Epidemiology of Antibody-Positive Autoimmune Encephalitis in Southwest China: A Multicenter Study

Abstract

In recent years, as an increasing number of neuronal autoantibodies have been detected and used for clinical diagnosis, clinicians have become more aware of autoimmune encephalitis, causing its reported incidence to trend upward over several years. To date, however, there has been no large-scale epidemiological survey of autoimmune encephalitis in adults and children, and its epidemiological characteristics remain unclear. Six main types of antibodies are detected and used to diagnose autoimmune encephalitis in Chongqing, Southwestern China: anti-NMDA receptor antibody, anti-GABAB receptor antibody, anti-LGI1 antibody, anti-CASPR2 antibody, anti-AMPA1 receptor antibody, and anti-AMPA2 receptor antibody. From January 2012 to February 2018, 189 patients at six general hospitals in Chongqing were diagnosed with autoimmune encephalitis and were positive for neuronal autoantibodies. In this report, the epidemic situation and the antibody distribution among these patients are analyzed and described in detail. The differences in disease severity among different ages and between the sexes are evaluated, and the correlation between antibody titer and disease severity is also assessed.

Commentary: Epidemiology of Antibody-Positive Autoimmune Encephalitis in Southwest China: A Multicenter Study

“…Recently, Gu et al reported an epidemiological survey about autoimmune encephalitis (AE) in southwestern China, involving six large general hospitals in Chongqing ( 1 ). Their study revealed the underlying relationship between several factors and disease severity ( 1 ).…”

“…Recently, Gu et al reported an epidemiological survey about autoimmune encephalitis (AE) in southwestern China, involving six large general hospitals in Chongqing ( 1 ). Their study revealed the underlying relationship between several factors and disease severity ( 1 ). Although there have been no large-scale epidemiological investigations of AE in China prior to this report ( 1 ), the conclusions of this research would have been more reliable had the following concerns been addressed.…”

“…Their study revealed the underlying relationship between several factors and disease severity ( 1 ). Although there have been no large-scale epidemiological investigations of AE in China prior to this report ( 1 ), the conclusions of this research would have been more reliable had the following concerns been addressed.…”

“…Moreover, it is noteworthy that researchers excluded patients with thyroid disease ( 1 ). However, some patients with Hashimoto's encephalopathy (HE), which is an important cause of autoimmune encephalopathy, may be neglected.…”

“…The tissue immunohistochemistry has been widely used by some studies of AE ( 5 – 7 ). In the author's study, only CBA based on indirect immunofluorescence (IIF) assay was performed to analyze both the CSF and serum of each patient ( 1 ). Thus, owing to significant inter-operator variability in CBA performed by different technologists, the standard of determining antibody titers should be explained in detail.…”