Department of Neurology, Affiliated Zhejiang Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Neuroimmunol. 2021 Oct 15;359:577673. doi: 10.1016/j.jneuroim.2021.577673. Epub 2021 Jul 26.
The aim of this study was to examine the seasonal distribution in clinical onset of autoimmune encephalitis (AE) in a multi-center cohort in China.
This retrospective study consecutively recruited patients with new-onset definite neuronal surface antibody-associated AE between January 2015 and December 2020 from 3 tertiary hospitals. Demographic and clinical characteristics of the participants were comprehensively collected. Statistical analyses were performed using R.
Of the 184 patients of AE in our database, 149 (81.0%) were included in the final analysis. The median age of onset was 40.0 years, and 66 (44.3%) patients were female. AE predominantly started in autumn (47, 31.5%) and summer (43, 28.9%) months. Summer-autumn predominance of the clinical onsets was also present in the anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis group (54, 60.0%) and anti-leucine-rich glioma inactivated 1 (LGI1) encephalitis group (20, 76.9%). No obvious seasonal variations were observed among gender, onset age, disease duration, prodromal symptoms, clinical type of initial symptoms, and disease severity by the time of admission.
This study suggested summer-autumn predominance of the clinical onsets in patients with AE, especially anti-NMDAR and anti-LGI1 encephalitis. Therefore, clinicians should have a high index of suspicion for AE in encephalopathy patients in summer and autumn period.
本研究旨在探讨中国多中心队列中自身免疫性脑炎（AE）临床发病的季节性分布。
本回顾性研究连续纳入了 2015 年 1 月至 2020 年 12 月期间来自 3 家三级医院的新诊断的明确神经元表面抗体相关 AE 患者。全面收集了参与者的人口统计学和临床特征。使用 R 进行统计分析。
在我们的数据库中，184 名 AE 患者中，有 149 名（81.0%）被纳入最终分析。发病的中位年龄为 40.0 岁，66 名（44.3%）患者为女性。AE 主要在秋季（47 例，31.5%）和夏季（43 例，28.9%）发病。抗 N-甲基-D-天冬氨酸受体（NMDAR）脑炎组（54 例，60.0%）和抗亮氨酸丰富胶质瘤失活 1（LGI1）脑炎组（20 例，76.9%）也存在夏季-秋季发病高峰。性别、发病年龄、病程、前驱症状、初始症状的临床类型和入院时疾病严重程度等因素在夏季和秋季无明显季节性变化。
本研究提示 AE 患者的临床发病具有夏季-秋季发病高峰的特点，尤其是抗 NMDAR 和抗 LGI1 脑炎。因此，临床医生在夏秋季应高度警惕 AE 脑病患者。
