Coexistence of Autoimmune Encephalitis and Other Systemic Autoimmune Diseases
Coexistence of Autoimmune Encephalitis and Other Systemic Autoimmune Diseases
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DOI：
10.3389/fneur.2019.01142
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发表时间：
2019-10-31
影响因子：
3.4
通讯作者：
Guan, Hongzhi
中科院分区：
文献类型：
--
作者：
Zhao, Jing;Wang, Cancan;Guan, Hongzhi
背景资料：近年来，在自身免疫性脑炎（AE）患者中，系统性自身免疫性疾病（AD）并存的现象越来越多，但其临床意义尚不清楚。本研究旨在研究抗体阳性AE患者中自身免疫性合并症的类型和潜在临床相关性。方法：对2011年至2018年发生抗体阳性AE的患者进行回顾性队列研究。人口统计学，临床特征和随访数据进行了审查。结果如下：我们招募了517例患者，其中45例患有一种或多种AD，包括桥本甲状腺炎（HT）（n = 28），系统性红斑狼疮（SLE）（n = 3），过敏性紫癜（n = 3），白癜风（n = 3），干燥综合征（SS）（n = 2），慢性荨麻疹（n = 2），大疱性类天疱疮（n = 1），葡萄膜炎1例，重症肌无力1例，SLE合并过敏性紫癜1例。抗富亮氨酸胶质瘤灭活1（LGI 1）脑炎患者中并存AD的患者比例高于抗N-甲基-d-天冬氨酸受体（NMDAR）脑炎患者（13/111 vs. 16/307）（P = 0.021）。在抗NMDAR和抗LGI 1脑炎患者中，有和无AD组之间的发病年龄、性别比、肿瘤患者比例、疾病严重程度或复发率无显著差异。结论：AE患者发生一种或多种AD，抗LGI 1脑炎患者的自身免疫性合并症频率高于抗NMDAR脑炎患者。我们发现自身免疫性合并症并不影响AE的临床病程。
Background: In recent years, the phenomenon of coexisting systemic autoimmune diseases (ADs) in patients with autoimmune encephalitis (AE) has been increasingly found, while its clinical significance remains unexplored. This study aimed to investigate the types and potential clinical associations of autoimmune comorbidities in patients with antibody-positive AE. Methods: A retrospective cohort study of patients with antibody-positive AE was conducted from 2011 to 2018. The demographics, clinical characteristics, and follow-up data were reviewed. Results: We enrolled 517 patients, among whom 45 were affected by one or more types of ADs, including Hashimoto's thyroiditis (HT) (n = 28), systemic lupus erythematosus (SLE) (n = 3), anaphylactoid purpura (n = 3), vitiligo (n = 3), Sjogren's syndrome (SS) (n = 2), chronic urticaria (n = 2), bullous pemphigoid (n = 1), uveitis (n = 1), myasthenia gravis (MG) (n = 1), and the coexistence of SLE and anaphylactoid purpura (n = 1). The proportion of patients with coexisting ADs was higher in those with anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis than in those with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis (13/111 vs. 16/307) (P = 0.021). In anti-NMDAR and anti-LGI1 encephalitis patients, there were no significant differences in the age at onset, sex ratio, proportion of patients with tumors, disease severity, or recurrence between the groups with and without ADs. Conclusions: One or more types of ADs developed in AE patients, and patients with anti-LGI1 encephalitis had a higher frequency of autoimmune comorbidities than those with anti-NMDAR encephalitis. And we found that autoimmune comorbidities did not affect the clinical course of AE.