Autoimmune encephalitis: proposed recommendations for symptomatic and long-term management

被引：88

作者：

Abboud, Hesham ^{[1
,2
]}

Probasco, John ^{[3
]}

Irani, Sarosh R. ^{[4
]}

Ances, Beau ^{[5
]}

Benavides, David R. ^{[6
]}

Bradshaw, Michael ^{[7
,8
]}

Christo, Paulo Pereira ^{[9
]}

Dale, Russell C. ^{[10
]}

Fernandez-Fournier, Mireya ^{[11
]}

Flanagan, Eoin P. ^{[12
]}

Gadoth, Avi ^{[13
]}

George, Pravin ^{[14
]}

Grebenciucova, Elena ^{[15
]}

Jammoul, Adham ^{[14
]}

Lee, Soon-Tae ^{[16
]}

Li, Yuebing ^{[14
]}

Matiello, Marcelo ^{[17
,18
]}

Morse, Anne Marie ^{[19
]}

Rae-Grant, Alexander ^{[14
]}

Rojas, Galeno ^{[20
,21
]}

Rossman, Ian ^{[22
]}

Schmitt, Sarah ^{[23
]}

Venkatesan, Arun ^{[3
]}

Vernino, Steven ^{[24
]}

Pittock, Sean J. ^{[12
]}

Titulaer, Maarten ^{[25
]}

机构：

[1] Case Western Reserve Univ, Neurol, Cleveland, OH 44106 USA

[2] Univ Hosp Cleveland, Multiple Sclerosis & Neuroimmunol Program, Cleveland, OH 44106 USA

[3] Johns Hopkins Med, Neurol, Baltimore, MD USA

[4] John Radcliffe Hosp, Oxford Autoimmune Neurol Grp, Oxford, England

[5] Washington Univ St Louis, Neurol, St Louis, MO USA

[6] Univ Maryland, Sch Med, Neurol, Baltimore, MD 21201 USA

[7] Rosalind Franklin Univ Med & Sci, Neurol, N Chicago, IL USA

[8] Billings Clin, Neurol, Billings, MT USA

[9] Minas Gerais Fed Univ, Neurol, Risoleta Tolentino Neves Hosp, Belo Horizonte, MG, Brazil

[10] Univ Sydney, Neuroimmunol Grp, Fac Med & Hlth, Sydney, NSW, Australia

[11] La Paz Univ Hosp, Neurol, Madrid, Spain

[12] Mayo Clin, Neurol, Rochester, MN USA

[13] Tel Aviv Sourasky Med Ctr, Neurol, Tel Aviv, Israel

[14] Cleveland Clin, Neurol, Cleveland, OH 44106 USA

[15] Northwestern Univ, Neurol, Feinberg Sch Med, Chicago, IL 60611 USA

[16] Seoul Natl Univ, Neurol, Coll Med, Seoul, South Korea

[17] Massachusetts Gen Hosp, Neurol, Boston, MA 02114 USA

[18] Harvard Med Sch, Neurol, Boston, MA 02115 USA

[19] Geisinger Commonwealth Sch Med, Pediat Neurol, Scranton, PA USA

[20] Sanatorio La Trinidad Mitre, Neurol, Buenos Aires, DF, Argentina

[21] Favaloro Fdn, Buenos Aires, DF, Argentina

[22] Akron Childrens Hosp, Neurodev Sci Ctr, Akron, OH 44308 USA

[23] MUSC, Neurol, Charleston, SC USA

[24] UT Southwestern, Neurol, Dallas, TX USA

[25] Erasmus MC, Neurol, Rotterdam, Zuid Holland, Netherlands

来源：

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY | 2021年 / 92卷 / 08期

基金：

英国惠康基金;

关键词：

PARANEOPLASTIC SYNDROMES; RECEPTOR ANTIBODY; IMMUNOTHERAPY;

D O I：

10.1136/jnnp-2020-325302

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

The objective of this paper is to evaluate available evidence for each step in autoimmune encephalitis management and provide expert opinion when evidence is lacking. The paper approaches autoimmune encephalitis as a broad category rather than focusing on individual antibody syndromes. Core authors from the Autoimmune Encephalitis Alliance Clinicians Network reviewed literature and developed the first draft. Where evidence was lacking or controversial, an electronic survey was distributed to all members to solicit individual responses. Sixty-eight members from 17 countries answered the survey. The most popular bridging therapy was oral prednisone taper chosen by 38% of responders while rituximab was the most popular maintenance therapy chosen by 46%. Most responders considered maintenance immunosuppression after a second relapse in patients with neuronal surface antibodies (70%) or seronegative autoimmune encephalitis (61%) as opposed to those with onconeuronal antibodies (29%). Most responders opted to cancer screening for 4 years in patients with neuronal surface antibodies (49%) or limbic encephalitis (46%) as opposed to non-limbic seronegative autoimmune encephalitis (36%). Detailed survey results are presented in the manuscript and a summary of the diagnostic and therapeutic recommendations is presented at the conclusion.

引用

页码：897 / 907

页数：11

共 40 条

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