Clinical Characteristics Of Autoimmune Encephalitis And Correlation Between Peripheral Blood NLR Level And Disease Severity

Objective:This article is to investigate the clinical characteristics of different antibody types of encephalitis in patients with autoimmune encephalitis and correlation between lymphocyte ratio level of neutrophils in peripheral blood and disease severity,providing more clinical experience for the diagnosis,treatment and severity of AE.Methods:30 patients who met the diagnostic criteria of autoimmune encephalitis in the inpatient department of neurology department of affiliated hospital of Guilin Medical University from January 2014 to November 2019 were selected and 31 healthy subjects from affiliated hospital of Guilin Medical University who were matched with the group of autoimmune encephalitis by collecting the basic data of the same region,age and gender in the same period of time.The clinical data of different types of autoimmune encephalitis were collected,including age,gender,blood routine(WBC,neut,ly,PLT,RDW),ALB,m RS,cererospinal fluid LDH,cererospinal fluid ADA,EEG,MRI).The clinical characteristics of the three types of encephalitis were compared and NLR was calculated.The severity of the disease was evaluated and analyzed according to the m RS score.Results:(1)Among the 30 AE patients in this study,9 were male and 21 were female;(2)There were13 cases epilepsy,13 cases abnormal mental behavior,6 cases fever,4cases headache,6 cases speech disorders and 3 cases memory disorders as the first symptoms.The main clinical manifestations of patients with AE are epilepsy,the mental behavior,sleep disorder,language barrier,involuntary movement,dystonia.There were 25 cases of anti-NMDAR antibody encephalitis,3 cases of anti-LGI1 antibody encephalitis,and 2cases of anti-GABA_BR antibody encephalitis.(3)There were 8 cases of normal EEG,6 cases of mild abnormal EEG,8 cases of moderate abnormal EEG and 8 cases of severe abnormal EEG.(4)Among the 30patients,23 were normal and 7 were abnormal.(5)Compared with the healthy control group,the level of NLR in patients with autoimmune encephalitis was significantly higher,with statistically significant difference.(6)According to the severity,all patients were divided into MD group and SD group.AE patients in the SD group had significantly higher NLR level than AE patients in MD group.There were statistically significant differences in white blood cell and neutrophil counts and NLR between the two groups.There were no significant differences in age,gender,lymphocyte and RDW between SD group and MD group.(7)The increase of NLR is an independent indicator of the severity of AE.(8)According to the ROC curve,the sensitivity and specificity of NLR in predicting severe AE diseases were 80%and 80%respectively.The Z value is 2.673.The optimal cutoff value is 3.82.The AUC was 0.795(95%CI:0.609-0.920),P=0.0075.It's statistically significant.Conclusion:(1)Anti-NMDAR antibody encephalitis is characterized by epilepsy,abnormal mental behavior,sleep disorder.The main clinical symptoms of anti-lgi1 antibody encephalitis are abnormal mental behavior,epilepsy,involuntary movement,sleep disorder.Anti-GABA_BR antibody encephalitis mainly epilepsy,involuntary movement as the main clinical symptoms.(2)Most of the EEG patients with AE were abnormal,and the anti-LGI1 encephalitis and anti-GABA_BR encephalitis were all abnormal.Only a small number of AE patients had abnormal head MRI.(3)NLR and WBC may be risk factors of AE,ALB may be protective factors of AE.(4)NLR has the value of predicting severity in AE.