Expanded phenotypes and outcomes among 256 LGI1/CASPR2 ‐IgG–positive patients
ObjectiveTo describe an expanded phenotypic spectrum and longitudinal outcome in 256 LGI1‐IgG–seropositive and/or CASPR2‐IgG–seropositive patients.
MethodsPatients were identified through service neural autoantibody evaluation. Ninety‐five had longitudinal follow‐up (7–456 months; median = 35).
ResultsAmong 3,910 patients tested, 196 were LGI1‐IgG positive, 51 were CASPR2‐IgG positive, and 9 were dual positive. Cerebrospinal fluid testing was less sensitive than serum testing, detecting only 24 of 38 (63%) LGI1‐IgG–positive and 5 of 6 (83%) CASPR2‐IgG–positive patients. LGI1‐IgG–positive specimens had higher voltage‐gated potassium channel–IgG immunoprecipitation values (0.33nmol/l, range = 0.02–5.14) than CASPR2‐IgG–positive specimens (0.10nmol/l, range = 0.00–0.45, p < 0.001). Of patients presenting with pain or peripheral nervous system (PNS) manifestations, 39% were LGI1‐IgG seropositive (7% had solely neuropathy or pain). Multivariate analysis identified age as the only significant predictor of central nervous system (CNS) versus PNS involvement (>50 years; odds ratio = 15, p < 0.001). Paroxysmal dizziness spells (PDS), a unique LGI1‐IgG accompaniment (14% of patients), frequently delayed the diagnosis. T2‐mesiotemporal hyperintensity was more common in LGI1‐IgG–positive (41%) than in CASPR2‐IgG–positive patients (p = 0.033). T1‐bright basal ganglia were confined to LGI1‐IgG–positive patients with fac...
Source: Annals of Neurology - Category: Neurology Authors: Avi Gadoth, Sean J. Pittock, Divyanshu Dubey, Andrew McKeon, Jeff W. Britton, John E. Schmeling, Aurelia Smith, Amy L. Kotsenas, Robert E. Watson, Daniel H. Lachance, Eoin P. Flanagan, Vanda A. Lennon, Christopher J. Klein Tags: Research Article Source Type: research
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