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Background: Autoimmune encephalitis (AIE) is the main cause of non-infectious encephalitis and results from the peripheral immune response against cell surface antigens in the central nervous system. The clinical presentations are varied and known triggers are tumors and herpetic infections. Arboviruses Zika (ZIKV), Dengue (DENGV) and Chikungunya (CHIKV) are neurotropic infections that present neurological manifestations whose mechanism is unknown. Objective: Verify the frequency of arboviruses antibodies in patients with autoimmune encephalitis in a Brazilian cohort Design and setting: It is a transversal study performed by Hospital Israelita Albert Einstein in Brazil Methods: Patients who met the criteria for probable AIE (Graus 2016) evaluated at the 18 centers of the BrAIN network were included. Clinical, epidemiological and laboratory data were compiled. Antineuronal antibodies were detected using TBA, CBA and immunoblot in serum and CSF; antibodies against ZIKV, DENGV and CHIKV were detected by ELISA. The cohort was divided into two groups: seropositive encephalitic (SPE) and non-encephalitic (NE) and the frequencies of viral serologies were compared. Results: Among 619 patients included in the BrAIN cohort, serology for arboviruses was performed in 482 patients, being 79 SPE and 99 NE. The SPEgroup showed the following frequency of antibodies: 58.2% anti-NMDA, 7.6% antiLGI1, 6.3% anti-Caspr2, 2.5% anti-GABA B, 1.3% anti-GABA A, 3.8% anti-AMPAr, 1.3% anti-AQ4, 8.9% anti-MOG, 1.3% anti-IgLON5, 7.6% anti-GlyR and 5.1% others. The frequency of serology was IgG DENG (SPE 42.3% X NP 43.4%, p = 0.82); IgG CHIK (SPE 16.5% X 3.1% NP, p = 0.001); IgG ZIKV (SPE31.6% X NP 28.3%, p = 0.62). The frequency of triple positive serology (IgG DENG, ZIKV, CHIK) was 11.39% (SPE X 2.02% NP, p = 0.009). Conclusions: Patients with SPE have IgG CHIKV antibodies most commonly. In addition, they present a higher frequency of positivity for IgG CHIKV, ZIKV, DENGV simultaneously. Future studies should assess the association between arboviruses as a trigger for AIE or as a marker of susceptibility to immunological alteration. |
