Open AccessElevated LGI 1‐IgG CSF index predicts worse neurological outcome
Author(s) -
Gadoth Avi,
Zekeridou Anastasia,
Klein Christopher J.,
Thoreson Colton J.,
Majed Masoud,
Dubey Divyanshu,
Flanagan Eoin P.,
McKeon Andrew,
Jenkins Sarah M.,
Len Vanda A.,
Pittock Sean J.
Publication year - 2018
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.561
Subject(s) - medicine , titer , subclass , intrathecal , modified rankin scale , immunotherapy , immunology , antibody , gastroenterology , immune system , anesthesia , ischemic stroke , ischemia
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.