A Prognostic Analysis of the Outcomes in Patients With Anti-γ-Aminobutyric Acid B Receptor Encephalitis

作者：Weibi Chen, Yunyun Wang, Xiaoyuan Guo, Lehong Gao, Zhaoyang Huang, Yicong Lin, Xue Qin, Gang Liu, Yan Zhang, Yingying Su · 发表于：Frontiers in Immunology · 年份：2022 · DOI：10.3389/fimmu.2022.847494 · 被引用次数：12 · 研究领域：Autoimmune Neurological Disorders and Treatments、Epilepsy research and treatment、Long-Term Effects of COVID-19

Objective To evaluate neurological function and its influencing factors in patients with anti-γ -aminobutyric acid B receptor (GABA B R) encephalitis. Methods This was a clinical cohort study of patients diagnosed with anti-GABA B R encephalitis; long-term follow-up was performed by telephone. Clinical factors associated with prognosis were analyzed, including clinical manifestations, laboratory examinations, imaging features, tumor comorbidities and therapeutic responses. Results Twenty-two patients with anti-GABA B R encephalitis were evaluated (median age: 55 years). Lung cancer was detected in eight patients. All were with serum tumor markers (mainly NSE), and three of them had additional onconeuronal antibodies. The patients with tumors were older than the patients without tumors and more likely to develop status epilepticus (62.5% vs. 14.3%; p = 0.052), central hypoventilation (50% vs. 7.1%; p = 0.039), and hyponatremia (87.5% vs. 14.3%; p = 0.001). The patients with tumors had higher mortality (87.5% vs. 0%; p < 0.05). Although 92.9% of the patients without tumors became functionally independent (mRS ≤2), sequelae of symptomatic seizures, neuropsychiatric symptoms, and cognitive impairment were still observed in 14.3%, 21.4%, and 21.4% of patients, respectively. Conclusions (1) Elderly patients with anti-GABA B R antibodies, especially those with severe symptoms, serum tumor markers, and additional onconeuronal antibodies, should be screened for lung cancer. (2)...