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Abstract Details

Brazilian autoimmune encephalitis network (BrAIN): preliminary results from a nationwide multicentric study
Autoimmune Neurology
P10 - Poster Session 10 (5:30 PM-6:30 PM)
15-006

To assess the clinical profile of autoimmune encephalitis in Brazil.

Autoimmune encephalitis (AIE) is one of the most common causes of noninfectious encephalitis. Data on profile of AIE in low-income countries are lacking.

Prospective study involving 18 sites from all Brazilian regions in partnership with the Medical University of Vienna. Patients possible criteria for AIE were tested for antineuronal antibodies with tissue based-assays, cell-based assays and immunoblot for oncooneural antibodies. Epidemiological and clinical data were collected. 

372 patients were included in 12 months (mean age 39.1 ± 24,38 years; 55,8% female). Of those, 71 (22,1%) were seropositive (SP) (mean age 31.6 ± 22,68 years; 62,5% female). Anti-NMDAR (43,87%), anti-GAD (11,73%), anti-LGI1 (8,5%), anti-Caspr2 (7,0%), anti-MOG (8,5%), anti-GlyR (5,6%), anti-Hu (4,2%), anti-Yo (4,2%), anti-GABA-BR (2,8%), anti-AMPAR (2,8%) were the most common antibodies. Twenty-one (7,7%) patients were classified as seronegative (SN). There were no differences among SP and SN regarding gender (62,5% x 44,4%, p=0.1) and age (31,3±22,89 x 34.7±24,66, p=0.55). Common clinical manifestations were behaviour/cognition (SP 84,8% x SN 74,1%, p=0.07), movement disorders (SP 73,4% x SN 40,7%, p=0.02*) and epilepsy (SP 69,6% x SN 55,6%, p=0.31). MRI abnormalities were found in 48% of the SP patients and in all SN, and consisted of mesial temporal hyperintensities (SP 23,5% x SN 25,9%, p=0.99), cortical (SP 16,2% x SN 48,1%, p=0.02*) and white matter hyperintensities (SP 13,2% x SN 33,3%, p=0.051). Pleocytosis was more frequently in SN (47,88% x 78,7%, p= 0.01*). There was no difference in neoplasia incidence among groups (11,6% x 14,8%, p= 0.99). 

In Brazil the most common AIE is anti-NMDAR, followed by anti-GAD encephalopathy, anti-LgI1 and anti-Caspr-2 encephalitis. We report an unexpected higher incidence of anti-glycine receptor encephalitis. In our population, SP patients have more movement disorders when compared to SN patients, and frequency of malignancy is low.
Authors/Disclosures
Fabio F. Toso, MD (Universidade Federal de São Paulo, São Paulo, Brazil)
PRESENTER 		Dr. Toso has nothing to disclose.
Rene D. Gleizer, Jr., MD (Universidade De Sao Paulo (UNIFESP)) Dr. Gleizer has nothing to disclose.
Bruna de Freitas Dias, MD (Stanford university) Dr. Dias has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Romana Hoeftberger (Medical University of Vienna) Romana Hoeftberger has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology: Neuroimmunology and Neuroinflammation. Romana Hoeftberger has received personal compensation in the range of $500-$4,999 for serving as a speaker with BMS and UCB Biopharma.
Orlando G. Barsottini, MD, PhD (Universidade Federal de São Paulo) Dr. Barsottini has nothing to disclose.
Livia A. Dutra, MD (Hospital Israelita Albert Einstein) Dr. Dutra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. The institution of Dr. Dutra has received research support from Hospital Israelita Albert Einstein. The institution of Dr. Dutra has received research support from Laboratório Fleury. Dr. Dutra has received personal compensation in the range of $0-$499 for serving as a Speaker with Roche.