title: High concentration of immunoglobulin A is associated with temporal lobe epilepsy.
abstract: BACKGROUND
  Dysfunction of immunoglobulins (Igs) has been detected in association with antiepileptic drugs (AEDs) and in newly diagnosed epilepsy patients. The aim of this study was to evaluate the effect of clinical features and the current or past use of AEDs on serum Ig concentrations in a well-examined group of patients with refractory epilepsy.
  
  
  METHODS
  Using a nephelometric method, concentrations of IgA, IgG and IgM were analyzed in the sera of 257 patients with refractory epilepsy, 15 patients with controlled epilepsy and 584 healthy control subjects.
  
  
  RESULTS
  A low IgA concentration was found in 8.8% of the patients with epilepsy compared with 1.9% of the control subjects. High concentrations of IgA were associated with temporal lobe epilepsy (TLE) compared with other epilepsy types (p=0.042). The high concentrations of IgA (p=0.042), low concentrations of IgG (p=0.002), and high concentrations of IgG (p=0.008) were also associated with autoimmune diseases. The use of lamotrigine, nitrazepam, oxcarbazepine, topiramate and valproic acid was associated with alterations in Ig concentrations. Current use of topiramate was associated with high serum IgG and IgM concentrations (OR 10.39; 95% CI: 3.08-35.04 and OR 7.02; 95% CI: 1.25-39.55, respectively).
  
  
  CONCLUSIONS
  The finding of high serum IgA concentration in patients with TLE strengthens the previously found association of immunological activity in the epileptic temporal lobe rather than other brain regions. The newly observed immunological effects of topiramate are important to proper AED choice in patients with refractory epilepsy.
authors: Department of Neurology and Rehabilitation, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland. suvi.liimatainen@fimnet.fi
authors: Suvi
authors: S
authors: Liimatainen
authors: Mahdi
authors: M
authors: Fallah
authors: Elham
authors: E
authors: Kharazmi
authors: Anna-Maija
authors: AM
authors: Haapala
authors: Jouko
authors: J
authors: Isojärvi
authors: Jukka
authors: J
authors: Peltola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000096:biosynthesis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D015415:Biomarkers; D007070:Immunoglobulin A