Clinical Characteristics Of 107 Patients With Autoimmune Encephalitis In Henan Province

Background and AimsAutoimmune encephalitis(AE)is a research hotspot in the field of neurology in recent years.The clinical reports of cases increase significantly,as the related antibodies start to be detected nationally in clinical laboratory.However,most studies are case-reports or small simple studies due to its low incidence.Based on the former research,the data of 107 AE cases in our hospital were collected and analyzed,to explore the clinical characteristics of AE in Henan province,and to provide evidence-based medicine support for clinical practice.Materials and methodsThis study included 107 AE patients admitted to the First Affiliated Hospital of Zhengzhou University and People’s Hospital of Zhengzhou University from January 2013 to December 2016.These include department of pediatric medicine,neurology and with severe nerve.Among the 107 cases,74 cases were diagnosed as N-Methyl-D-Aspartate Receptor(NMDAR)encephalitis,23 cases were autoimmune encephalitis,6 cases were gamma-aminobutyric acid B Receptor(GABABR)encephalitis,4 cases were with Leucine rich glioma inactivating protein 1(LGI1)antibodies positive in encephalitis.We collected the clinical data of AE patients,including main symptoms,serological examination,cranial MRI and EEG(Electroencephalogram,EEG),final diagnosis,treatment,and prognosis.The data are reported as the frequency or percentage,and are analyzed to explore the possible factors affecting the treatment and prognosis.Results1.Among the patients with positive antibodies,46 were male and 38 were female.8 cases suffered from central hypoventilation,and 6 cases suffered from unclear vision.2.As for tumor markers detection,there were 21 AE patients with abnormal thyroid function and thyroid-related antibody positive,one with anti-titin positive,one with anti-PNMA2 weak positive,one with anti-GAD65 positive.3.Among the patients diagnosed with anti-nmda receptor antibody in this study,2 patients with complicated tumor were detected,all of whom were teratomas,female,25 years old;In the present study,1 patient with uterine fibroids was detected in each of the proposed patients and 1 patient with anti-gabab-receptor encephalitis.In this study,no patients with positive LGI1 antibody were found to have complicated tumors.4.Among AE patients with anti-NMDA positive,there were 2 patients complicated with teratoma,aged 25 years old,and one case complicated with hysteromyoma.Among patients with GABAb receptor antibody positive,4 cases were complicated with cancer(SCLC).No cancer was found in patients with LGI1 antibody positive.5.In AE patients,cranial MRI findings were abnormal in 52 cases,including 14 cases with single lesion and 38 with multiple lesions.22 patients were with symmetrical lesions.There were 23 patients with temporal lobe involvement,21 cases frontal lobe involvement,16 cases with thalamus involvement,and 1 case cerebellar involvement.5.Most patients were given glucocorticoid,human gamma globulin and other first-line treatment,3 patients arranged with plasma exchange,1 patient given rituximab,and 3 patients given surgical treatment.The prognosis of most patients was good,and few patients were left neurological impairment.Conclusions1.This study found that there were more male patients with autoimmune encephalitis than female patients,suggesting that the incidence of this disease in males was higher than that in females,which was different from previous literature reports.The incidence of central hypopnea in patients with autoimmune encephalitis included in the study was 7.5%,lower than that reported in previous literature.And the optic nerve damage occurred in all patients with anti-nmda receptor encephalitis.2 The incidence of autoimmune encephalitis patients with tumor was about 6.54%,which was also relatively low compared with the previous literature.Among the patients with anti-nmda receptor antibody,all the patients with tumor(teratoma)were young women of reproductive age,and 4 patients with anti-gabab receptor encephalitis with small-cell lung cancer tumor,which was relatively high.3.Patients with autoimmune encephalitis can be combined with other autoimmune antibodies,such as thyroid antibodies;4.MR findings in patients with autoimmune encephalitis are heterogeneous,with multiple lesions,single lesions and symmetrical onset,most commonly involving temporal lobe and frontal lobe.5.Most of the first-and second-line drugs can get a good prognosis in the treatment of autoimmune encephalitis.