Retrospective study of N-methyl-D-aspartate glutamate receptor IgG testing outcomes at LabPLUS, Auckland City Hospital, New Zealand, 2015 - 2020, in a clinically demand-managed setting

ABSTRACT

Conclusions: Under the framework of neurologist gate keeping and liaison LabPLUS was able to implement and consistently deliver high value clinical results (antibody positive and negative) that allowed rapid treatment intervention when indicated which then translated into the best possible outcomes for patients with NMDAR encephalitis. NZJ Med Lab Sci 2021;75192-201 INTRODUCTION Anti-NMDAR (N-methyl-D-aspartate glutamate receptor) encephalitis is an autoimmune based syndrome with a progressive clinical course that can be treated. For reasons outlined earlier in this introduction, NMDAR encephalitis was the first condition chosen to deliver on-site testing, not only to improve patient outcomes but also to demonstrate proof of concept of the new service which, if delivered, would then allow future expansion. After a further set of incubation and wash steps slides had cover slips applied and were viewed for characteristic (nuclear with cytoplasmic extensions) staining using Zeiss LED-based fluorescence microscopy (excitation 470/40nm;emission 515nm) at a magnification of X200 (Figure 1).