Clinical features and inflammatory markers in autoimmune encephalitis associated with antibodies against neuronal surface in brazilian patients

Detalhes bibliográficos
Autor(a) principal: Nóbrega, Paulo Ribeiro
Data de Publicação: 2019
Outros Autores: 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
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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spelling 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
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