AIM To identify the spectrum of autoimmune encephalitis antibody biomarkers (AE-Abs) in children with suspected autoimmune encephalitis and explore the clinical features indicating AE-Abs presence. METHOD We included children with suspected autoimmune encephalitis who underwent AE-Abs tests at the Children's Hospital of Chongqing Medical University between June 2020 and June 2022. Clinical features suggestive of AE-Abs were analysed based on AE-Abs test results. RESULTS A total of 392 children were tested for AE-Abs with suspected autoimmune encephalitis. Of these, 49.5% were male, with a median age of 7 years 11 months (6 months-17 years 11 months); 93.6% (367/392) of all patients had both serum and cerebrospinal fluid (CSF) tests performed. The antibody-positive rate in the cohort was 23.7% (93/392), the serum antibody-positive rate was 21.9% (84/384), and the CSF antibody-positive rate was 20.8% (78/375). Eleven different AE-Abs were detected. Serum analysis revealed that N-methyl-D-aspartate receptor immunoglobulin-G (NMDAR-IgG) (15.1%) was greater than myelin oligodendrocyte glycoprotein (MOG)-IgG (14.6%) and glial fibrillary acidic protein (GFAP)-IgG (3.3%). CSF analysis revealed that NMDAR-IgG (16.3%) was greater than MOG-IgG (13.8%) and GFAP-IgG (3.3%). Compared with antibody-negative patients, antibody-positive patients were more often female (odds ratio [OR] 1.86, p = 0.03), with memory impairment (OR 2.91, p = 0.01) and sleep disorders (OR 2.08, p = 0.02). INTERPRETATION In children, the most frequent AE-Abs detected were NMDAR-IgG and MOG-IgG. Female sex, memory impairment, and sleep disorders predict a higher likelihood of AE-Abs.

中文翻译：

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疑似自身免疫性脑炎儿童的自身免疫性脑炎抗体谱及临床特征。

目的 鉴定疑似自身免疫性脑炎儿童的自身免疫性脑炎抗体生物标志物（AE-Abs）谱，并探讨AE-Abs存在的临床特征。方法纳入2020年6月至2022年6月在重庆医科大学儿童医院接受AE-Abs检测的疑似自身免疫性脑炎儿童。根据AE-Abs检测结果分析提示AE-Abs的临床特征。结果 共有 392 名疑似患有自身免疫性脑炎的儿童接受了 AE-Ab 检测。其中，49.5%为男性，中位年龄为7岁11个月（6个月-17岁11个月）；93.6% (367/392) 的所有患者均进行了血清和脑脊液 (CSF) 检测。该队列抗体阳性率为23.7%（93/392），血清抗体阳性率为21.9%（84/384），脑脊液抗体阳性率为20.8%（78/375）。检测到 11 种不同的 AE-Ab。血清分析显示，N-甲基-D-天冬氨酸受体免疫球蛋白-G (NMDAR-IgG) (15.1%) 高于髓磷脂少突胶质细胞糖蛋白 (MOG)-IgG (14.6%) 和胶质纤维酸性蛋白 (GFAP)-IgG。 3.3%）。CSF 分析显示，NMDAR-IgG (16.3%) 高于 MOG-IgG (13.8%) 和 GFAP-IgG (3.3%)。与抗体阴性患者相比，抗体阳性患者多为女性（比值比 [OR] 1.86，p = 0.03），患有记忆障碍（OR 2.91，p = 0.01）和睡眠障碍（OR 2.08，p = 0.02） 。解释 在儿童中，最常见的 AE-Ab 是 NMDAR-IgG 和 MOG-IgG。女性、记忆障碍和睡眠障碍预测 AE-Ab 的可能性较高。