1. Racial and Ethnic Disparities in the Incidence of Anti-NMDA Receptor Encephalitis.
- Author
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Alsalek S, Schwarzmann KB, Budhathoki S, Hernandez-Lopez V, Smith JB, Li BH, and Langer-Gould A
- Subjects
- Adolescent, Adult, Female, Humans, Male, Young Adult, Black or African American ethnology, California epidemiology, Ethnicity, Health Status Disparities, Hispanic or Latino statistics & numerical data, Incidence, Ovarian Neoplasms ethnology, Ovarian Neoplasms epidemiology, Retrospective Studies, Teratoma epidemiology, Teratoma ethnology, White People ethnology, White, Asian American Native Hawaiian and Pacific Islander, Anti-N-Methyl-D-Aspartate Receptor Encephalitis ethnology, Anti-N-Methyl-D-Aspartate Receptor Encephalitis epidemiology
- Abstract
Objectives: To estimate the incidence of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis., Methods: We conducted a retrospective cohort study of >10 million person-years of observation from members of Kaiser Permanente Southern California, 2011-2022. The electronic health record of individuals with text-string mention of NMDA and encephalitis were reviewed to identify persons who met diagnostic criteria for anti-NMDAR encephalitis. Age-standardized and sex-standardized incidences stratified by race and ethnicity were estimated according to the 2020 US Census population., Results: We identified 70 patients who met diagnostic criteria for anti-NMDAR encephalitis. The median age at onset was 23.7 years (IQR = 14.2-31.0 years), and 45 (64%) were female patients. The age-standardized and sex-standardized incidence of anti-NMDAR encephalitis per 1 million person-years was significantly higher in Black (2.94, 95% CI 1.27-4.61), Hispanic (2.17, 95% CI 1.51-2.83), and Asian/Pacific Island persons (2.02, 95% CI 0.77-3.28) compared with White persons (0.40, 95% CI 0.08-0.72). Ovarian teratomas were found in 58.3% of Black female individuals and 10%-28.6% in other groups., Discussion: Anti-NMDA receptor encephalitis disproportionately affected Black, Hispanic, or Asian/Pacific Island persons. Ovarian teratomas were a particularly common trigger in Black female individuals. Future research should seek to identify environmental and biological risk factors that disproportionately affect minoritized individuals residing in the United States.
- Published
- 2024
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