Diagnostic significance of immunoglobulin in CSF and serum and CSF oligoclonal bands for autoimmune en-cephalitis

doi:10.3969/j.issn.1009-6574.2016.04.018

Abstract：Objective To explore the diagnostic significance of immunoglobulin in CSF and serum and CSF oligoclonal bands (OCB) for autoimmune encephalitis .Methods From March 2014 to March 2016 ,12 cases of hospitalized patients with autoimmune encephalitis (AE)in our hospital were prospec-tively collected .Twenty - eight cases of viral encephalitis(VE) and 16 cases of multiple sclerosis (MS) were chosen as the control group .Antibody - associated autoimmune encephalitis was screened in AE suspected patients .The concentration of IgG in CSF and serum IgG ,IgA and IgM in the three groups were determined synchronously ,IgG index were calculated .Agarose isoelectric focusing method was used to detect OCB in serum and CSF .All patients underwent MR and electroencephalogram (EEG ) .Results Levels of IgG index and CSF - IgG in AE and MS group were higher than those in VE group , The AE group was higher than the MS group (P < 0 .05) .Levels of serum IgG in AE and MS group were higher than those in VE group ,serum IgM was lower than that in VE group (P < 0 .05) ,while there was no obvious difference between AE group and MS group (P > 0 .05) .Serum IgA levels had no significant difference in three groups (P > 0 .05) ;The positive rate of CSF OCB ,VE group was 7 .14% , MS group was 62 .50% ,AE group was 91 .67% ,which was was higher in AE group than that in MS and VE group (χ2 = 13 .75 ,P < 0 .05) .IgG index > 0 .7 percentage ,the VE ,MS and AE group was 7 .14% , 62 .50% and 91 .66% respectively ,and there were obvious differences among three groups (χ2 = 25 .61 , P < 0 .05) .The performance of MR imaging in patients with the three groups ,VE involving the tempo-ral lobe and frontal lobe ,AE involving the temporal lobe ,parietal lobe ,occipital lobe and insula ,showed bilateral symmetry or multiple .MS was located in the periventricular white matter ,optic nerve ,spinal cord ,brainstem and cerebellar .Conclusions Intrathecal protein synthesis is increased in patients with AE ,CSF OCB and IgG index have certain significance to the early diagnosis of AE .