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Conference Paper: Aetiology, clinical presentation, and outcome of encephalitis in Hong Kong

TitleAetiology, clinical presentation, and outcome of encephalitis in Hong Kong
Authors
Issue Date2017
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/
Citation
The 22nd Medical Research Conference (MRC 2017), Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, 14 January 2017. In Hong Kong Medical Journal, 2017, v. 23 n. 1, Suppl. 1, p. 42, abstract no. 66 How to Cite?
AbstractIntroduction: Autoimmune encephalitis is now recognised as an important cause of encephalitis. On the other hand, encephalitis of unknown aetiology remained a diagnostic and management challenge. We aimed to study the clinical presentation and outcome of encephalitis of different aetiologies. Methods: Immunocompetent patients aged 18 years or above with encephalitis, who were admitted from January 2010 to September 2016, were recruited in this single-centre cohort study. Systemic laboratory testing was utilised to identify the aetiology of the encephalitis. The 6-month outcome was assessed using the Modified Rankin Scale (mRS). Good outcome was defined as mRS 0-2 and poor outcome was defined as mRS 3-6. Results: We identified 26 patients with encephalitis. Herpes simplex encephalitis was the most common identified aetiology (n=6; 23%), followed by anti-NMDA receptor encephalitis (n=3; 12%). There were six patients with encephalitis of unknown aetiology. Patients with autoimmune encephalitis had a lower frequency of fever at presentation (25.0% vs 88.9%; P=0.001) and cerebrospinal fluid protein level elevation (25.0% vs 70.6%; P=0.032), and a longer duration of symptoms before presentation (median 19.5 days, interquartile range 8.5-30 vs 1 day, interquartile range 1-3; P=0.030). The aetiology of the encephalitis was the major determination factor for neurological outcome. Autoimmune encephalitis was associated with good neurological outcome (hazard ratio=8.8; P=0.064). Encephalitis of unknown aetiology was associated with poor neurological outcome (hazard ratio=11.7; P=0.040) with the 6-month mortality rate of 50%. Conclusion: Autoimmune encephalitis has a distinct clinical characteristic and was associated with a good neurological outcome. Further research is required for the management of encephalitis of unknown aetiology, which has a much guarded prognosis.
Persistent Identifierhttp://hdl.handle.net/10722/247866
ISSN
2019 Impact Factor: 1.679
2015 SCImago Journal Rankings: 0.279

 

DC FieldValueLanguage
dc.contributor.authorTeo, KC-
dc.contributor.authorLee, CY-
dc.contributor.authorChang, SKR-
dc.contributor.authorHo, SL-
dc.contributor.authorChan, KH-
dc.date.accessioned2017-10-18T08:33:54Z-
dc.date.available2017-10-18T08:33:54Z-
dc.date.issued2017-
dc.identifier.citationThe 22nd Medical Research Conference (MRC 2017), Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, 14 January 2017. In Hong Kong Medical Journal, 2017, v. 23 n. 1, Suppl. 1, p. 42, abstract no. 66-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/247866-
dc.description.abstractIntroduction: Autoimmune encephalitis is now recognised as an important cause of encephalitis. On the other hand, encephalitis of unknown aetiology remained a diagnostic and management challenge. We aimed to study the clinical presentation and outcome of encephalitis of different aetiologies. Methods: Immunocompetent patients aged 18 years or above with encephalitis, who were admitted from January 2010 to September 2016, were recruited in this single-centre cohort study. Systemic laboratory testing was utilised to identify the aetiology of the encephalitis. The 6-month outcome was assessed using the Modified Rankin Scale (mRS). Good outcome was defined as mRS 0-2 and poor outcome was defined as mRS 3-6. Results: We identified 26 patients with encephalitis. Herpes simplex encephalitis was the most common identified aetiology (n=6; 23%), followed by anti-NMDA receptor encephalitis (n=3; 12%). There were six patients with encephalitis of unknown aetiology. Patients with autoimmune encephalitis had a lower frequency of fever at presentation (25.0% vs 88.9%; P=0.001) and cerebrospinal fluid protein level elevation (25.0% vs 70.6%; P=0.032), and a longer duration of symptoms before presentation (median 19.5 days, interquartile range 8.5-30 vs 1 day, interquartile range 1-3; P=0.030). The aetiology of the encephalitis was the major determination factor for neurological outcome. Autoimmune encephalitis was associated with good neurological outcome (hazard ratio=8.8; P=0.064). Encephalitis of unknown aetiology was associated with poor neurological outcome (hazard ratio=11.7; P=0.040) with the 6-month mortality rate of 50%. Conclusion: Autoimmune encephalitis has a distinct clinical characteristic and was associated with a good neurological outcome. Further research is required for the management of encephalitis of unknown aetiology, which has a much guarded prognosis.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.titleAetiology, clinical presentation, and outcome of encephalitis in Hong Kong-
dc.typeConference_Paper-
dc.identifier.emailChang, SKR: skrchang@hku.hk-
dc.identifier.emailHo, SL: slho@hku.hk-
dc.identifier.emailChan, KH: koonho@hku.hk-
dc.identifier.authorityHo, SL=rp00240-
dc.identifier.authorityChan, KH=rp00537-
dc.identifier.hkuros281428-
dc.identifier.volume23-
dc.identifier.issue1, Suppl. 1-
dc.identifier.spage42, abstract no. 66-
dc.identifier.epage42, abstract no. 66-
dc.publisher.placeHong Kong-

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