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Guan et al. D-cycloserin for anti-NMDAR encephalitis

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cyclophosphamide and mycophenolate may take with anti-NMDAR encephalitis. Lancet Neurol 2011;10:63-74.
3-4 months to have responses. We cannot draw 2. Moscato EH, Peng X, Jain A, Parsons TD, Dalmau J, Balice-Gordon
conclusions that the clinical improvement was a RJ. Acute mechanisms underlying antibody effects in anti-N-methyl-D-
aspartate receptor encephalitis. Ann Neurol 2014;76:108-19.
consequence of the D-cycloserine treatment.
3. Sideris S, Lagoumintzis G, Kordas G, Kostelidou K, Sotiriadis A,
Poulas K, Tzartos SJ. Isolation and functional characterization of anti-
In conclusion, D-cycloserine seems to be a promising acetylcholine receptor subunit-specific autoantibodies from myasthenic
symptomatic treatment for anti-NMDAR encephalitis. patients: receptor loss in cell culture. J Neuroimmunol 2007;189:111-7.
Further studies are warranted to evaluate the 4. Watson GB, Bolanowski MA, Baganoff MP, Deppeler CL, Lanthorn
effectiveness of D-cycloserine. Understanding the TH. D-cycloserine acts as a partial agonist at the glycine modulatory
mechanisms underlying the disorder will lead to site of the NMDA receptor expressed in Xenopus oocytes. Brain Res
discover novel therapy including other NMDA-agonists. 1990;510:158-60.
5. Schade S, Paulus W. D-Cycloserine in Neuropsychiatric Diseases: A
Acknowledgments Systematic Review. Int J Neuropsychopharmacol 2016; doi: 10.1093/
We thank our patient and her family. ijnp/pyv102.
6. Storch EA, Murphy TK, Goodman WK, Geffken GR, Lewin AB,
Financial support and sponsorship Henin A, Micco JA, Sprich S, Wilhelm S, Bengtson M, Geller DA.
A preliminary study of D-cycloserine augmentation of cognitive-
Nil. behavioral therapy in pediatric obsessive-compulsive disorder. Biol
Psychiatry 2010;68:1073-6.
Conflicts of interest 7. Zhu M, Nix DE, Adam RD, Childs JM, Peloquin CA. Pharmacokinetics
There are no conflicts of interest. of cycloserine under fasting conditions and with high-fat meal, orange
juice, and antacids. Pharmacotherapy 2001;21:891-7.
Patient consent 8. D’Souza DC, Gil R, Cassello K, Morrissey K, Abi-Saab D, White J,
Obtained. Sturwold R, Bennett A, Karper LP, Zuzarte E, Charney DS, Krystal JH.
IV glycine and oral D-cycloserine effects on plasma and CSF amino
Ethics approval acids in healthy humans. Biol Psychiatry 2000;47:450-62.
The patient was treated within the standards of our 9. MacMahon M, Naysmith MR, McCallion S, Rhodes J. Ketamine
institute and the report was approved. infusion associated with improved neurology in a patient with NMDA
receptor encephalitis. Case Rep Crit Care 2013;2013:383125.
10. Heresco-Levy U, Durrant AR, Ermilov M, Javitt DC, Miya K, Mori H.
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