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Since its original description nearly 15 years ago, anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARe) has been part of the differential diagnosis for first episode of psychosis (FEP), one treatable with immunosuppression and oncologic management. The differentiation of anti-NMDARe from FEP due to psychiatric disease (pFEP) remains challenging. In a single-center observational study, researchers determined serum neurofilament light chain (sNfL) levels in 118 patients with anti-NMDARe (median age, 23.5 years; 33 with isolated psychosis at presentation), 45 with pFEP, 36 with herpes simplex encephalitis (HSE), and 36 health controls.
Among the anti-NMDARe patients with isolated psychosis, 15% had an sNfL level <15 pg/mL, compared wi…