Autoimmune encephalitis antibody profiles and clinical characteristics of children with suspected autoimmune encephalitis

Abstract

AbstractAimTo identify the spectrum of autoimmune encephalitis antibody biomarkers (AE‐Abs) in children with suspected autoimmune encephalitis and explore the clinical features indicating AE‐Abs presence.MethodWe included children with suspected autoimmune encephalitis who underwent AE‐Abs tests at the Children's Hospital of Chongqing Medical University between June 2020 and June 2022. Clinical features suggestive of AE‐Abs were analysed based on AE‐Abs test results.ResultsA total of 392 children were tested for AE‐Abs with suspected autoimmune encephalitis. Of these, 49.5% were male, with a median age of 7 years 11 months (6 months–17 years 11 months); 93.6% (367/392) of all patients had both serum and cerebrospinal fluid (CSF) tests performed. The antibody‐positive rate in the cohort was 23.7% (93/392), the serum antibody‐positive rate was 21.9% (84/384), and the CSF antibody‐positive rate was 20.8% (78/375). Eleven different AE‐Abs were detected. Serum analysis revealed that N‐methyl‐D‐aspartate receptor immunoglobulin‐G (NMDAR‐IgG) (15.1%) was greater than myelin oligodendrocyte glycoprotein (MOG)‐IgG (14.6%) and glial fibrillary acidic protein (GFAP)‐IgG (3.3%). CSF analysis revealed that NMDAR‐IgG (16.3%) was greater than MOG‐IgG (13.8%) and GFAP‐IgG (3.3%). Compared with antibody‐negative patients, antibody‐positive patients were more often female (odds ratio [OR] 1.86, p = 0.03), with memory impairment (OR 2.91, p = 0.01) and sleep disorders (OR 2.08, p = 0.02).InterpretationIn children, the most frequent AE‐Abs detected were NMDAR‐IgG and MOG‐IgG. Female sex, memory impairment, and sleep disorders predict a higher likelihood of AE‐Abs.