Autoimmune Encephalitis Misdiagnosis in Adults; A Multicenter Observational Study of Outpatient Subspecialty Clinics
| العنوان: | Autoimmune Encephalitis Misdiagnosis in Adults; A Multicenter Observational Study of Outpatient Subspecialty Clinics |
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| المؤلفون: | Michael Geschwind, A. Sebastian Lopez-Chiriboga, Kyle Blackburn, Sanchit Turaga, Sophie Binks, Jennifer Zitser, Jeffrey Gelfand, Gregory Day, Steven Dunham, Stefanie Rodenbeck, Stacey Clardy, Andrew Solomon, Sean Pittock, Andrew McKeon, Divyanshu Dubey, Anastasia Zekeridou, Michel Toledano, Lindsey Turner, Steven Vernino, Sarosh Irani, Eoin Flanagan |
| المصدر: | Neurology. 99:S55.2-S57 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Neurology (clinical) |
| الوصف: | ObjectiveTo determine the diseases misdiagnosed as AE and potential reasons for misdiagnosis.BackgroundMisdiagnosis of autoimmune encephalitis (AE) may harm patients.Design/MethodsPatients with AE misdiagnosis were identified (1/1/2014-12/31/2020) from outpatient AE subspecialty clinics including: Mayo Clinic (n = 44); Oxford (n = 18); UT Southwestern (n = 18); UCSF (n = 17); Washington University (n = 6); University of Utah (n = 4). Inclusion criteria were adults (=18 years) with: 1) A prior diagnosis of AE; and 2) An alternative diagnosis made at a participating center. We collected data on clinical features, investigations, fulfillment of possible AE criteria, alternative diagnoses, and potential contributors to misdiagnosis.ResultsWe identified 107 patients misdiagnosed with AE. Thirty (28%) fulfilled diagnostic criteria for “possible AE”. Median onset age was 48 years (inter-quartile range, 35.5-60.5) and 65 (61%) were female. Correct diagnoses included: functional neurologic disorder, 27 (25%); neurodegenerative disease, 22 (21%); primary psychiatric disease, 19 (18%); cognitive deficits from comorbidities, 11 (10%); cerebral neoplasm, 10 (9%); and other, 18 (17%). Onset was insidious (>3 months) in 51 (48%). MRI brain was suggestive of encephalitis in 19/104 (18%) and CSF pleocytosis occurred in 16/84 (19%). Thyroid-peroxidase antibodies were elevated in 24/62 (39%). Positive neural autoantibodies were more frequent in serum (48/105[46%]) than CSF (7/91[8%]; pConclusionsRed flags suggesting alternative diagnoses to AE include lack of fulfillment of “possible autoimmune encephalitis” criteria, positive non-specific serum antibody, and insidious onset. Avoiding AE misdiagnosis will prevent morbidity from unnecessary immunotherapies and delayed treatment of the correct diagnosis. |
| تدمد: | 1526-632X 0028-3878 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::51dbae043990d51822dd71a99047ca3bTest https://doi.org/10.1212/01.wnl.0000903448.98416.0eTest |
| رقم الانضمام: | edsair.doi...........51dbae043990d51822dd71a99047ca3b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1526632X 00283878 |
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