Increased Intrathecal B and Plasma Cells in Patients With Anti-IgLON5 Disease : A Case Series

Background and Objectives: Despite detection of autoantibodies, anti-IgLON5 disease was historically considered a tau-associated neurodegenerative disease, with limited treatment options and detrimental consequences for the patients. Observations in increasing case numbers hint toward underlying inf...

Verfasser: Strippel, Christine
Heidbreder, Anna Elisabeth
Schulte-Mecklenbeck, Andreas
Korn, Lisanne
Warnecke, Tobias
Melzer, Nico
Wiendl, Heinz
Pawlowski, Matthias
Gross, Catharina C.
Kovać, Stjepana
FB/Einrichtung:FB 05: Medizinische Fakultät
Dokumenttypen:Artikel
Medientypen:Text
Erscheinungsdatum:2022
Publikation in MIAMI:06.03.2023
Datum der letzten Änderung:06.03.2023
Angaben zur Ausgabe:[Electronic ed.]
Quelle:Neurology: Neuroimmunology & Neuroinflammation 9 (2022) 2, 1-5
Schlagwörter:All Immunology; Autoimmune diseases
Fachgebiet (DDC):610: Medizin und Gesundheit
Lizenz:CC BY-NC-ND 4.0
Sprache:Englisch
Förderung:Finanziert durch den Open-Access-Publikationsfonds der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format:PDF-Dokument
URN:urn:nbn:de:hbz:6-51009442234
Weitere Identifikatoren:DOI: 10.17879/81009517835
Permalink:https://nbn-resolving.de/urn:nbn:de:hbz:6-51009442234
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Onlinezugriff:10.1212_NXI.0000000000001137.pdf

Background and Objectives: Despite detection of autoantibodies, anti-IgLON5 disease was historically considered a tau-associated neurodegenerative disease, with limited treatment options and detrimental consequences for the patients. Observations in increasing case numbers hint toward underlying inflammatory mechanisms that, early detection provided, open a valuable window of opportunity for therapeutic intervention. We aimed to further substantiate this view by studying the CSF of patients with anti-IgLON5. Methods: We identified 11 patients with anti-IgLON5 from our database and compared clinical, MRI, and CSF findings with a cohort of 20 patients with progressive supranuclear palsy (PSP) (as a noninflammatory tauopathy) and 22 patients with functional neurologic disorder. Results: Patients with anti-IgLON5 show inflammatory changes in routine CSF analysis, an increase in B-lymphocyte frequency, and the presence of plasma cells in comparison to the PSP-control group and functional neurologic disease controls. Patients with intrathecal plasma cells showed a clinical response to rituximab. Discussion: Our findings indicate the importance of inflammatory mechanisms, in particular in early and acute anti-IgLON5 cases, which may support the use of immune-suppressive treatments in these cases. The main limitation of the study is the small number of cases due to the rarity of the disease.