التفاصيل البيبلوغرافية
| العنوان: |
Autoimmune encephalitis: A retrospective monocentric experience. |
| المؤلفون: |
Maniscalco, Giorgia Teresa, Manzo, Valentino, Napolitano, Massimo, Ranieri, Angelo, Renna, Rosaria, Servillo, Giovanna, Alfieri, Gennaro, Candelaresi, Paolo, Iorio, Walter Di, Rippa, Mariana, Bozzetti, Silvia, Zeccolini, Fabio, Gatta, Luigi Della, Viola, Assunta, Santangelo, Claudio, Peluso, Rosa, Ferrari, Sergio, Mariotto, Sara |
| المصدر: |
Multiple Sclerosis & Related Disorders; Oct2021, Vol. 55, pN.PAG-N.PAG, 1p |
| مستخلص: |
• Autoimmune encephalitis includes an heterogeneus group of syndromes characterized by brain inflammation, associated with the detection of several neuronal autoantibodies. However a large proportion of AE shows no specific auto-antibodies and is referred as 'seronegative'. • Seropositive and seronegative AEs have a similar clinical, radiological, and CSF profile. • AEs show a good response to immunotherapy but clinicians were less confident to use long-term immunosuppressors in the seronegative cases. Abstract Autoimmune encephalitis includes an heterogeneous group of neurological disorders characterized by brain inflammation and usually associated with specific autoantibodies in serum and/or cerebrospinal fluid. Nevertheless, a proportion of suspected autoimmune encephalitis shows no specific auto-antibodies and is therefore referred as 'seronegative'. We present a monocentric retrospective study which aims to analyse and present the differences between seropositive and seronegative patients with autoimmune encephalitis. 39 patients were retrospectively identified. For each patient demographic data, clinical features, laboratory data (including infection screening, cerebrospinal fluid profile and autoimmune profile), instrumental findings (including brain MRI, EEG, and whole-body CT), treatment, and final outcome were analyzed using appropriate statistical tests. No significant differences emerged in demographic characteristics, baseline disability, radiological/EEG abnormalities, first treatment strategies, and final outcome in the seropositive (n=13) and seronegative (n=26) group. A significant correlation between CSF cell number and disease duration was observed in the antibody negative group (p =0.02). Comorbidities (96.1% vs 53.8%, p =0.003) and an antecedent infection (19.2% vs 0, p =0.04) were more common in the seronegative group. First treatment strategies were not different in the two groups, while Rituximab was not administered in seronegative cases. Seropositive and seronegative autoimmune encephalitis have a similar clinical, radiological, and cerebrospinal fluid profile suggesting that treatment strategies should be also similar. An extensive diagnostic workup including live cell-based assay and tissue-based assay is of utmost importance to identify these conditions and guide therapeutic strategies. [ABSTRACT FROM AUTHOR] |
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