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Predictive value of persistent antibodies at 6 months for relapse in neuronal surface antibody-associated autoimmune encephalitis

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Abstract

Background

For patients with neuronal surface antibody-associated autoimmune encephalitis (NSAE) whose clinical symptoms gradually improve, the recommended course of immunotherapy in China is about 6 months. We aim to explore the relationship between persistent antibody positivity when immunotherapy is discontinued at 6 months and subsequent relapse.

Methods

Prospective inclusion of NSAE patients with clinical remission after 6-month immunotherapy. Their antibody titers and other clinical data were collected at onset and 6 months later. Based on the antibody test results at 6 months, patients were divided into an antibody-persistent group and an antibody-negative conversion group, and then the rate of relapse between the two groups were compared.

Results

The study included 28 NSAE patients who were antibody-positive at diagnosis. After 6-month immunotherapy, there were 16 (57.1%) cases with persistent antibodies and 12 (42.9%) cases with antibody-negative conversion. In the acute phase of onset, seizures were more common in patients with persistent antibodies (87.5% vs. 50.0%, p = 0.044). During a mean follow-up period of 22 months, patients with persistent antibodies were more likely to experience relapse than those with antibody-negative conversion (37.5% vs. 0.0%, p = 0.024). There were no significant differences in antibody types, CSF findings, results of MRI and EEG, tumor combination, immunotherapy, and long-term outcome between the two groups (p > 0.05).

Conclusions

For patients with persistent antibodies when immunotherapy is discontinued at 6 months, persistent antibody positivity was associated with a higher relapse rate.

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Data Availability

Anonymized data, not published in the article, can be made available upon reasonable request from the corresponding author.

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Authors and Affiliations

  1. Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China

    Fang Zhang, Yingshi Guo, Miaomiao Liu, Huijun Shen, Hong Zhou, Yujie Yi & Jie Wang

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  1. Fang Zhang
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Contributions

FZ designed the study and drafted the manuscript. YG, ML, HS, HZ, and YY collected and analyzed the data. JW designed the study and revised the manuscript. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Jie Wang.

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Ethical approval

The study was performed according to the ethical principles of the Declaration of Helsinki and was approved by the Ethics Committee of the First Hospital of Shanxi Medical University. Written informed consent was obtained from all patients or their legal representatives.

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The authors declare that there are no conflicts of interest in connection with this article.

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Zhang, F., Guo, Y., Liu, M. et al. Predictive value of persistent antibodies at 6 months for relapse in neuronal surface antibody-associated autoimmune encephalitis. Neurol Sci 45, 1599–1607 (2024). https://doi.org/10.1007/s10072-023-07151-7

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  • DOI: https://doi.org/10.1007/s10072-023-07151-7

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