Yan Wu, Mengke Wang, Zhiqiang Su, Jiaao Gu, Fulin Guan
First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Xinqiao Hospital and Second Affiliated Hospital of Army Medical University, Chongqing, China.
Acta Neurol Belg. 2024 Oct;124(5):1569-1580. doi: 10.1007/s13760-024-02537-6. Epub 2024 Apr 18.
Autoimmune encephalitis (AE) is a rare, treatable disease of the central nervous system (CNS) caused by an antibody-related immune response. This study is to investigate the correlation of clinical features, cerebrospinal fluid (CSF) characteristics, and prognosis in patients with AE.
A total of 71 patients diagnosed with antibody-positive AE were retrospectively analyzed. The patients were divided into three groups: anti-NMDAR group, anti-LGI1 group, and other types. Clinical data were collected to analyze clinical features and CSF results, and prognosis was determined by modified Rankin Scale (mRS).
There was statistical difference in the incidences of decreased consciousness level (P < 0.001), memory loss (P = 0.017), speech disorders (P = 0.035), and dyskinesia (P = 0.001) in different antibodies groups. Younger age (P = 0.018), elevated CSF chloride content (P = 0.006), and white blood cells > 50/mm (P = 0.026) were highly correlated with ICU admission. Anti-LGI1 encephalitis had a relatively small risk for ICU admission (P = 0.034), and a lower risk of poor functional recovery (P = 0.048) and recurrence (P = 0.041). Patients with first-line treatment failure (P = 0.021) had an increased risk of poor functional recovery. Delayed treatment (P = 0.011) would increase the risk of recurrence.
There are differences in age, gender, clinical characteristics, and CSF results in different subtypes of AE. First-line therapy failure would have poor functional recovery, and delayed therapy would increase the risk of relapse. Chloride ion content and white blood cell count in cerebrospinal fluid are positively correlated with the patient's exacerbation and admission to ICU. These indicators have certain clinical value for the prognosis of AE patients.
自身免疫性脑炎（AE）是一种由抗体相关免疫反应引起的罕见的、可治疗的中枢神经系统（CNS）疾病。本研究旨在探讨AE患者的临床特征、脑脊液（CSF）特征与预后的相关性。
对71例诊断为抗体阳性AE的患者进行回顾性分析。患者分为三组：抗NMDAR组、抗LGI1组和其他类型。收集临床资料以分析临床特征和CSF结果，并采用改良Rankin量表（mRS）评估预后。
不同抗体组在意识水平下降（P<0.001）、记忆力减退（P=0.017）、言语障碍（P=0.035）和运动障碍（P=0.001）的发生率上存在统计学差异。年龄较小（P=0.018）、CSF氯化物含量升高（P=0.006）和白细胞>50/mm（P=0.026）与入住重症监护病房（ICU）高度相关。抗LGI1脑炎入住ICU的风险相对较小（P=0.034），功能恢复不良（P=0.048）和复发（P=0.041）的风险较低。一线治疗失败的患者功能恢复不良的风险增加（P=0.021）。延迟治疗（P=0.011）会增加复发风险。
AE不同亚型在年龄、性别、临床特征和CSF结果方面存在差异。一线治疗失败会导致功能恢复不良，延迟治疗会增加复发风险。脑脊液中的氯离子含量和白细胞计数与患者病情加重及入住ICU呈正相关。这些指标对AE患者的预后具有一定的临床价值。
