Table 2.
Factors associated with prognosis.
| Initial response to immune therapy | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| All cases (N = 32) | Second week | Third week | Fourth week | ||||||||
| Responder (n = 15) | Non-responder (n = 17) | P-value | Responder (n = 18) | Non-responder (n = 14) | P-value | Responder (n = 20) | Non-responder (n = 12) | P-value | |||
| Demographics and Disease | |||||||||||
| Age (<50) (% of cases) | 15 (46.9%) | 5 (33.3%) | 10 (58.8%) | 0.178 | 8 (44.4%) | 7 (50.0%) | 1.000 | 9 (45.0%) | 6 (50.0%) | 1.000 | |
| Male (% of cases) | 16 (50.0%) | 12 (80.0%) | 4 (23.5%) | 0.004 | 12 (66.7%) | 4 (28.6%) | 0.073 | 12 (60.0%) | 4 (33.3%) | 0.273 | |
| Autoantibody (% of cases) | Anti-NMDAR | 15 (46.9%) | 3 (20.0%) | 12 (70.6%) | 0.010 | 6 (33.3%) | 9 (64.3%) | 0.256 | 7 (35.0%) | 8 (66.7%) | 0.229 |
| Anti-LGI1 | 14 (43.8%) | 10 (66.7%) | 4 (23.5%) | 10 (55.6%) | 4 (28.6%) | 11 (55.0%) | 3 (25.0%) | ||||
| Others (Anti-GABAB, Caspr2, AMPA2) | 3 (9.4%) | 2 (13.3%) | 1 (5.9%) | 2 (11.1%) | 1 (7.1%) | 2 (10.0%) | 1 (8.3%) | ||||
| Tumor (% of cases) | 9 (28.1%) | 2 (13.3%) | 7 (41.2%) | 0.122 | 4 (22.2%) | 5 (35.7%) | 0.453 | 5 (25.0%) | 4 (33.3%) | 0.696 | |
| BMI (% of cases) | Low (<18.5 kg/m2) | 4 (12.5%) | 1 (6.7%) | 3 (17.7%) | 0.776 | 1 (5.6%) | 3 (21.4%) | 0.454 | 2 (10.0%) | 2 (16.7%) | 1.000 |
| Normal (18.5 to 24.9 kg/m2) | 19 (59.4%) | 9 (60.0%) | 10 (58.8%) | 12 (66.7%) | 7 (50.0%) | 12 (60.0%) | 7 (58.3%) | ||||
| High (≥25 kg/m2) | 9 (28.2%) | 5 (33.3%) | 4 (23.5%) | 5 (27.8%) | 4 (28.6%) | 3 (25.0%) | 6 (30.0%) | ||||
| Initial Severity (mRS ≥ 4) (% of cases) | 14 (43.8%) | 4 (26.7%) | 10 (58.8%) | 0.087 | 6 (33.3%) | 8 (57.1%) | 0.283 | 6 (30.0%) | 8 (66.7%) | 0.068 | |
| Laboratory | |||||||||||
| Low albumin level (<4.0) (% of cases) | 17 (53.1%) | 5 (33.3%) | 12 (70.1%) | 0.074 | 5 (27.8%) | 12 (85.7%) | 0.002 | 7 (35.0%) | 10 (83.3%) | 0.012 | |
| Total cholesterol level (mean, mg/dL) | 155.5 (34.3) | 159.1 (34.7) | 152.4 (34.7) | 0.734* | 159.8 (31.9) | 150 (37.8) | 0.436* | 159.8 (30.9) | 148.3 (39.8) | 0.360* | |
| LFT abnormality: AST > 40 or ALT > 40 (% of cases) | 9 (28.1%) | 2 (13.3%) | 7 (41.2%) | 0.122 | 3 (16.7%) | 6 (42.9%) | 0.132 | 3 (15.0%) | 6 (50.0%) | 0.049 | |
| C-reactive protein elevation (>3 mg/L) | 8 (25.0%) | 3 (20.0%) | 5 (29.4%) | 0.691 | 3 (16.7%) | 5 (35.7%) | 0.252 | 3 (15.0%) | 5 (41.7%) | 0.116 | |
| Creatinine Kinase (U/L)† | 289.7 ± 366.9 | 242.3 ± 2276.5 | 315.5 ± 418.5 | 0.763* | 389.6 ± 464.2 | 219.8 ± 287.3 | 0.283* | 348.6 ± 445.1 | 237.3 ± 299.0 | 0.563* | |
| GFR (ml/min) | 113.6 ± 39.8 | 100.7 ± 26.1 | 125.1 ± 46.6 | 0.117* | 103.6 ± 25.8 | 126.5 ± 50.8 | 0.210* | 106.3 ± 31.2 | 125.8 ± 50.2 | 0.242* | |
| CSF (% of cases) | Lymphocytosis (WBC > 5) | 15 (55.6%) | 3 (25.0%) | 12 (80.0%) | 0.007 | 6 (40.0%) | 9 (75.0%) | 0.121 | 7 (41.2%) | 8 (80.0%) | 0.107 |
| Elevated protein (>45 g/dl) | 13 (48.2) | 6 (50.0%) | 7 (46.7%) | 1.000 | 7 (46.7%) | 6 (50.0%) | 1.000 | 8 (47.1%) | 5 (50.0%) | 1.000 | |
| EEG abnormality (% of cases) | 11 (34.4%) | 5 (33.3%) | 6 (35.3%) | 1.000 | 6 (33.3%) | 5 (35.7%) | 1.000 | 7 (35.0%) | 4 (33.3%) | 1.000 | |
| Brain MRI abnormality (% of cases) | 13 (40.6%) | 9 (60.0%) | 4 (23.5%) | 0.070 | 10 (55.6%) | 3 (21.4%) | 0.075 | 10 (50.0%) | 3 (25.0%) | 0.267 | |
| Management | |||||||||||
| Onset to first-line immune therapy (weeks) | 5 [3–12] | 5.5 [4–32] | 4 [2–10.5] | 0.123* | 4.5 [3–24] | 6.5 [2–11] | 0.568* | 5 [3.5–20] | 5 [2–9.3] | 0.212* | |
| Combination with steroid pulse | 21 (65.6%) | 11 (73.3%) | 10 (58.8%) | 0.472 | 13 (72.2%) | 8 (57.1%) | 0.465 | 15 (75.0%) | 6 (50.0%) | 0.250 | |
| Administration of second-line immune therapy | 24 (75.0%) | 8 (53.3%) | 16 (94.1%) | 0.013 | 11 (61.1%) | 13 (92.9%) | 0.053 | 13 (65.0%) | 11 (91.7%) | 0.204 | |
| Duration to second-line immune therapy from first-line (days) | 6 [5–13] | 7 [5.5–19.5] | 6 [4.5–10.5] | 0.579* | 8 [6–13] | 6 [4–8] | 0.325* | 8 [6–13] | 5 [3–8] | 0.130* | |
NMDAR = N-methyl D-aspartate receptor; LGI1 = leucine-rich glioma inactivated 1; GABAB = γ-aminobutyric acid B; Caspr2 = contactin-associated protein-like 2; AMAPA2 = α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid 2; BMI = body mass index; mRS = modified Rankin Scale; LFT = liver function tests; AST = aspartate aminotransferase; ALT = alanine aminotransferase; GFR = glomerular filtration rate; CSF = cerebrospinal fluid; WBC = white blood cell; EEG = electroencephalogram; MRI = magnetic resonance imaging; Fisher’s exact test unless otherwise stated; *Mann-Whitney U test; †17 patients were analyzed because the data of 15 patients were missing. ‡27 patients were analyzed because the data of 5 patients were missing.