Autoimmune encephalitis associated with antibodies against intracellular antigens in children

TL;DR

This study examines autoimmune encephalitis in children linked to antibodies against intracellular brain antigens, highlighting seizures as a key symptom and the importance of early treatment.

Contribution

The study identifies specific intracellular antibodies and emphasizes early immunosuppressive therapy for better pediatric outcomes in autoimmune encephalitis.

Findings

Seizures were the most common clinical manifestation in children with AE caused by intracellular antibodies.

Most patients showed reduced antibody titers or negative results after immunotherapy.

Prognosis in children differs from adults, with many recovering well after active treatment.

Abstract

In neurological disorders associated with autoantibodies against intracellular antigens, response to therapy tends to be poor and is associated with irreversible neuronal death. This study aimed to analyze autoimmune encephalitis (AE) associated with antibodies (Abs) against intracellular antigens in children, clarify the clinical characteristics of the disease.

We retrospectively analyzed patients with Abs against intracellular antigens at Qilu Hospital of Shandong University from 2024 to 2025. Detailed clinical characteristics were collected based on AE-Abs test results.

Fourteen pediatric patients with AE caused by intracellular Abs were recruited. The Abs included PCA-2, AGO, GFAP, SOX1, Ri, Yo, KLHL11, and AK5. All the patients received immunotherapy. After treatment, the antibody titers in the cerebrospinal fluid and serum of patients mostly decreased or even turned negative. Some patients were discharged with sequelae.

In AE associated with Abs against intracellular antigens of children, seizures were the most common clinical manifestation. For patients with seizures without obvious inducement or suspected encephalitis, AE-related Abs should be detected promptly, and immunosuppressive therapy should be administered as early as possible. The prognosis of pediatric patients with encephalitis with Abs differs from that in adults, and most patients recover well after active treatment.

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