Epidemiology of neuronal surface antibody-mediated autoimmune encephalitis and antibody-based diagnostics

2021 ◽  
pp. 577598
Author(s):  
Luigi Zuliani ◽  
Sabrina Marangoni ◽  
Piera De Gaspari ◽  
Irene Rosellini ◽  
Margherita Nosadini ◽  
...  
Keyword(s):  
Autoimmune Encephalitis ◽  
Surface Antibody

Surface Antibody-Mediated Autoimmune Encephalitis

2019 ◽  
pp. 159-168
Author(s):  
Amanda L. Piquet ◽  
Jenny J. Linnoila
Keyword(s):  
Autoimmune Encephalitis ◽  
Surface Antibody

scholarly journals Efficacy of tacrolimus as long-term immunotherapy for neuronal surface antibody-mediated autoimmune encephalitis

2022 ◽  
Vol 13 ◽  
pp. 204062232110630
Author(s):  
Chenchen Liu ◽  
Suqiong Ji ◽  
Huajie Gao ◽  
Zhuajin Bi ◽  
Qin Zhang ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Autoimmune Encephalitis ◽  
Efficacy And Safety ◽  
Nmda Receptor Encephalitis ◽  
Significant Difference ◽  
Observational Cohort ◽  
Surface Antibody ◽  
Retrospective Observational Cohort Study

Aims: We aimed to verify the efficacy and safety of tacrolimus as long-term immunotherapy for the treatment of neuronal surface antibody-mediated autoimmune encephalitis (AE) during the first attack. Methods: In this retrospective observational cohort study, patients with neuronal surface antibody-mediated AE who experienced the first attack were enrolled. We compared the outcomes of 17 patients who received tacrolimus with those of 47 patients treated without tacrolimus. Patients were assessed at onset and 3, 6, and 12 months, as well as at the last follow-up, by using the modified Rankin scale (mRS) and the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). The efficacy of tacrolimus was also compared in a subgroup of patients with anti-NMDA receptor encephalitis. Results: Among all patients with neuronal surface antibody-mediated AE, those receiving tacrolimus had lower median mRS scores [1 (IQR = 0–1) versus 2 (IQR = 1–3) in controls, p = 0.001)], CASE scores [2 (IQR = 1–3) versus 3 (IQR = 2–7), p = 0.006], and more favorable mRS scores (94.1% versus 68.1%, p = 0.03) at the 3-month follow-up. No difference was found at the last follow-up. There was no significant difference in the occurrence of relapse and adverse events between the two groups (11.8% versus 14.9%, p = 0.75). In the subgroup of patients with anti-NMDA receptor encephalitis, patients treated with tacrolimus had a lower median mRS score at the 3-month follow-up [1 (IQR = 0–2) versus 2 (IQR = 1–3), p = 0.03]; however, no difference in the outcome was detected at the last follow-up. Conclusion: Tacrolimus can be used as long-term immunotherapy in patients with neuronal surface antibody-mediated AE during the first attack. Treatment with tacrolimus appears to accelerate the clinical improvement of neuronal surface antibody-mediated AE.

scholarly journals Differences and diversity of autoimmune-mediated encephalitis in 77 cases from a single tertiary care center

2019 ◽  
Author(s):  
Abhinbhen Wasontiwong Saraya ◽  
Kanthita Worachotsueptrakun ◽  
Kritchai Vutipongsatorn ◽  
Chanikarn Sonpee ◽  
Thiravat Hemachudha
Keyword(s):  
Behavioral Change ◽  
Care Center ◽  
Tertiary Care ◽  
Autoimmune Encephalitis ◽  
Numerical Data ◽  
Clinical Findings ◽  
Exact Test ◽  
Abnormal Movements ◽  
Surface Antibody ◽  
Surface Antibodies

Abstract Background Since the discovery of N-methyl-D-aspartate receptor (NMDAr) antibody in 2007, the incidence of autoantibody-mediated encephalitis has risen globally. Here we analyzed and compared groups of autoantibody-associated encephalitis patients based on clinical findings and laboratory results in order to find differences between two major groups of autoantibody-mediated encephalitis: intracellular and neuronal surface antibodies. Methods 77 records of autoimmune encephalitis/encephalomyelitis patients admitted to King Chulalongkorn Memorial Hospital (KCMH) between October 2010 and February 2017 were reviewed. Patients with infections or those with classic central nervous system demyelinating features were excluded. Categorical data was analyzed using chi-square and Fisher’s exact test. Unpaired, two-tailed t-test was performed to analyze numerical data. Results Of 77 patients, 40% presented with neuronal surface antibodies and 33% had intracellular antibodies. The most common autoantibody detected in each group was anti-NMDA receptor antibody (25/31, 81%) and anti-Ri antibody (7/25, 28%) respectively. In the neuronal surface antibody group, behavioral change was the most common complaint (45%), followed by seizures (39%), abnormal movements (29%) and psychosis/mood disorder (23%). In the latter group, seizure was the most common presenting symptom (32%), followed by motor weakness (20%), behavioral change (16%) and abnormal movements (16%). Patients with neuronal surface antibodies were significantly younger (35 vs 48 years old, p=0.04) and were more likely to present with behavioral change (45% vs 16%, p=0.02). Mortality rate was higher in the intracellular group although this was statistically insignificant (16% vs 3.2%, p=0.09). No significant differences were detected in magnetic resonance imaging and cerebrospinal fluid (CSF) profile. Conclusions The prevalence of neuronal surface antibody group was much higher than the intracellular group. In the earlier stages of the disease, both groups have comparable clinical outcomes. Furthermore, it is difficult to distinguish autoantibody-associated encephalitis patients based on clinical data, neuroimaging and CSF profile. Therefore, we recommend that patients with features of autoimmune encephalitis should be screened for both the neuronal surface and intracellular antibodies regardless of clinical presentation.

scholarly journals Neuronal Surface Antibody-Mediated Autoimmune Encephalitis

2014 ◽  
Vol 34 (04) ◽  
pp. 458-466 ◽  
Author(s):  
Jenny Linnoila ◽  
Myrna Rosenfeld ◽  
Josep Dalmau
Keyword(s):  
Autoimmune Encephalitis ◽  
Surface Antibody

scholarly journals Differences and diversity of autoimmune-mediated encephalitis in 77 cases from a single tertiary care center

2019 ◽  
Author(s):  
Abhinbhen Wasontiwong Saraya ◽  
Kanthita Worachotsueptrakun ◽  
Kritchai Vutipongsatorn ◽  
Chanikarn Sonpee ◽  
Thiravat Hemachudha
Keyword(s):  
Behavioral Change ◽  
Care Center ◽  
Tertiary Care ◽  
Autoimmune Encephalitis ◽  
Numerical Data ◽  
Clinical Findings ◽  
Exact Test ◽  
Abnormal Movements ◽  
Surface Antibody ◽  
Surface Antibodies

Abstract Background Since the discovery of N-methyl-D-aspartate receptor (NMDAr) antibody in 2007, the incidence of autoantibody-mediated encephalitis has risen globally. Here we analyzed and compared groups of autoantibody-associated encephalitis patients based on clinical findings and laboratory results in order to find differences between two major groups of autoantibody-mediated encephalitis: intracellular and neuronal surface antibodies. Methods 77 records of autoimmune encephalitis/encephalomyelitis patients admitted to King Chulalongkorn Memorial Hospital (KCMH) between October 2010 and February 2017 were reviewed. Patients with infections or those with classic central nervous system demyelinating features were excluded. Categorical data was analyzed using chi-square and Fisher’s exact test. Unpaired, two-tailed t-test was performed to analyze numerical data. Results Of 77 patients, 40% presented with neuronal surface antibodies and 33% had intracellular antibodies. The most common autoantibody detected in each group was anti-NMDA receptor antibody (25/31, 81%) and anti-Ri antibody (7/25, 28%) respectively. In the neuronal surface antibody group, behavioral change was the most common complaint (45%), followed by seizures (39%), abnormal movements (29%) and psychosis/mood disorder (23%). In the latter group, seizure was the most common presenting symptom (32%), followed by motor weakness (20%), behavioral change (16%) and abnormal movements (16%). Patients with neuronal surface antibodies were significantly younger (35 vs 48 years old, p=0.04) and were more likely to present with behavioral change (45% vs 16%, p=0.02). Mortality rate was higher in the intracellular group although this was statistically insignificant (16% vs 3.2%, p=0.09). No significant differences were detected in magnetic resonance imaging and cerebrospinal fluid (CSF) profile. Conclusions The prevalence of neuronal surface antibody group was much higher than the intracellular group. In the earlier stages of the disease, both groups have comparable clinical outcomes. Furthermore, it is difficult to distinguish autoantibody-associated encephalitis patients based on clinical data, neuroimaging and CSF profile. Therefore, we recommend that patients with features of autoimmune encephalitis should be screened for both the neuronal surface and intracellular antibodies regardless of clinical presentation.

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