Racial and ethnic disparities in pediatric autoimmune encephalitis: A systematic review

Area of Science:

• Pediatric Neurology
• Autoimmune Diseases
• Health Disparities Research

Background:

• Health disparities and social determinants of health (SDOH) are crucial for understanding clinical outcomes in autoimmune diseases.
• However, research in pediatric autoimmune encephalitis (AE) specifically addressing these factors is limited.

Purpose of the Study:

• To systematically review the existing literature on health disparities and SDOH in pediatric AE.
• To identify gaps in research regarding the impact of these factors on disease outcomes in children.

Main Methods:

• A systematic literature review was conducted following PRISMA guidelines, searching major databases up to October 2024.
• Inclusion criteria focused on pediatric AE patients (≤18 years) with reported race/ethnicity, diagnostics, outcomes, and sufficient participant numbers (n≥5).
• Study quality was assessed using the Newcastle-Ottawa scale and the Joanna Briggs Institute Critical Appraisal Checklist.

Main Results:

• Out of 35 included studies, 94% contained pediatric-specific data, but only 34% reported outcomes by racial or ethnic groups.
• Most studies were retrospective cohorts of good or fair quality.
• Crucially, no studies directly compared clinical outcomes between different racial or ethnic groups in pediatric AE.

Conclusions:

• There is a significant lack of rigorous research on health disparities in pediatric autoimmune encephalitis.
• Future research must investigate individual, social, and structural risk factors influencing treatment and long-term outcomes in this population.