Prevalence of Antineuronal Antibodies in Children with Autoimmune Thyreoiditis and/or Encephalitis of Unclear Etiology

Aims: Recently there has been increasing evidence that inflammatory processes can contribute to the pathophysiology of encephalopathies and epilepsies. This is reflected by an increase of publications about antineuronal antibodies in different forms of autoimmune encephalitis. Furthermore, it has been shown that in some cases of drug resistant epilepsies steroids and other anti-inflammatory treatments display anticonvulsant activities and that elevated numbers of leukocytes are found in resected brain tissue from patients undergoing epileptic surgery. Steroid-Responsive Encephalopathy Associated with Autoimmune Thyreoiditis (SREAT, “Hashimoto-Encephalopathy”) is a rare condition of presumed autoimmune etiology, but it is unclear whether the immune reaction is primarily directed against neurons or cerebral blood vessels.

Objective: Our objective is to analyse the prevalence of antineuronal antibodies in serum and cerebrospinal fluid (CSF) in children with autoimmune thyreoiditis and/or encephalopathy of unclear etiology. There have been no systematic investigations on this context in children to date. Thereby we hope to open up new diagnostic and therapeutic pathways.

Patients: We are planning to examine a total of 50 children with autoimmune thyreoiditis. Furthermore, all children treated in our clinic with unclear encephalitis or drug resistant epilepsy will be included in our study. Blood samples will be taken during routine diagnosis. In case of CSF, remaining material after laboratory analysis will be used.

Methods: Onconeuronal antibodies will be screened by immunohistochemistry performed on neuronal tissue sections and neuronal cell cultures. For the analysis of antineuronal antibodies, serum and CSF samples will be send to Euroimmun-AG (Lübeck).