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GLYCINE RECEPTOR ANTIBODY—A MARKER FOR NMO/ NON-MS DEMYELINATION?
  1. Shahd Hamid1,
  2. Liene Elsone1,
  3. Patrick Waters2,
  4. Mark Woodhall Woodhall2,
  5. Kerry Mutch1,
  6. Cahal Rafferty1,
  7. Lisa Tang1,
  8. Tom Solomon3,1,
  9. Angela Vincent2,
  10. Anu Jacob1
  1. 1The Walton Centre NHS Foundation Trust, Liverpool
  2. 2John Radcliffe Hospital, Oxford
  3. 3Institute of Infectious Disease, University of Liverpool

Abstract

Background Antibodies against glycine receptors (GlyR Ab) have been strongly linked to progressive encephalomyelitis with rigidity and myoclonus (PERM). Their association with other neurological disorders is poorly understood.

Methods We looked retrospectively at all patients who were tested for (GlyR Abs) in the Walton Centre between 2010–2014.

Results 138 patients were tested. The pre-test diagnoses (n) were transverse myelitis (34), NMO (22, (7 AQP4 IgG+ve and 15 AQP4 IgG-ve), optic neuritis (17), MS (22), ADEM (4), other atypical demyelination (4), encephalitis (11), epilepsy (4), dementia (4), parkinsonism (3), functional disorders (3) and others (10). 53.6% (74) had a relapsing course

6/138 (4%) were positive for GlyR Ab. The diagnoses (n) were optic neuritis (2) one of which was AQP4 IgG+ve, NMO-AQP4-IgG negative (1), transverse myelitis (1), tumefactive demyelination (1) and undiagnosed spastic ataxic syndrome with normal imaging (1). 5/6 had a relapsing course and are on immunosuppressants.

Conclusion Antibodies against GlyR are not common and seem to be associated with some non-PERM inflammatory CNS diseases, with a relapsing course. Larger studies are required to understand the clinical and prognostic significance of these early findings.

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