1. Age-dependent characteristics and prognostic factors of pediatric anti-N-methyl-d-aspartate receptor encephalitis in a Chinese single-center study.
- Author
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Zhang, Weihua, Ren, Changhong, Wang, Xiaohui, Li, Jiuwei, Ding, Changhong, Han, Tongli, Lv, Junlan, Chen, Chunhong, Gong, Shuai, Xiuwei, Zhuo, Dai, Lifang, Feng, Weixing, Yang, Xinying, Zhang, Shen, Zhou, Ji, Ren, Haitao, Guan, Hongzhi, Ren, Xiaotun, and Fang, Fang
- Subjects
ANTI-NMDA receptor encephalitis ,PROGNOSIS ,VIRAL encephalitis ,MOVEMENT disorders ,ENCEPHALITIS ,SYMPTOMS - Abstract
To describe the clinical features and prognosis of pediatric anti - N -methyl- d -aspartate receptor (NMDAR) encephalitis from a single center in northern China. The clinical and laboratory characteristics of hospitalized patients with anti -NMDAR encephalitis, stratified by age, were retrospectively studied. Risk factors including relapse and long-term (follow-up ≥1 year) outcomes were analyzed. A total of 273 patients were included between November 2011 and December 2019, and the average age of onset was 7.5 ± 4.0 years (0.5–15.8 years). Of them, 159(58.2%) were female, and the proportion of females increased with age. Seizures were the most common initial symptom. Movement disorders(86.1%) and psychiatric(82.4%) symptoms were most frequent in the acute phase. In the acute stage, the incidence of movement disorders decreased with age (χ
2 = 10.676, p = 0.011), while the proportion of psychiatric symptoms increased with age (χ2 = 21.85, p < 0.001) The recurrence rate was 9.6% (24/250). Demyelination was an independent risk factor for relapse (p = 0.006, OR = 5.877, 95% CI: 1.658–20.835). Among the 210 patients who were followed up for more than one year, 28 patients had a poor prognosis (mRS ≥3). Onset age (p = 0.038,OR = 0.844, 95% CI: 0.720–0.991), precursor of viral encephalitis (p = 0.007,OR = 9.876, 95% CI: 1.878–51.940), and ICU admission (p = 0.023,OR = 5.924, 95% CI: 1.280–27.064) significantly affected the prognosis. The mortality rate was 2.9%. The characteristics of anti -NMDAR encephalitis in children are age-dependent. Early-onset, the precursor of viral encephalitis, and ICU admission may indicate poor prognosis. Demyelination may be a risk factor for recurrence. • Pediatric anti -NMDAR encephalitis has age-dependent characteristics. • Early onset, precursor of viral encephalitis, and ICU admission indicate poor prognosis. • Patintes with demyelination prone to relapse. [ABSTRACT FROM AUTHOR]- Published
- 2021
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