CSF |
| ARUP #: 0020515 |
| Methodology: Enzymatic |
| Use: Rule out infection |
| Test name: Protein, Total, CSF |
| ARUP #: 0020514 |
| Methodology: Reflectance Spectrophotometry |
| Use: Rule out infection |
| Test name: Fungal Culture |
| ARUP #: 0060149 |
| Methodology: Standard reference procedures for fungal culture. Standard reference procedures for identification and/or ITS rDNA Sequencing. DNA probes available for Histoplasma, Coccidioides, and Blastomyces |
| Use: May identify fungal causes or help identify organism responsible for meningitis |
| Limitations: Need 5cc fluid to culture for fungus |
| Test name: Blood Culture, Fungal |
| ARUP #: 0060070 |
| Methodology: BACTEC® Continuous Monitoring System. Standard reference procedures for identification and/or DNA Sequencing |
| Use: May identify fungal causes or help identify organism responsible for encephalitis/meningitis |
| Test name: Fungal Culture, Skin, Hair or Nails |
| ARUP #: 0060728 |
| Methodology: Standard reference procedures for fungal culture. Standard reference procedures for identification and/or ITS rDNA Sequencing. |
| Use: May identify fungal causes or help identify organism responsible for encephalitis/meningitis |
| Test name: Oligoclonal Band Profile |
| ARUP #: 0080440 |
| Methodology: Qualitative Isoelectric Focusing/Immunofixation/Nephelometry |
| Use: May be useful to differentiate antiNMDA disease from multiple sclerosis Profile includes:
|
| Test name: N-methyl-D-Aspartate Receptor Antibody, IgG, CSF |
| ARUP #: 2005164 |
| Methodology: Qualitative Indirect Fluorescent Antibody |
| Use: Confirm diagnosis of anti-NMDAR encephalitis in CSF |
| Test name: N-methyl-D-Aspartate Receptor Antibody, IgG, Serum |
| ARUP #: 2004221 |
| Methodology: Indirect Fluorescent Antibody |
| Use: Confirm diagnosis of anti-NMDAR encephalitis |