title: Antineuronal antibodies and infectious pathogens in severe acute pediatric encephalitis.
abstract: The pathogenesis of acute encephalitis is divided into either direct infection or by immune-mediated inflammation, but the cause is still unknown. This retrospective study aimed to screen antineuronal antibodies in children with severe acute encephalitis. Thirty-four children (22 boys and 12 girls) underwent assessments such as antineuronal antibodies survey for autoimmune encephalitis and polymerase chain reaction/viral culture and antibody assays for all commonly recognized causes of infectious encephalitis. Sixteen (47.1%) were positive for autoantibodies, including antiglutamic acid decarboxylase antibodies in 16 and voltage-gated potassium channel complex antibodies in 1. Sixteen patients (47.1%) had presumed infectious etiologies, including 6 with influenza, 6 with Mycoplasma pneumoniae, 3 with enterovirus, and 1 with herpes simplex virus. In this study, influenza and Mycoplasma pneumoniae infection are the main presumed causes of severe acute encephalitis in children, although an immune-mediated mechanism may also play a role.
authors.affiliation: 1Division of Pediatric Neurology, Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Taoyuan, Taiwan.
authors.forename: Jainn-Jim
authors.initials: JJ
authors.lastname: Lin
authors.forename: Kuang-Lin
authors.initials: KL
authors.lastname: Lin
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
authors.forename: Shao-Hsuan
authors.initials: SH
authors.lastname: Hsia
authors.forename: Huei-Shyong
authors.initials: HS
authors.lastname: Wang
authors.forename: I-Jun
authors.initials: IJ
authors.lastname: Chou
authors.forename: Yun-Tong
authors.initials: YT
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood* / Q000134:cerebrospinal fluid; D001342:Autonomic Nervous System Diseases / Q000191:economics; D002648:Child; D002675:Child, Preschool; D004660:Encephalitis / Q000150:complications / Q000209:etiology* / Q000378:metabolism; D004827:Epilepsy / Q000209:etiology; D005260:Female; D015600:Glasgow Coma Scale; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009980:Influenza A virus / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009177:Mycoplasma pneumoniae / Q000472:pathogenicity*; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology*; D012189:Retrospective Studies; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D001323:Autoantibodies; D024642:Potassium Channels, Voltage-Gated; D005968:Glutamate Decarboxylase
keywords: antineuronal antibody; immune-mediated inflammation; severe acute encephalitis