Description of suspected autoimmune encephalitis cases in two neurological reference hospitals in Curitiba, Brazil

Address for correspondence: Alana Bacelar Limeira Sales (email: [e-mail]).

Abstract

A description of suspected cases of autoimmune encephalitis (AIE) was conducted among patients admitted to two neurological reference hospitals in the city of Curitiba, state of Paraná, Brazil. The objective was to assess the frequency of possible AIE and the positivity of known antibodies in these patients. Samples of suspected AIE were collected for an autoimmune panel to determine how many of them had relevant antibodies and met the criteria for possible AIE. Out of 56 patients with suspected AIE, 28 met the criteria for possible AIE, 7 tested positive for antibodies (of these, all met the criteria for possible AIE, except 1 case with positive anti-GAD, diagnosed with Rasmussen encephalitis, with etiological factors not yet defined in the literature and uncertain relationship with the antibody in question); 7 patients are still waiting for the antibody results (all meeting criteria for possible AIE). Among the patients with positive antibodies, 3 had positive anti-GAD65, 2 had positive anti-NMDA, 1 had positive anti-Yo, and 1 had positive anti-AMPA. Possible AIE is defined by subacute onset with progression in fewer than 3 months of deficits in working memory, alteration in mental status, or psychiatric symptoms. Furthermore, the patients should present at least one of the following: new focal neurological findings, epileptic seizures unexplained by a known previous disease, pleocytosis in the cerebrospinal fluid, and/or MRI findings suggestive of encephalitis. However, it is essential to exclude alternative diagnoses. These findings highlight the importance of considering AIE in patients presenting with specific clinical criteria. Prompt diagnosis and appropriate management are crucial to improve patient outcomes.

Publication History

Article published online:
02 October 2024