AUTHOR=Lei Chunyan , Li Yongyu , Li Haijiang , Zhu Xiaoyan , Jiang Wen , Chang Xiaolong 

TITLE=Presence of anti-nuclear antibody associated with worse clinical outcomes of anti-NMDAR encephalitis

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.975583

DOI=10.3389/fneur.2022.975583

ISSN=1664-2295

ABSTRACT=<sec><title>Purpose</title><p>Systemic autoantibodies are important for the diagnosis of autoimmune diseases, but their roles in anti-<italic>N</italic>-methyl-D-aspartate receptor (anti-NMDAR) encephalitis are unknown. The purpose of our study is to investigate the characteristics and a prognosis of anti-NMDAR encephalitis with the prevalence of autoantibodies.</p></sec><sec><title>Methods</title><p>Systemic autoantibodies were evaluated in 64 patients with anti-NMDAR encephalitis and 14 patients with autoimmune encephalitis with other forms. Then, according to systemic autoantibodies, patients with anti-NMDAR encephalitis were divided into an anti-nuclear antibody (ANA) positive group and an ANA negative group. The clinical outcome was assessed by a modified Rankin score at 12 months after the disease onset.</p></sec><sec><title>Results</title><p>A total of 64 patients with anti-NMDAR encephalitis were enrolled, of which 28.13% (18/64) were positive for ANA. The titers of a positive anti-NMDAR antibody in CSF (<italic>p</italic> = 0.041) and serum (<italic>p</italic> = 0.031) in the ANA-positive group were significantly higher than the ANA-negative group. Patients with ANA positive than those with ANA negative showed lower rates of headache (<italic>p</italic> = 0.047) and speech disorder (<italic>p</italic> = 0.049). The presence of ANA was associated with a worse clinical outcome at 12 months (<italic>p</italic> = 0.043).</p></sec><sec><title>Conclusion</title><p>ANA was prevalent in patients with anti-NMDAR encephalitis, and associated with a worse prognosis and impaired neurological recovery.</p></sec>