Autoantibody status, neuroradiological and clinical findings in children with acute cerebellitis

Background - Acute cerebellitis (AC) in children and adolescents is an inflammatory disease of the cerebellum due to viral or bacterial infections but also autoimmune-mediated processes. - Objective - To investigate the frequency of autoantibodies in serum and CSF as well as the neuroradiological fe...

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Hauptverfasser: Quack, Lisa (VerfasserIn) , Glatter, S. (VerfasserIn) , Wegener-Panzer, A. (VerfasserIn) , Cleaveland, R. (VerfasserIn) , Bertolini, A. (VerfasserIn) , Endmayr, V. (VerfasserIn) , Seidl, R. (VerfasserIn) , Breu, M. (VerfasserIn) , Wendel, E. (VerfasserIn) , Schimmel, M. (VerfasserIn) , Baumann, M. (VerfasserIn) , Rauchenzauner, M. (VerfasserIn) , Pritsch, M. (VerfasserIn) , Boy, Nikolas (VerfasserIn) , Muralter, T. (VerfasserIn) , Kluger, G. (VerfasserIn) , Makoswski, C. (VerfasserIn) , Kraus, V. (VerfasserIn) , Leiz, S. (VerfasserIn) , Loehr-Nilles, C. (VerfasserIn) , Kreth, J. H. (VerfasserIn) , Braig, S. (VerfasserIn) , Schilling, S. (VerfasserIn) , Kern, J. (VerfasserIn) , Blank, C. (VerfasserIn) , Tro Baumann, B. (VerfasserIn) , Vieth, Simon (VerfasserIn) , Wallot, M. (VerfasserIn) , Reindl, M. (VerfasserIn) , Ringl, Helmut Rupert (VerfasserIn) , Wandinger, K. P. (VerfasserIn) , Leypoldt, Frank (VerfasserIn) , Höftberger, Romana (VerfasserIn) , Rostásy, Kevin (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: November 2023
In: European journal of paediatric neurology
Year: 2023, Jahrgang: 47, Pages: 118-130
ISSN:1532-2130
DOI:10.1016/j.ejpn.2023.10.005
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ejpn.2023.10.005
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1090379823001605
Volltext
Verfasserangaben:L. Quack, S. Glatter, A. Wegener-Panzer, R. Cleaveland, A. Bertolini, V. Endmayr, R. Seidl, M. Breu, E. Wendel, M. Schimmel, M. Baumann, M. Rauchenzauner, M. Pritsch, N. Boy, T. Muralter, G. Kluger, C. Makoswski, V. Kraus, S. Leiz, C. Loehr-Nilles, J. H. Kreth, S. Braig, S. Schilling, J. Kern, C. Blank, B. Tro Baumann, S. Vieth, M. Wallot, M. Reindl, H. Ringl, K. P. Wandinger, F. Leypoldt, R. Höftberger, K. Rostásy

MARC

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245 1 0 |a Autoantibody status, neuroradiological and clinical findings in children with acute cerebellitis  |c L. Quack, S. Glatter, A. Wegener-Panzer, R. Cleaveland, A. Bertolini, V. Endmayr, R. Seidl, M. Breu, E. Wendel, M. Schimmel, M. Baumann, M. Rauchenzauner, M. Pritsch, N. Boy, T. Muralter, G. Kluger, C. Makoswski, V. Kraus, S. Leiz, C. Loehr-Nilles, J. H. Kreth, S. Braig, S. Schilling, J. Kern, C. Blank, B. Tro Baumann, S. Vieth, M. Wallot, M. Reindl, H. Ringl, K. P. Wandinger, F. Leypoldt, R. Höftberger, K. Rostásy 
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520 |a Background - Acute cerebellitis (AC) in children and adolescents is an inflammatory disease of the cerebellum due to viral or bacterial infections but also autoimmune-mediated processes. - Objective - To investigate the frequency of autoantibodies in serum and CSF as well as the neuroradiological features in children with AC. - Material and methods - Children presenting with symptoms suggestive of AC defined as acute/subacute onset of cerebellar symptoms and MRI evidence of cerebellar inflammation or additional CSF pleocytosis, positive oligoclonal bands (OCBs), and/or presence of autoantibodies in case of negative cerebellar MRI. Children fulfilling the above-mentioned criteria and a complete data set including clinical presentation, CSF studies, testing for neuronal/cerebellar and MOG antibodies as well as MRI scans performed at disease onset were eligible for this retrospective multicenter study. - Results - 36 patients fulfilled the inclusion criteria for AC (f:m = 14:22, median age 5.5 years). Ataxia was the most common cerebellar symptom present in 30/36 (83 %) in addition to dysmetria (15/36) or dysarthria (13/36). A substantial number of children (21/36) also had signs of encephalitis such as somnolence or seizures. In 10/36 (28 %) children the following autoantibodies (abs) were found: MOG-abs (n = 5) in serum, GFAPα-abs (n = 1) in CSF, GlyR-abs (n = 1) in CSF, mGluR1-abs (n = 1) in CSF and serum. In two further children, antibodies were detected only in serum (GlyR-abs, n = 1; GFAPα-abs, n = 1). MRI signal alterations in cerebellum were found in 30/36 children (83 %). Additional supra- and/or infratentorial lesions were present in 12/36 children, including all five children with MOG-abs. Outcome after a median follow-up of 3 months (range: 1 a 75) was favorable with an mRS ≤2 in 24/36 (67 %) after therapy. Antibody (ab)-positive children were significantly more likely to have a better outcome than ab-negative children (p = .022). - Conclusion - In nearly 30 % of children in our study with AC, a range of abs was found, underscoring that autoantibody testing in serum and CSF should be included in the work-up of a child with suspected AC. The detection of MOG-abs in AC does expand the MOGAD spectrum. 
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