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@ARTICLE{Endres:269340,
      author       = {Endres, Dominique and von Zedtwitz, Katharina and Nickel,
                      Kathrin and Runge, Kimon and Maier, Alexander and Domschke,
                      Katharina and Salzer, Ulrich and Prüss, Harald and Venhoff,
                      Nils and van Elst, Ludger Tebartz},
      title        = {{A}ssociation of rheumatological markers with neuronal
                      antibodies, cerebrospinal fluid, electroencephalography, and
                      magnetic resonance imaging findings in 224 patients with
                      psychotic syndromes},
      journal      = {Brain, behavior and immunity},
      volume       = {119},
      issn         = {0889-1591},
      address      = {Orlando, Fla.},
      publisher    = {Academic Press},
      reportid     = {DZNE-2024-00509},
      pages        = {482 - 493},
      year         = {2024},
      abstract     = {Psychotic syndromes can have autoimmune-mediated causes in
                      some patients. Thus, this retrospective work aims to
                      investigate the role of rheumatological markers in the
                      development of psychosis.In total, 224 patients with
                      psychotic syndromes receiving a 'rheumatological laboratory
                      screening' (including C-reactive protein [CRP],
                      immunofixation, complement factors, rheumatoid factor [RF],
                      antiphospholipid antibodies [APAs], antineutrophil
                      cytoplasmic antibodies [ANCAs], and antinuclear antibodies
                      [ANAs]) were analyzed. A further diagnostic work-up included
                      investigations of neuronal antibodies and cerebrospinal
                      fluid (CSF), as well as electroencephalography (EEG) and
                      magnetic resonance imaging (MRI) of the brain. ANA testing
                      was routinely performed in all patients using serum on human
                      epithelioma-2 (Hep2) cells, and a subset of patients (N =
                      73) also underwent tissue-based assays from serum and CSF.
                      The number of cases with autoimmune psychotic syndromes was
                      descriptively collected, and ANA-positive and -negative
                      patients were compared in detail.CRP was elevated in 9 $\%$
                      of patients, immunofixation identified alterations in 8
                      $\%,$ complement factor C3 was decreased in 14 $\%,$ RF was
                      elevated in 1 $\%,$ APAs were elevated in 7 $\%,$ ANCAs were
                      not clearly positive, and ANAs were positive in 19 $\%$
                      (extractable nuclear antigen [ENA] differentiation resulted
                      in positive findings in 14 patients). From the 73 patient
                      samples additionally investigated using tissue-based assays,
                      there were 26 positive results for some kind of ANA (36
                      $\%),$ and overall using both methods, 54 patients (24 $\%)$
                      were considered positive for ANAs. A neuropsychiatric
                      evaluation revealed a possible autoimmune psychotic syndrome
                      in seven patients (3 $\%)$ and a probable autoimmune
                      psychotic syndrome in two patients (1 $\%).$ ANA-positive
                      patients were more frequently treated with antidepressants
                      (p = 0.040) and had a higher number of somatic comorbidities
                      (p < 0.001). In addition, (chronic) inflammatory MRI lesions
                      (p = 0.008) and focal atrophies (p = 0.012) were found more
                      frequently in ANA-positive than ANA-negative
                      patients.Rheumatological screening led to suspicion of a
                      possible or probable autoimmune psychotic syndrome in $4\%.$
                      ANAs were associated with MRI pathologies. Therefore,
                      rheumatological processes may contribute to the development
                      of psychotic syndromes in rare cases.},
      keywords     = {Humans / Psychotic Disorders: immunology / Male / Female /
                      Adult / Electroencephalography: methods / Middle Aged /
                      Magnetic Resonance Imaging: methods / Retrospective Studies
                      / Biomarkers: cerebrospinal fluid / Biomarkers: blood /
                      C-Reactive Protein: analysis / C-Reactive Protein:
                      metabolism / Autoantibodies: cerebrospinal fluid /
                      Autoantibodies: blood / Antibodies, Antinuclear:
                      cerebrospinal fluid / Aged / Brain: diagnostic imaging /
                      Brain: metabolism / Young Adult / Autoimmune Diseases:
                      cerebrospinal fluid / Neurons: metabolism / Adolescent /
                      Rheumatic Diseases: cerebrospinal fluid / ANA (Other) /
                      Antibody (Other) / Autoimmune psychosis (Other) / Complement
                      (Other) / Immunological (Other) / Biomarkers (NLM Chemicals)
                      / C-Reactive Protein (NLM Chemicals) / Autoantibodies (NLM
                      Chemicals) / Antibodies, Antinuclear (NLM Chemicals)},
      cin          = {AG Prüß},
      ddc          = {150},
      cid          = {I:(DE-2719)1810003},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38599500},
      doi          = {10.1016/j.bbi.2024.04.001},
      url          = {https://pub.dzne.de/record/269340},
}