Department of Neurology, Mayo Clinic, Rochester, MN, United States.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.
Front Immunol. 2022 Oct 11;13:948479. doi: 10.3389/fimmu.2022.948479. eCollection 2022.
To evaluate and characterize cardiac arrythmias associated with LGI1-IgG (Leucine-rich glioma inactivated 1-IgG) autoimmune encephalitis (AE).
In this retrospective descriptive study, we identified Mayo Clinic patients (May 1, 2008 - December 31, 2020) with LGI1-IgG AE who had electrocardiogram proven bradyarrhythmias during the initial presentation. Inclusion criteria were 1) LGI1-IgG positivity with a consistent clinical syndrome; 2) electrocardiographic evidence of bradyarrhythmia; and 3) sufficient clinical details. We excluded patients who were taking negative ionotropic agents at the time of their bradyarrhythmias. We collected demographic/clinical data including details of bradyarrhythmia (severity, duration, treatments), and neurologic and cardiac outcomes.
We found that patients with LGI1-IgG AE had bradyarrhythmia at a frequency of 8% during the initial presentation. The bradyarrhythmia was often asymptomatic (6/11, 55%); however, the episode was severe with one patient requiring a pacemaker. Outcome was also generally favorable with the majority (8/11, 73%) having full resolution without further cardiac intervention. Lastly, we found that mouse and human cardiac tissues express LGI1 (mRNA and protein).
LGI1-IgG AE can be rarely associated with bradyarrhythmias. Although the disease course is mostly favorable, some cases may require pacemaker placement to avoid devastating outcomes.
评估和描述与 LGI1-IgG（富亮氨酸胶质瘤失活 1 型免疫球蛋白 G）自身免疫性脑炎（AE）相关的心律失常。
在这项回顾性描述性研究中，我们确定了梅奥诊所（Mayo Clinic）患者（2008 年 5 月 1 日-2020 年 12 月 31 日），这些患者在初始表现期间存在心电图证实的心动过缓。纳入标准为 1）LGI1-IgG 阳性，具有一致的临床综合征；2）心电图有心动过缓证据；3）有足够的临床细节。我们排除了在发生心动过缓时服用离子通道阻滞剂的患者。我们收集了人口统计学/临床数据，包括心动过缓（严重程度、持续时间、治疗）的详细信息以及神经和心脏结局。
我们发现，LGI1-IgG AE 患者在初始表现时有 8%发生心动过缓。心动过缓常常无症状（6/11，55%）；然而，该发作很严重，一名患者需要植入起搏器。大多数患者（8/11，73%）结局良好，无需进一步心脏干预即可完全缓解。最后，我们发现，小鼠和人类心脏组织表达 LGI1（mRNA 和蛋白质）。
LGI1-IgG AE 可罕见引起心动过缓。尽管疾病过程大多良好，但某些病例可能需要植入起搏器以避免严重后果。
