Seronegative autoimmune encephalitis: exploring the unknown

Steenhoven, Robin W van; Titulaer, Maarten J.

doi:10.1093/brain/awac338

Cited by 2 publications

(2 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent study concluded that more aggressive treatment regimens in autoimmune encephalitis patients improved the 2-year outcome. However, a comment on this study suggested that first-line immunotherapy's effect was underestimated while second-line immunotherapy's effect was overestimated 26 , 43 . Based on our study, early treatment with anti-inflammatory drugs should be considered to minimize the risk of an unfavourable outcome in cases of CNS inflammatory diseases.…”

Section: Discussionmentioning

confidence: 74%

Predictors of unfavourable outcome in adults with suspected central nervous system infections: a prospective cohort study

ter Horst,

van Zeggeren,

Olie

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Suspected central nervous system (CNS) infections may pose a diagnostic challenge, and often concern severely ill patients. We aim to identify predictors of unfavourable outcome to prioritize diagnostics and treatment improvements. Unfavourable outcome was assessed on the Glasgow Outcome Scale at hospital discharge, defined by a score of 1 to 4. Of the 1152 episodes with suspected CNS infection, from two Dutch prospective cohorts, the median age was 54 (IQR 37–67), and 563 episodes (49%) occurred in women. The final diagnoses were categorized as CNS infection (N = 358 episodes, 31%), CNS inflammatory disease (N = 113, 10%), non-infectious non-inflammatory neurological disorder (N = 388, 34%), non-neurological infection (N = 252, 22%), and other systemic disorder (N = 41, 4%). Unfavourable outcome occurred in 412 of 1152 (36%), and 99 died (9%). Predictors for unfavourable outcomes included advanced age, absence of headache, tachycardia, altered mental state, focal cerebral deficits, cranial nerve palsies, low thrombocytes, high CSF protein, and the final diagnosis of CNS inflammatory disease (odds ratio 4.5 [95% confidence interval 1.5–12.6]). Episodes suspected of having a CNS infection face high risk of experiencing unfavourable outcome, stressing the urgent need for rapid and accurate diagnostics. Amongst the suspected CNS infection group, those diagnosed with CNS inflammatory disease have the highest risk.

show abstract

Section: Discussionmentioning

confidence: 74%

Predictors of unfavourable outcome in adults with suspected central nervous system infections: a prospective cohort study

ter Horst,

van Zeggeren,

Olie

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…It has been proposed that the underlying mechanism in ANPRA may involve T-cell mediated cytotoxicity. However, there have been only three cases associated with tumors in this context [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

An Autopsy-proven Case-based Review of Autoimmune Encephalitis

Shim,

Kim,

Lim

et al. 2024

Exp Neurobiol

View full text Add to dashboard Cite

Autoimmune encephalitis (AIE) is a type of immunoreactive encephalitic disorder and is recognized as the most prevalent noninfectious encephalitis. Nevertheless, the rarity of definitive AIE diagnosis through biopsy or autopsy represents a significant hurdle to understanding and managing the disease. In this article, we present the pathological findings of AIE and review the literature based on a distinct case of AIE presenting as CD8+ T-lymphocyte predominant encephalitis. We describe the clinical progression, diagnostic imaging, laboratory data, and autopsy findings of an 80-year-old deceased male patient. The patient was diagnosed with pulmonary tuberculosis 6 months before death and received appropriate medications. A week before admission to the hospital, the patient manifested symptoms such as a tendency to sleep, decreased appetite, and confusion. Although the patient temporally improved with medication including correction of hyponatremia, the patient progressed rapidly and died in 6 weeks. The brain tissue revealed lymphocytic infiltration in the gray and white matter, leptomeninges, and perivascular infiltration with a predominance of CD8+ T lymphocytes, suggesting a case of AIE. There was no detectable evidence of viral infection or underlying neoplasm. The autopsy revealed that this patient also had Alzheimer’s disease, atherosclerosis, arteriolosclerosis, and aging-related tau astrogliopathy. This report emphasizes the pivotal role of pathological examination in the diagnosis of AIE, especially when serological autoantibody testing is not available or when a patient is suspected of having multiple diseases.

show abstract

Seronegative autoimmune encephalitis: exploring the unknown

Abstract: This scientific commentary refers to ‘Seronegative autoimmune encephalitis: clinical characteristics and factors associated with outcomes’ by Lee et al. (https://doi.org/10.1093/brain/awac166).

Cited by 2 publications

References 9 publications

Predictors of unfavourable outcome in adults with suspected central nervous system infections: a prospective cohort study

Predictors of unfavourable outcome in adults with suspected central nervous system infections: a prospective cohort study

An Autopsy-proven Case-based Review of Autoimmune Encephalitis

Contact Info

Product

Resources

About