In children, N-Methyl-D-Aspartate receptor antibody encephalitis incidence exceeds that of Japanese encephalitis in Vietnam
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
The recognition of autoimmune causes of encephalitis has led to epidemiological shifts in the worldwide characteristics. N-Methyl-D-Aspartate receptor antibody encephalitis leads to well-established complex neuropsychiatric manifestations. In low- and middle-income countries, including Vietnam, its relative incidence, especially in children, is unknown and most neurologists currently consider infectious encephalitis prior to autoimmune etiologies.
Methods
The study was prospectively conducted at Children’s Hospital 1 in Ho Chi Minh City between March 2020 and December 2022. Any child admitted to the Department of Infectious Diseases and Neurology fulfilling the case definition of encephalitis, was eligible to participate. Cerebrospinal fluid samples were collected alongside meta-clinical data for analysis.
Results
We recruited 164 children with a clinical diagnosis of encephalitis. Etiologies were determined as N-Methyl-D-Aspartate receptor antibody encephalitis in 23/164 cases (14.0%), Japanese Encephalitis Virus in 14/164 (8.5%) and Herpes Simplex Virus in 4/164 (2.4%). Clinical categorizations suggested idiopathic viral encephalitis in another 71 (43.3%), and autoimmune encephalitis of unknown origin in the remaining 52. Factors including demographics, specific clinical features, cerebrospinal fluid and electroencephalogram findings, and length of hospital stay were significantly different between N-Methyl-D-Aspartate receptor antibody encephalitis and Japanese encephalitis.
Conclusions
At a tertiary children’s hospital in Vietnam, the prevalence of N-Methyl-D-Aspartate receptor antibody encephalitis exceeds that of Japanese encephalitis, the most common infectious encephalitis cause in Southeast Asia. N-Methyl-D-Aspartate receptor antibody encephalitis is associated with long hospital stay and poor outcomes. These findings should change paediatric diagnostics, to earlier consider autoimmune treatments in this clinical setting.
The recognition of autoimmune causes of encephalitis has led to epidemiological shifts in the worldwide characteristics. N-Methyl-D-Aspartate receptor antibody encephalitis leads to well-established complex neuropsychiatric manifestations. In low- and middle-income countries, including Vietnam, its relative incidence, especially in children, is unknown and most neurologists currently consider infectious encephalitis prior to autoimmune etiologies.
Methods
The study was prospectively conducted at Children’s Hospital 1 in Ho Chi Minh City between March 2020 and December 2022. Any child admitted to the Department of Infectious Diseases and Neurology fulfilling the case definition of encephalitis, was eligible to participate. Cerebrospinal fluid samples were collected alongside meta-clinical data for analysis.
Results
We recruited 164 children with a clinical diagnosis of encephalitis. Etiologies were determined as N-Methyl-D-Aspartate receptor antibody encephalitis in 23/164 cases (14.0%), Japanese Encephalitis Virus in 14/164 (8.5%) and Herpes Simplex Virus in 4/164 (2.4%). Clinical categorizations suggested idiopathic viral encephalitis in another 71 (43.3%), and autoimmune encephalitis of unknown origin in the remaining 52. Factors including demographics, specific clinical features, cerebrospinal fluid and electroencephalogram findings, and length of hospital stay were significantly different between N-Methyl-D-Aspartate receptor antibody encephalitis and Japanese encephalitis.
Conclusions
At a tertiary children’s hospital in Vietnam, the prevalence of N-Methyl-D-Aspartate receptor antibody encephalitis exceeds that of Japanese encephalitis, the most common infectious encephalitis cause in Southeast Asia. N-Methyl-D-Aspartate receptor antibody encephalitis is associated with long hospital stay and poor outcomes. These findings should change paediatric diagnostics, to earlier consider autoimmune treatments in this clinical setting.
Date Issued
2024-12
Date Acceptance
2024-11-28
Citation
Open Forum Infectious Diseases, 2024, 11 (12)
ISSN
2328-8957
Publisher
Oxford University Press
Journal / Book Title
Open Forum Infectious Diseases
Volume
11
Issue
12
Copyright Statement
© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
Identifier
https://doi.org/10.1093/ofid/ofae710
Publication Status
Published
Article Number
ofae710
Date Publish Online
2024-12-06