Clinical Features and Inflammatory Markers in Autoimmune Encephalitis Associated With Antibodies Against Neuronal Surface in Brazilian Patients

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art_NOBREGA_Clinical_Features_and_Inflammatory_Markers_in_Autoimmune_Encephalitis_2019.PDF (286.42 KB)
Citações na Scopus
15
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
FRONTIERS MEDIA SA
Autores
NOBREGA, Paulo Ribeiro
MENDES, Lucas Silvestre
KRUEGER, Mariana Braatz
SANTOS, Carolina Figueiredo
MORAIS, Norma Martins de Menezes
MAIA, Fernanda Martins
BRAGA-NETO, Pedro
Citação
FRONTIERS IN NEUROLOGY, v.10, article ID 472, 6p, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Acute encephalitis is a debilitating neurological disorder associated with brain inflammation and rapidly progressive encephalopathy. Autoimmune encephalitis (AE) is increasingly recognized as one of the most frequent causes of encephalitis, however signs of inflammation are not always present at the onset which may delay the diagnosis. We retrospectively assessed patients with AE associated with antibodies against neuronal surface diagnosed in reference centers in Northeast of Brazil between 2014 to 2017. CNS inflammatory markers were defined as altered CSF (pleocytosis >5 cells/mm(3)) and/or any brain parenchymal MRI signal abnormality. Thirteen patients were evaluated, anti-NMDAR was the most common antibody found (10/13, 77%), followed by anti-LGI1 (2/13, 15%), and anti-AMPAR (1/13, 7%). Median time to diagnosis was 4 months (range 2-9 months). Among these 13 patients, 6 (46.1%) had inflammatory markers and when compared to those who did not present signs of inflammation, there were no significant differences regarding the age of onset, time to diagnosis and modified Rankin scale score at the last visit. Most of the patients presented partial or complete response to immunotherapy during follow-up. Our findings suggest that the presence of inflammatory markers may not correlate with clinical presentation or prognosis in patients with AE associated with antibodies against neuronal surface. Neurologists should be aware to recognize clinical features of AE and promptly request antibody testing even without evidence of inflammation in CSF or MRI studies.
Palavras-chave
autoimmune encephalitis, Inflammatory biomarkers, neuronal surface antibody, NMDAR, LGI1, AMPAR, low-income population
URI
https://observatorio.fm.usp.br/handle/OPI/32558
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - ODS/03