Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da Universidade Federal do Ceará (UFC) |
Texto Completo: | http://www.repositorio.ufc.br/handle/riufc/46868 |
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/mm3) 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. |
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Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patientsEncefaliteEncephalitisBiomarcadoresBiomarkersAnticorposAntibodiesPobrezaPovertyAcute 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/mm3) 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.Frontiers in Neurology2019-10-17T14:04:51Z2019-10-17T14:04:51Z2019-05info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfNÓBREGA, Paulo Ribeiro et al. Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients. Front. Neurol., v. 10, p. 1-6, may. 2019.1664-2295http://www.repositorio.ufc.br/handle/riufc/46868Nóbrega, Paulo RibeiroPitombeira, Milena SalesMendes, Lucas SilvestreKrueger, Mariana BraatzSantos, Carolina FigueiredoMorais, Norma Martins de MenezesSimabukuro, Mateus MistieriMaia, Fernanda MartinsBraga-Neto, Pedroengreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2019-10-17T14:04:51Zoai:repositorio.ufc.br:riufc/46868Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:45:40.402204Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false |
dc.title.none.fl_str_mv |
Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients |
title |
Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients |
spellingShingle |
Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients Nóbrega, Paulo Ribeiro Encefalite Encephalitis Biomarcadores Biomarkers Anticorpos Antibodies Pobreza Poverty |
title_short |
Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients |
title_full |
Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients |
title_fullStr |
Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients |
title_full_unstemmed |
Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients |
title_sort |
Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients |
author |
Nóbrega, Paulo Ribeiro |
author_facet |
Nóbrega, Paulo Ribeiro Pitombeira, Milena Sales Mendes, Lucas Silvestre Krueger, Mariana Braatz Santos, Carolina Figueiredo Morais, Norma Martins de Menezes Simabukuro, Mateus Mistieri Maia, Fernanda Martins Braga-Neto, Pedro |
author_role |
author |
author2 |
Pitombeira, Milena Sales Mendes, Lucas Silvestre Krueger, Mariana Braatz Santos, Carolina Figueiredo Morais, Norma Martins de Menezes Simabukuro, Mateus Mistieri Maia, Fernanda Martins Braga-Neto, Pedro |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Nóbrega, Paulo Ribeiro Pitombeira, Milena Sales Mendes, Lucas Silvestre Krueger, Mariana Braatz Santos, Carolina Figueiredo Morais, Norma Martins de Menezes Simabukuro, Mateus Mistieri Maia, Fernanda Martins Braga-Neto, Pedro |
dc.subject.por.fl_str_mv |
Encefalite Encephalitis Biomarcadores Biomarkers Anticorpos Antibodies Pobreza Poverty |
topic |
Encefalite Encephalitis Biomarcadores Biomarkers Anticorpos Antibodies Pobreza Poverty |
description |
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/mm3) 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. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-10-17T14:04:51Z 2019-10-17T14:04:51Z 2019-05 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
NÓBREGA, Paulo Ribeiro et al. Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients. Front. Neurol., v. 10, p. 1-6, may. 2019. 1664-2295 http://www.repositorio.ufc.br/handle/riufc/46868 |
identifier_str_mv |
NÓBREGA, Paulo Ribeiro et al. Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients. Front. Neurol., v. 10, p. 1-6, may. 2019. 1664-2295 |
url |
http://www.repositorio.ufc.br/handle/riufc/46868 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Frontiers in Neurology |
publisher.none.fl_str_mv |
Frontiers in Neurology |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da Universidade Federal do Ceará (UFC) instname:Universidade Federal do Ceará (UFC) instacron:UFC |
instname_str |
Universidade Federal do Ceará (UFC) |
instacron_str |
UFC |
institution |
UFC |
reponame_str |
Repositório Institucional da Universidade Federal do Ceará (UFC) |
collection |
Repositório Institucional da Universidade Federal do Ceará (UFC) |
repository.name.fl_str_mv |
Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC) |
repository.mail.fl_str_mv |
bu@ufc.br || repositorio@ufc.br |
_version_ |
1813028935810678784 |