Prognostic value of acute cerebrospinal fluid abnormalities in antibody-positive autoimmune encephalitis.

2021-04-15

Broadley, James

Wesselingh, Robb

Seneviratne, Udaya

Kyndt, Chris

Beech, Paul

Buzzard, Katherine

Nesbitt, Cassie

D'souza, Wendyl

Brodtmann, Amy

Macdonell, Richard A L

Kalincik, Tomas

Butzkueven, Helmut

O'Brien, Terence J

Monif, Mastura

Autoimmune encephalitis

Biomarker

CSF

Lymphocytosis

Prognosis

Journal Article

10.1016/j.jneuroim.2021.577508

To examine the prognostic value of CSF abnormalities in seropositive autoimmune encephalitis (AE). We retrospectively studied 57 cases of seropositive AE. Primary outcomes were mortality and modified Rankin Scale, while secondary outcomes were first line treatment failure, ICU admission and relapse. Regression analysis was performed. CSF white cell count (WCC) was higher in the NMDAR group, while elevated protein was more common amongst other subtypes. We found an association between WCC >5 cells/mm3 and treatment failure (OR 16.0, p = 0.006)), and between WCC >20 cells/mm3 and ICU admission (OR 19.3, p = 0.026). Different subsets of AE have characteristic CSF abnormalities, which may aid recognition during early evaluation. CSF WCC had prognostic significance in our study.

link

Journal of Neuroimmunology 2021; 353: 577508

Journal of Neuroimmunology