Relapse factors of patients of anti-N-methyl-D-aspartate receptor encephalitis
Ying-Ying Zhao1, Hai-Xu Wang1, Meng Wang1
1The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background:
The factors associated with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis relapse are yet to be elucidated.
Aims Of The Study:
To investigate the factors associated with relapse and prognosis of anti-NMDA receptor encephalitis.
Methods:
This retrospective study included patients diagnosed with anti-NMDA receptor encephalitis admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to October 2019. The clinical features, auxiliary examinations, treatment regimens, and follow-up were recorded. The outcomes were relapse and 2-year disease prognosis.
Results:
A total of 160 patients were included. Consequently, 6 (5%) deaths, 34 (25.4%) relapses, and 19 (15.2%) patients had a poor prognosis (modified Rankin score (mRS) ≥3) were recorded. The multivariable analyses showed that age (p = .011), abnormal magnetic resonance imaging (MRI) (p = .019), glucocorticoid pulse (p = .009), and intracranial pressure (p = .023) were independently associated with the relapse, while age (p = .030) and central hypoventilation (p = .020) were independently associated with a poor prognosis at 2 years.
Conclusion:
Glucocorticoid pulse therapy reduces the relapse of anti-NMDA receptor encephalitis. Age, abnormal MRI, and intracranial pressure are risk factors for relapse, while age and central hypoventilation are independently associated with poor prognosis.
Insights
Factors like age, abnormal MRI, and intracranial pressure increase anti-NMDA receptor encephalitis relapse risk. Glucocorticoid pulse therapy can reduce relapses, while age and central hypoventilation predict poor prognosis.
Area of Science:
- Neuroimmunology
- Neurology
- Clinical Medicine
Background:
- Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune neurological disorder.
- Factors influencing relapse and long-term prognosis remain incompletely understood.
Purpose of the Study:
- To identify clinical and demographic factors associated with relapse in anti-NMDA receptor encephalitis.
- To determine predictors of 2-year disease prognosis in patients with anti-NMDA receptor encephalitis.
Main Methods:
- Retrospective analysis of 160 patients diagnosed with anti-NMDA receptor encephalitis.
- Data collection included clinical features, imaging, treatments, and follow-up outcomes.
- Multivariable analyses were used to assess associations with relapse and prognosis.
Main Results:
- Relapse occurred in 25.4% of patients; 15.2% had a poor 2-year prognosis.
- Independent predictors of relapse included older age, abnormal MRI findings, glucocorticoid pulse therapy, and elevated intracranial pressure.
- Older age and central hypoventilation were independently associated with poor 2-year prognosis.
Conclusions:
- Glucocorticoid pulse therapy is associated with a reduced risk of relapse in anti-NMDA receptor encephalitis.
- Age, abnormal MRI, and intracranial pressure are significant risk factors for relapse.
- Age and central hypoventilation are independently linked to a worse long-term prognosis.
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