Autoimmune Encephalitis - A comparison of patients with anti-GAD and anti-NMDAR antibodies

• Main Author: Daníel Kristinn Hilmarsson 1994-
• Other Authors: Háskóli Íslands
• Format: Thesis
• Language: English
• Published: 2017
• Subjects: Læknisfræði; Heilabólga; Sjálfsofnæmissjúkdómar; Rannsóknir; Reykjavík; Iceland
• Online Access: http://hdl.handle.net/1946/27581

Autoimmune Encephalitis A comparison of patients with anti-GAD and anti-NMDAR antibodies Daníel Kristinn Hilmarsson1, Radu Constantinescu2,3 1Department of Medicine, University of Iceland, Reykjavík, Iceland; 2Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; 3Department of Neurology, Sahlgrenska University Hospital, Göteborg, Sweden. Introduction: Autoimmune encephalitis (AIE) comprises a group of disorders characterized by rapidly progressive short-term memory deficits, psychiatric symptoms and/or epileptic seizures. They are generally considered to be caused by immunological mechanisms, including autoantibodies directed against different neuronal antigens. The clinical presentation, effect of treatment and long-term outcome of these patients is variable and may differ between antibody groups. Results from recent studies indicate that early diagnosis and treatment may result in better recovery. In this study we compare AIE patients with anti-glutamic acid decarboxylase (GAD) antibodies and patients with anti-N-methyl-D-aspartate receptor (NMDAR) antibodies. Materials and Methods: Three follow-up periods were established; onset, a baseline visit and 12 months from the baseline visit. Onset was defined as the date of onset of symptoms and the associated hospital visit and baseline visit as the closest date of return for each patient (median: 86 days after onset, range: 4-435). Clinical data and lab results were collected retrospectively for these periods. Scores on the Karnofsky performance scale and the modified Rankin scale as well as ability to work were used to assess a patient's state and recovery. Fisher's exact test was performed with JMP for associations and Mann-Whitney U test was used to compare median values with RStudio. Results: Out of 41 AIE patients treated at Sahlgrenska University Hospital, five had anti-GAD antibodies, three had anti-NMDAR antibodies and one had both. These patients were subsequently classified into three groups, for ...