Analysis Of The Correlation Between The Main Clinical Manifestation Of Autoimmune Encephalitis And Aberrant Intrathecal IgG Synthesis

Objective: To study the correlation between the clinical manifestations and prognosis of patients with autoimmune encephalitis(AE)and abnormal intrathecal IgG synthesis rate and impairment of blood brain barrier(BBB).Methods: One hundred and one patients with AE in The First Affiliated Hospital of Guangxi Medical University from January 2014 to March 2019 were enrolled as research subjects,and divided into three study groups according to different test results.Fifty-two patients with abnormal 24-hour intrathecal IgG synthesis rate were selected as experiment group 1,while the other forty-nine patients with normal 24-hour intrathecal IgG synthesis rate as control group 1;six patients with BBB destruction were included in the experiment group 2,while ninety-five patients without BBB destruction were selected as control group 2;forty-one patients with abnormal IgG index were assigned to the experiment group 3,and sixty patients with normal IgG index were treated as the control group 3.General clinical data,laboratory examination results and medication history of the patients were collected and SPSS19.0 software was used for statistical analysis,and Modified Rankin Scale(MRS)was used toevaluate prognosis.Results: The distribution of patients with different laboratory examination results shows no statistical significant differences among age,gender and course of disease.Among the patients,gender distribution ratio as male versus female was 50 to 51,among experiment group 1 was 29 to 23,while among control group 1 was 21 to 28,and the average age of experiment group 1 was21.92±14.64 years,while that of control group 1 was 16.55±15.14 years.The incidence of mental behavior or cognitive impairment was higher in patients with abnormal 24-hour intrathecal IgG synthesis rate compared to its control group,while shown no statistical significance among patients with different Albumin index and IgG index.The occurrences of seizures,unconsciousness,dyskinesia and speech disorder were comparatively higher in patients with abnormal 24-hour intrathecal IgG synthesis rate and IgG index than their control group respectively.However,the occurrence of seizures and unconsciousness shown no statistical significant difference among patients with different Albumin index,while that of dyskinesia and speech disorder was comparatively lower in patients with abnormal Albumin index than its control group.The prognosis of patients with dyspraxia,involuntary movement,and speech and consciousness disorders was relatively poor.Conclusion: The incidence of mental behavior or cognitive impairment,seizures,dyskinesia or involuntary movement,speech disorders,and consciousness disorders was higher in patients with abnormal 24-hour intrathecal IgG synthesis rate.The incidence of seizures,dyskinesia or involuntary movement,speech disorders,and consciousness disorders was higher in patients with abnormal IgG index.These data indicate that AE patientswith different clinical characteristics could present with different CSF abnormalities.