Elevated LGI1-IgG CSF index predicts worse neurological outcome

Avi Gadoth; Anastasia Zekeridou; Christopher J. Klein; Colton J. Thoreson; Masoud Majed; Divyanshu Dubey; Eoin P. Flanagan; Andrew McKeon; Sarah M. Jenkins; Vanda A. Lennon; Sean J. Pittock

doi:10.1002/acn3.561

Elevated LGI1-IgG CSF index predicts worse neurological outcome

Avi Gadoth, Anastasia Zekeridou, Christopher J. Klein, Colton J. Thoreson, Masoud Majed, Divyanshu Dubey, Eoin P. Flanagan, Andrew McKeon, Sarah M. Jenkins, Vanda A. Lennon, Sean J. Pittock

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6 Scopus citations

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.

Original language	English (US)
Pages (from-to)	646-650
Number of pages	5
Journal	Annals of Clinical and Translational Neurology
Volume	5
Issue number	5
DOIs	https://doi.org/10.1002/acn3.561
State	Published - May 2018

ASJC Scopus subject areas

General Neuroscience
Clinical Neurology

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title = "Elevated LGI1-IgG CSF index predicts worse neurological outcome",

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.",

author = "Avi Gadoth and Anastasia Zekeridou and Klein, {Christopher J.} and Thoreson, {Colton J.} and Masoud Majed and Divyanshu Dubey and Flanagan, {Eoin P.} and Andrew McKeon and Jenkins, {Sarah M.} and Lennon, {Vanda A.} and Pittock, {Sean J.}",

note = "Publisher Copyright: {\textcopyright} 2018 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association.",

year = "2018",

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doi = "10.1002/acn3.561",

language = "English (US)",

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journal = "Annals of Clinical and Translational Neurology",

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T1 - Elevated LGI1-IgG CSF index predicts worse neurological outcome

AU - Gadoth, Avi

AU - Zekeridou, Anastasia

AU - Klein, Christopher J.

AU - Thoreson, Colton J.

AU - Majed, Masoud

AU - Dubey, Divyanshu

AU - Flanagan, Eoin P.

AU - McKeon, Andrew

AU - Jenkins, Sarah M.

AU - Lennon, Vanda A.

AU - Pittock, Sean J.

PY - 2018/5

Y1 - 2018/5

N2 - 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.

AB - 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.

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Elevated LGI1-IgG CSF index predicts worse neurological outcome

Abstract

ASJC Scopus subject areas

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