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Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient

OBJECTIVE: Autoimmune encephalitis (AE) is an important and treatable cause of acute encephalitis. Diagnosis of AE in a developing child is challenging because of overlap in clinical presentations with other diseases and complexity of normal behavior changes. Existing diagnostic criteria for adult A...

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Autores principales: Cellucci, Tania, Van Mater, Heather, Graus, Francesc, Muscal, Eyal, Gallentine, William, Klein-Gitelman, Marisa S., Benseler, Susanne M., Frankovich, Jennifer, Gorman, Mark P., Van Haren, Keith, Dalmau, Josep, Dale, Russell C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7051207/
https://www.ncbi.nlm.nih.gov/pubmed/31953309
http://dx.doi.org/10.1212/NXI.0000000000000663
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author Cellucci, Tania
Van Mater, Heather
Graus, Francesc
Muscal, Eyal
Gallentine, William
Klein-Gitelman, Marisa S.
Benseler, Susanne M.
Frankovich, Jennifer
Gorman, Mark P.
Van Haren, Keith
Dalmau, Josep
Dale, Russell C.
author_facet Cellucci, Tania
Van Mater, Heather
Graus, Francesc
Muscal, Eyal
Gallentine, William
Klein-Gitelman, Marisa S.
Benseler, Susanne M.
Frankovich, Jennifer
Gorman, Mark P.
Van Haren, Keith
Dalmau, Josep
Dale, Russell C.
author_sort Cellucci, Tania
collection PubMed
description OBJECTIVE: Autoimmune encephalitis (AE) is an important and treatable cause of acute encephalitis. Diagnosis of AE in a developing child is challenging because of overlap in clinical presentations with other diseases and complexity of normal behavior changes. Existing diagnostic criteria for adult AE require modification to be applied to children, who differ from adults in their clinical presentations, paraclinical findings, autoantibody profiles, treatment response, and long-term outcomes. METHODS: A subcommittee of the Autoimmune Encephalitis International Working Group collaborated through conference calls and email correspondence to consider the pediatric-specific approach to AE. The subcommittee reviewed the literature of relevant AE studies and sought additional input from other expert clinicians and researchers. RESULTS: Existing consensus criteria for adult AE were refined for use in children. Provisional pediatric AE classification criteria and an algorithm to facilitate early diagnosis are proposed. There is also discussion about how to distinguish pediatric AE from conditions within the differential diagnosis. CONCLUSIONS: Diagnosing AE is based on the combination of a clinical history consistent with pediatric AE and supportive diagnostic testing, which includes but is not dependent on antibody testing. The proposed criteria and algorithm require validation in prospective pediatric cohorts.
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spelling pubmed-70512072020-03-13 Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient Cellucci, Tania Van Mater, Heather Graus, Francesc Muscal, Eyal Gallentine, William Klein-Gitelman, Marisa S. Benseler, Susanne M. Frankovich, Jennifer Gorman, Mark P. Van Haren, Keith Dalmau, Josep Dale, Russell C. Neurol Neuroimmunol Neuroinflamm Article OBJECTIVE: Autoimmune encephalitis (AE) is an important and treatable cause of acute encephalitis. Diagnosis of AE in a developing child is challenging because of overlap in clinical presentations with other diseases and complexity of normal behavior changes. Existing diagnostic criteria for adult AE require modification to be applied to children, who differ from adults in their clinical presentations, paraclinical findings, autoantibody profiles, treatment response, and long-term outcomes. METHODS: A subcommittee of the Autoimmune Encephalitis International Working Group collaborated through conference calls and email correspondence to consider the pediatric-specific approach to AE. The subcommittee reviewed the literature of relevant AE studies and sought additional input from other expert clinicians and researchers. RESULTS: Existing consensus criteria for adult AE were refined for use in children. Provisional pediatric AE classification criteria and an algorithm to facilitate early diagnosis are proposed. There is also discussion about how to distinguish pediatric AE from conditions within the differential diagnosis. CONCLUSIONS: Diagnosing AE is based on the combination of a clinical history consistent with pediatric AE and supportive diagnostic testing, which includes but is not dependent on antibody testing. The proposed criteria and algorithm require validation in prospective pediatric cohorts. Lippincott Williams & Wilkins 2020-01-17 /pmc/articles/PMC7051207/ /pubmed/31953309 http://dx.doi.org/10.1212/NXI.0000000000000663 Text en Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Article
Cellucci, Tania
Van Mater, Heather
Graus, Francesc
Muscal, Eyal
Gallentine, William
Klein-Gitelman, Marisa S.
Benseler, Susanne M.
Frankovich, Jennifer
Gorman, Mark P.
Van Haren, Keith
Dalmau, Josep
Dale, Russell C.
Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient
title Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient
title_full Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient
title_fullStr Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient
title_full_unstemmed Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient
title_short Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient
title_sort clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7051207/
https://www.ncbi.nlm.nih.gov/pubmed/31953309
http://dx.doi.org/10.1212/NXI.0000000000000663
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