Publications

Authors:

De Napoli, Giulia; Gastaldi, Matteo; Natali, Patrizia; Bedin, Roberta; Simone, Anna Maria; Santangelo, Mario; Mariotto, Sara; Vitetta, Francesca; Smolik, Krzysztof; Cardi, Martina; Meletti, Stefano; Ferraro, Diana

Title:

Kappa index in the diagnostic work-up of autoimmune encephalitis

Year:

2024

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Format:

Elettronico

Referee:

Sì

Name of journal:

Journal of the Neurological Sciences

ISSN of journal:

0022-510X

N° Volume:

463

Number or Folder:

123146

Page numbers:

1-7

Keyword:

Autoimmune encephalitis; Cerebrospinal fluid; Free light chain; Kappa index; Oligoclonal bands

Short description of contents:

Background: The presence of inflammatory changes in the cerebrospinal fluid (CSF), including immunoglobulin intrathecal synthesis (IS), can support the diagnosis of autoimmune encephalitis (AE) and allow prompt treatment. The main aim of our study was to calculate the Kappa index as a marker of IS, in patients with AE. Methods: Charts of patients undergoing a diagnostic work-up for suspected AE between 2009 and 2023 were reviewed and the Graus criteria applied. CSF and serum kappa free light chains were determined using the Freelite assay (The Binding Site Group) and the turbidimetric Optilite analyzer. Results: We identified 34 patients with "definite" AE (9 anti-NMDAR AE and 25 limbic AE) and nine patients with "possible" AE. Five patients (15%) with definite AE had pleocytosis and twelve (34%) showed CSF-restricted oligoclonal bands (OCB) at isoelectric focusing. The Kappa index was >6 in 29.4% and > 3 in 50% of the definite AE patients. It was elevated (>3) in 36.4% of patients with definite AE who resulted negative to OCB testing and was the only altered parameter suggestive of an ongoing inflammatory process in the CNS in three definite AE patients with otherwise normal CSF findings (i.e. normal cell count and protein levels, no OCBs). In the possible AE group, one patient had a Kappa index >3 in the absence of OCB. Conclusions: The Kappa index could be useful, as a more sensitive marker of IS and as a supportive marker of neuroinflammation, in the diagnostic work-up of suspected AE.

Web page:

https://doi.org/10.1016/j.jns.2024.123146

Product ID:

140703

Handle IRIS:

11562/1132669

Last Modified:

October 12, 2024

Bibliographic citation:

De Napoli, Giulia; Gastaldi, Matteo; Natali, Patrizia; Bedin, Roberta; Simone, Anna Maria; Santangelo, Mario; Mariotto, Sara; Vitetta, Francesca; Smolik, Krzysztof; Cardi, Martina; Meletti, Stefano; Ferraro, Diana, Kappa index in the diagnostic work-up of autoimmune encephalitis «Journal of the Neurological Sciences» , vol. 463 , n. 123146 , 2024 , pp. 1-7

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo