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

Research output: Contribution to journalArticle

4 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 languageEnglish (US)
Pages (from-to)646-650
Number of pages5
JournalAnnals of Clinical and Translational Neurology
Volume5
Issue number5
DOIs
StatePublished - May 2018

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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