Clinical characteristics and prognosis of antibody-mediated autoimmune encephalitis: A single-center cohort study in Liuzhou, China.
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This retrospective observational study primarily aims to analyze the clinical characteristics and prognosis of patients with antibody-mediated autoimmune encephalitis (AE) in Liuzhou, China. We retrospectively reviewed the medical records of 32 patients diagnosed with acute AE between January 1, 2017, and August 31, 2024, for the following parameters: clinical features, results of laboratory and imaging studies, treatment, and clinical outcomes. Anti-N-methyl-d-aspartate receptor encephalitis was the most prevalent subtype (50%, 16/32). Other subtypes included glial fibrillary acidic protein astrocytopathy encephalitis (12.5%, 4/32), anti-myelin oligodendrocyte glycoprotein encephalitis (12.5%, 4/32), anti-leucine glioma inactivating protein 1 encephalitis (6.3%, 2/32), anti-GAD65 encephalitis (6.3%, 2/32), anti-GABABR encephalitis (6.3%, 2/32), and anti-contactin-associated protein-like 2 encephalitis (6.3%, 2/32). The most common prodromal manifestation were fever or influenza-like illness (56.25%). The primary clinical manifestations included seizures (25.68%), psychiatric and behavioral disorders (17.57%), disturbances in consciousness (9.46%), and dyssomnia (9.46%). Pneumonia, observed in 43.75% (14/32) of patients, was associated with older age (P = .017), higher intensive care unit admission rates (P = .042), increased need for mechanical ventilation (P = .002), and worse modified Rankin Scale scores at diagnosis (P = .005). Immunotherapy led to clinical improvement in most cases (78.13%), and these patients achieved favorable outcomes (modified Rankin Scale ≤ 2; median follow-up 37 months). In conclusion, the AE characteristics in our single-center retrospective study were consistent with previous findings. The proportion of anti-N-methyl-d-aspartate receptor encephalitis was the highest. Once AE is diagnosed, immunotherapy should be initiated promptly to reduce disease severity and improve outcomes. In clinical practice for AE management, emphasis should be placed on pneumonia prevention and treatment to reduce the rate of intensive care unit admission and mechanical ventilation and shorten the length of hospitalization.