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Abstract Details

Elucidating the Role of Myeloperoxidase in Distinguishing Acute Encephalitis Syndrome of Infectious, Immune mediated and Unknown Etiology
General Neurology
P16 - Poster Session 16 (5:30 PM-6:30 PM)
6-009
To study clinico-etiological profile of acute encephalitis syndrome (AES) and elucidate the role of Myeloperoxidase in distinguishing viral, immune mediated and unknown etiology.
AES is a multifactorial neurological emergency with overlapping clinical features and delayed diagnostic ascertainment due to non availability of suitable diagnostic assays leads to high morbidity and mortality. There is evidence that the host inflammatory response driven by myeloperoxidase may represent as biomarker for distinguishing subtypes of AES within a given etiology.
A total of 50 clinically diagnosed acute encephalitis patients were included prospectively from Jan 2017 to June 2018 using WHO criteria.  The CSF of all the patients was subjected to multiplex real time PCR (Fast track Diagnostics, Viral meningitis kit) for HSV1, HSV2, VZV, EBV, CMV, enterovirus and HHV6 and IgM capture ELISA for Japanese encephalitis and Dengue. Auto antibodies for autoimmune encephalitis were detected by Indirect immunoflorescence and immunoblot assay. Myeloperoxidase levels were measured in both CSF and serum using quantitative ELISA. 
After excluding 5 patients with pyogenic and cryotococcal meningitis, confirmed diagnosis of AES was established in 8 (17.7%) of 45 cases. A confirmed or probable viral agent of encephalitis was found in 5 (11.1%), autoimmune etiology was found in 3 (6.7%) and unknown etiology was found in 37 (82%).  Mean Myeloperoxidase values in CSF and serum was higher in viral encephalitis as compared to autoimmune and unknown etiology but not statistically significant (p value > 0.05). 

The etiologies of AES remained elusive in more than three fourth of the cases requiring advanced diagnostic techniques. Myeloperoxidase levels were higher in infectious etiology as compared to immune-mediated and unknown cause encephalitis but merit further investigation on a large sample size.
Authors/Disclosures

PRESENTER 		No disclosure on file
Vivek Barun, DM (ARTEMIS HOSPITAL, GURUGRAM) Dr. Varun has nothing to disclose.
Suman Kushwaha, MD (Insitute of Human Behavior & Allied Sciences) Dr. Kushwaha has nothing to disclose.
No disclosure on file