Seropositive Anti-NMDAR Mediated Autoimmune Encephalitis

Gowda, Vykuntaraju K; Nagarajan, Balamurugan; Shivappa, Sanjay K; Benakappa, Naveen

doi:10.1007/s12098-020-03312-0

Cited by 3 publications

(4 citation statements)

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“…Our research showed that after hospitalisation, 75.64% (59/78) of the patients basically recovered and were discharged normally according to the one-year follow-up and the mRS score. This was consistent with 80% of the expert consensus [ 16 ].…”

Section: Discussionsupporting

confidence: 90%

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RETRACTED ARTICLE: Immune characteristics of children with autoimmune encephalitis and the correlation with a short-term prognosis

et al. 2022

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Background Autoimmune encephalitis (AE) is a type of encephalopathy mediated by an antigenic immune response in the central nervous system. Most research related to autoimmune encephalitis (AE) is focused on early diagnosis, treatment and prognosis analysis; there has been little research conducted on the characteristics of immune function, and the relationship between immune function and prognoses of patients with autoimmune encephalitis needs to be studied further. Methods A total of 33 children with autoimmune encephalitis were identified through the clinic database and inpatient consults at Tianjin Children’s Hospital from January 2013 to January 2021. Based on the one-year follow-up and the modified Rankin Scale (mRS) prognosis score, they were divided into a good prognosis group and a poor prognosis group. The immune function characteristics of the two groups of children with autoimmune encephalitis (AE) were compared using Spearman correlation to analyse the mRS score and immune function indicators (IgA, IgG, IgM, CD4, CD8, CD4/CD8), and binary logistic regression was used to analyse the independent risk factors of the prognoses in patients with autoimmune encephalitis (AE). Results The differences in abnormal mental disorders and limb dyskinesia, cognitive impairment, onset types, modified Rankin Scale (mRS) scores at admission, and immune function status during remission between the two groups were statistically significant (p < 0.05). Conclusion There is a close correlation between modified Rankin Scale (mRS) scores and the immune function index CD4/CD8 in children with autoimmune encephalitis (AE) when they are admitted to the hospital. A young age, disturbance of consciousness, limb dyskinesia, abnormal immune function in remission and anti-NMDAR encephalitis are risk factors for poor prognoses in children with autoimmune encephalitis (AE). Clinical treatment requires more attention.

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Section: Discussionsupporting

confidence: 90%

“…Compared with adult patients with AE, there were significant differences in clinical presentation, antibody levels, treatment and prognoses of children with AE [ 16 ]. The children with AE showed different types of clinical presentation, as mentioned above [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: Immune characteristics of children with autoimmune encephalitis and the correlation with a short-term prognosis

et al. 2022

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“…[13] Compared with adult patients with AE, there were signi cant differences in clinical presentation, antibody levels, treatment and prognosis of children with AE. [14] The children with AE showed different types of clinical presentation, as mentioned above. [10] Infection and fever were mainly prodromal symptoms.…”

Section: Discussionmentioning

confidence: 93%

“…This was consistent with 80% of the expert consensus. [14] The pathogenesis of AE has not been clear. Previous studies have shown that AE is associated with virus infection, tumour or autoimmunity.…”

Section: Discussionmentioning

confidence: 99%

Immune Characteristics of Children With Autoimmune Encephalitis and the Correlation With Short-term Prognosis

Huang

Fan

Meng

et al. 2021

Preprint

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Objective: To explore the immune characteristics and short-term prognosis of children with autoimmune encephalitis (AE), then to analyse the relationship between them. Methods: A total of 78 children with AE were identified through the clinic database and inpatient consults in Tianjin Children’s Hospital (238 Long-Yan Road, Bei-Chen District, Tianjin, China) from January 2018 to January 2021. Based on the recent follow-up (one-year follow-up) of the modified Rankin Scale (mRS) prognosis score, they were divided into a good prognosis group (59 cases, mRS <3 points) and a poor prognosis group (19 cases, mRS ≥3 points). The immune function characteristics of the two groups of children with AE were compared using Spearman correlation to analyse the mRS score and immune function indicators (IgA, IgG, IgM, CD4, CD8, CD4/CD8), and using binary logistic regression to analyse the factors affecting the prognosis of children with AE. Results: The differences in age, consciousness disorder, limb dyskinesia, cognitive impairment, onset type, mRS score at admission, and immune function status during remission between the two groups were statistically significant (p < 0.05). The mRS score of the good prognosis group at admission was significantly lower than that of the poor prognosis group (2.65 ± 0.76 vs 3.05 ± 0.71, p ＜ 0.05). IgA (0.61 ± 0.19 vs 0.87 ± 0.25, p < 0.001), IgG (8.17 ± 1.12 vs 9.02 ± 1.39, p = 0.001). IgM (1.01 ± 0.26 vs 1.23 ± 0.33, p < 0.001) in the good prognosis group were significantly lower than those in the poor prognosis group, while CD4 (36.35 ± 8.74 vs 23.89 ± 6.97, p < 0.001) and CD4/CD8 (1.68 ± 0.32 vs 1.01 ± 0.24, p = 0.001) were significantly higher than those in the poor prognosis group. Spearman correlation analysis showed that the mRS score at admission was significantly negatively correlated with CD4/CD8 (r ＝−0.775, p < 0.001), but not significantly correlated with other immune function indexes. Binary logistic regression showed that age (OR = 0.385; 95% CI = 0.200–0.741), consciousness disorder (OR = 39.3569; 95% CI = 4.073–380.262), limb movement disorder (OR = 17.107; 95% CI = 2.769–105.701), and abnormal immune function in remission (OR = 0.050; 95% CI = 0.007–0.372) were risk factors for poor prognosis in children with AE. Conclusion: There is a close correlation between mRS and immune function index CD4/CD8 in children with AE when they are admitted to the hospital. Young age, disturbance of consciousness, limb dyskinesia, and abnormal immune function in remission are risk factors for poor prognosis of children with AE. More attention should be paid in clinical treatment.

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Anti-N-methyl D-aspartate Receptor Encephalitis in India

Chowdhury¹,

Panda²,

Gupta³

et al. 2023

Annals of Indian Academy of Neurology

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Anti N-methyl D-aspartate receptor encephalitis (NMDAR-E) though rare, is currently considered as the commonest antibody mediated encephalitis in the world. No review on perspectives of NMDAR-E from India is available. The aim of the study was to review all the cases of NMDAR-E reported from India until June 2021 in terms of clinical features, diagnosis, and treatment, and perform a comparison of adult and paediatric cases. A literature review of NMDAR-E case reports/case series published from India till June 2021 was done. Demography, clinical profile, triggers, electroencephalography (EEG), neuroimaging, treatment details and outcomes were analysed. Sixteen case series and 35 case reports with a total of 249 cases were analysed. 82% of cases were from paediatric age group. The female to male ratio was 3:1. Psychiatric deficits, movement disorders, seizures, and language abnormalities were the most common clinical features. MRI brain abnormalities were seen in 45% patients. Electroencephalographic abnormalities were seen in 85% of patients. Infective triggers (herpes simplex virus and various other agents) were reported in 11% of the cases. Pediatric patients as compared with adults had more encephalopathy, autonomic dysfunctions, and normal imaging whereas the latter had more cognitive dysfunctions and delta brush pattern in electroencephalography (p<0.005). Therefore, to conclude, this literature review suggests that overall, the clinical spectrum of Indian cases is like cases described from other parts of the world. However, most reported cases from India belonged to paediatric age group who had more encephalopathy, autonomic dysfunctions, and normal brain imaging compared to adults. A few novel infectious agents as triggers were described from India.

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Seropositive Anti-NMDAR Mediated Autoimmune Encephalitis

Cited by 3 publications

References 4 publications

RETRACTED ARTICLE: Immune characteristics of children with autoimmune encephalitis and the correlation with a short-term prognosis

RETRACTED ARTICLE: Immune characteristics of children with autoimmune encephalitis and the correlation with a short-term prognosis

Immune Characteristics of Children With Autoimmune Encephalitis and the Correlation With Short-term Prognosis

Anti-N-methyl D-aspartate Receptor Encephalitis in India

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