Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management.
Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management.
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DOI：
10.1136/jnnp-2020-325300
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Autoimmune Encephalitis Alliance Clinicians Network
中科院分区：
文献类型：
--
作者：
Abboud H;Probasco JC;Irani S;Ances B;Benavides DR;Bradshaw M;Christo PP;Dale RC;Fernandez-Fournier M;Flanagan EP;Gadoth A;George P;Grebenciucova E;Jammoul A;Lee ST;Li Y;Matiello M;Morse AM;Rae-Grant A;Rojas G;Rossman I;Schmitt S;Venkatesan A;Vernino S;Pittock SJ;Titulaer MJ;Autoimmune Encephalitis Alliance Clinicians Network
本文的目的是评估自身免疫性脑炎管理中每个步骤的可用证据，并在缺乏证据时提供专家意见。本文将自身免疫性脑炎作为一个广泛的类别，而不是集中在个别抗体综合征。来自自身免疫增强联盟临床医生网络的核心作者审查了文献并制定了初稿。在缺乏证据或存在争议的情况下，向所有成员分发了一份电子调查表，征求个人的答复。来自17个国家的68名成员回答了调查。84%的一般表现患者、74%的面臂肌张力障碍性癫痫发作患者、63%的NMDAR-IgG脑炎患者和48.5%的典型副肿瘤性脑炎患者选择皮质类固醇单独或联合其他药物（静脉注射IG或血浆置换）作为一线治疗。一半的应答者表示，只有在对一种以上的一线药物没有应答时，他们才会添加二线药物，32%的应答者表示，如果对一种一线药物没有应答，他们会添加二线药物，而只有15%的应答者表示，所有患者都使用二线药物。至于首选的二线药物，80%的应答者选择利妥昔单抗，而在抗体未知的临床情况下，只有10%的应答者选择环磷酰胺。详细的调查结果在手稿中提出，诊断和治疗建议的总结在结论中提出。
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. Corticosteroids alone or combined with other agents (intravenous IG or plasmapheresis) were selected as a first-line therapy by 84% of responders for patients with a general presentation, 74% for patients presenting with faciobrachial dystonic seizures, 63% for NMDAR-IgG encephalitis and 48.5% for classical paraneoplastic encephalitis. Half the responders indicated they would add a second-line agent only if there was no response to more than one first-line agent, 32% indicated adding a second-line agent if there was no response to one first-line agent, while only 15% indicated using a second-line agent in all patients. As for the preferred second-line agent, 80% of responders chose rituximab while only 10% chose cyclophosphamide in a clinical scenario with unknown antibodies. Detailed survey results are presented in the manuscript and a summary of the diagnostic and therapeutic recommendations is presented at the conclusion.
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影响因子：
9.9
作者：
Balu, Ramani;McCracken, Lindsey;Titulaer, Maarten J.
通讯作者：
Titulaer, Maarten J.
影响因子：
1.5
作者：
DeSena, Allen D.;Noland, Daniel K.;Graves, Donna
通讯作者：
Graves, Donna
影响因子：
3.5
作者：
GRAUS, F;ELKON, KB;AGUSTIVIDAL, A
通讯作者：
AGUSTIVIDAL, A
影响因子：
11.2
作者：
Irani, Sarosh R.;Michell, Andrew W.;Vincent, Angela
通讯作者：
Vincent, Angela
DOI：
10.1016/s1474-4422(15)00401-9
发表时间：
2016-04
期刊：
The Lancet. Neurology
影响因子：
--
作者：
Graus F;Titulaer MJ;Balu R;Benseler S;Bien CG;Cellucci T;Cortese I;Dale RC;Gelfand JM;Geschwind M;Glaser CA;Honnorat J;Höftberger R;Iizuka T;Irani SR;Lancaster E;Leypoldt F;Prüss H;Rae-Grant A;Reindl M;Rosenfeld MR;Rostásy K;Saiz A;Venkatesan A;Vincent A;Wandinger KP;Waters P;Dalmau J
通讯作者：
Dalmau J