Neurology® Podcast December 2024 Recall: Topics in Autoimmune Neurology
Dec 1, 2024
Join neurologists John Pluvinage, Andrew McKeon, Martin Tichler, Jolt Elesch, and Marius Ringelstein in a fascinating discussion on autoimmune neurology. Pluvinage dives into anti-CD320 antibodies and their clinical significance. McKeon reveals insights about paraneoplastic CAMKV autoimmune encephalitis. Tichler highlights long-term outcomes in anti-NMDAR encephalitis patients. Elesch examines mortality rates in AQP4 antibody-positive neuromyelitis optica, while Ringelstein evaluates the efficacy of Eculizumab in clinical settings. Tune in for cutting-edge insights in neurology!
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Autoimmune Vitamin B12 CNS Deficiency
- Autoantibodies against the transcobalamin receptor (CD320) cause vitamin B12 deficiency specifically affecting the CNS.
- This deficiency occurs despite normal serum B12 levels, as antibodies block B12 transport into the brain.
Index Case Revealed B12 Antibody
- A 67-year-old woman developed progressive neurological symptoms with normal serum B12 but had anti-CD320 antibodies blocking CNS B12 uptake.
- Steroid treatment and lupus diagnosis improved her symptoms, highlighting the autoimmune pathogenesis.
High Specificity of Transcobalamin Antibody
- Transcobalamin receptor antibody is highly specific and predictive for low CSF B12 and defective B12 metabolism.
- The antibody likely causes secondary B12 brain deficiency by blocking brain uptake, differing from typical neuronal autoantibodies.