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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1464165
This article is part of the Research Topic Neurological Autoimmunity: etiology, infectious complications, treatment strategies and outcomes in antibody-associated syndromes and beyond View all 17 articles

Clinical Features and Immunotherapy Outcomes in Antibody-Negative Autoimmune Encephalitis: A Retrospective Case-Control Study

Provisionally accepted
Weiwei Gao Weiwei Gao Jingjing She Jingjing She Lihong Su Lihong Su Shoyue Jin Shoyue Jin Qingwei Yang Qingwei Yang Xingyu Chen Xingyu Chen Renjing Zhu Renjing Zhu *
  • Zhongshan Hospital, Xiamen University, Xiamen, China

The final, formatted version of the article will be published soon.

    Objective: This study aimed to compare clinical features, laboratory findings, and immunotherapy responses between antibody-positive and antibody-negative Autoimmune encephalitis (AE) patients. Methods: A retrospective analysis of clinical data from 60 AE patients (33 antibody-positive, 27 antibody-negative) diagnosed at Zhongshan Hospital of Xiamen University between January 1, 2016, and March 1, 2024 was conducted. Disease severity and treatment response were assessed using the modified Rankin Scale (mRS) and the Clinical Assessment Scale for Autoimmune Encephalitis (CASE). Results: Antibody-positive AE patients more frequently presented with multiple symptoms (≥4 symptoms: 39.4% vs 14.8%, P=0.036). They demonstrated significantly elevated serum IgG concentrations (P=0.010) and cerebrospinal fluid (CSF) leukocyte counts (P=0.014). Conversely, antibody-negative AE patients presented with higher CSF total protein levels (P=0.025) and albumin quotients (P=0.018), indicative of more severe blood-brain barrier disruption. Antibody-positive AE patients more frequently received combination first-line immunotherapy (75.8% vs 48.1%, P=0.027) and exhibited superior treatment outcomes (90.9% vs 70%, P=0.022). Among critically ill patients (peak mRS score: 4-5), improvement in CASE scores was markedly greater in the antibody-positive cohort (median: 4.50 vs 1.00, P=0.024). Conclusion: Antibody-positive AE patients manifested a more diverse symptom spectrum, elevated serum IgG concentrations and CSF leukocyte counts, and superior responses to immunotherapy. In contrast, antibody-negative AE patients demonstrated more severe blood-brain barrier dysfunction, as evidenced by higher CSF total protein concentrations and albumin quotients.

    Keywords: autoimmune encephalitis1, Immunotherapy response2, clinical features3, Antibody-negative4, Intrathecal IgG synthesis5；Albumin quotient6

    Received: 13 Jul 2024; Accepted: 02 Sep 2024.

    Copyright: © 2024 Gao, She, Su, Jin, Yang, Chen and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Renjing Zhu, Zhongshan Hospital, Xiamen University, Xiamen, China

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