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- Title
Phenotyping the late- and younger-onset neuronal surface antibody-mediated autoimmune encephalitis: a multicenter study.
- Authors
Cai, Meng-Ting; Zheng, Yang; Lai, Qi-Lun; Fang, Gao-Li; Shen, Chun-Hong; Ding, Mei-Ping; Zhang, Yin-Xi
- Abstract
Neuronal surface antibody-mediated autoimmune encephalitis (NSAE) occurs across a wide age range. However, few studies focused on the onset age and their related characteristics. We aimed to explore the age-dependent profile of NSAE. A total of 134 patients with a definite diagnosis of NSAE were retrospectively enrolled from 3 tertiary hospitals between July 2014 and August 2020. Demographic, clinical, therapeutic, and prognostic data were collected and compared between the late- (≥45) and younger-onset (<45) groups. The results showed that 56 (41.8%) patients were classified as late-onset NSAE, and 78 (58.2%) as younger-onset NSAE. There were more males, especially in the late-onset group (P = 0.036). Prodromal symptoms were more common in the younger-onset group (P = 0.004). Among the onset symptoms, more late-onset patients presented as seizures, while more younger-onset patients presented as psychiatric symptoms. Throughout the disease course, the late-onset patients were more likely to have memory dysfunction (P < 0.001), but less likely to have central hypoventilation (P = 0.045). The late-onset patients also had a significantly lower modified Rankin Scale score on admission (P = 0.042), required intensive care unit (ICU) admission less frequently during hospitalization (P = 0.042) and had a shorter hospital stay (P = 0.014). Our study revealed that the late- and younger-onset NSAE had a distinct spectrum of demographic features, presentations, and prognoses. More attention is needed for the younger-onset patients, given a higher disease severity on admission, more frequent requirement for ICU admission and longer length of stay. Our study revealed several age-related features of NSAE. Generally speaking, male-dominant onset of seizures and memory dysfunctions had more diagnostic significance for the late-onset group. The prodromal symptoms, onset of psychiatric symptoms and central hypoventilation might be specific for those with younger-onset. Notably, in consideration of the higher severity and more frequent requirement for ICU admission, more attention is needed for the younger-onset patients, especially for those with anti-NMDAR encephalitis.
- Subjects
HYPOVENTILATION; ANTI-NMDA receptor encephalitis; ENCEPHALITIS; MEMORY disorders; INTENSIVE care units; DISEASE progression
- Publication
Clinical & Experimental Immunology, 2023, Vol 211, Issue 1, p78
- ISSN
0009-9104
- Publication type
Article
- DOI
10.1093/cei/uxac117