Elevated LGI1-IgG CSF index predicts worse neurological outcome

Annals of Clinical and Translational Neurology
Avi GadothSean J Pittock

Abstract

To determine whether CSF leucine-rich glioma-inactivated 1(LGI1)-IgG titer, index or IgG subclass has prognostic significance, we tested serum and CSF specimens collected concomitantly from 39 seropositive patients. LGI1-IgG index was elevated (>1) in 21 patients (54%), suggesting intrathecal synthesis. Patients with worse outcome at last follow-up (modified Rankin Scale >2) had significantly higher index (median 6.57 vs. 0.5, P = 0.048) compared to those with better outcome. Higher CSF LGI1-IgG4 subclass-specific titer and index correlated with worse outcome (P < 0.005 for both). These data suggest that evidence of intrathecal LGI1-IgG synthesis may correlate with neuronal injury and warrant consideration of aggressive immunotherapy.

References

Oct 24, 2014·Neurology. Neuroimmunology and Neuroinflammation·J P FryerA McKeon
Aug 28, 2015·Lancet·Sarosh R IraniH-Christian von Büdingen
Jul 29, 2016·Neurology·Helena AriñoFrancesc Graus
Sep 4, 2016·Neurology·Agnes van SonderenMaarten J Titulaer
Jun 20, 2017·Annals of Neurology·Avi GadothChristopher J Klein

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Citations

Feb 8, 2020·Neurology. Neuroimmunology and Neuroinflammation·Klaus Lehmann-HornH-Christian von Büdingen
Jun 27, 2019·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Khalil S Husari, Divyanshu Dubey
Jan 5, 2020·Annals of Neurology·Hans-Christian KornauDietmar Schmitz
Aug 14, 2019·Frontiers in Neurology·Tetyana Blinder, Jan Lewerenz
Feb 8, 2021·Journal of Neuroimmunology·Volodymyr SamogalskyiRonit Gilad
Apr 14, 2021·Neurology. Neuroimmunology and Neuroinflammation·Sergio Muñiz-CastrilloJérôme Honnorat
Oct 29, 2021·Neurology·Stephen A JohnsonChristopher J Klein
Dec 23, 2021·Neuropathology and Applied Neurobiology·Oliver CousinsFederico Roncaroli

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