Actualidades en encefalitis autoinmunes mediadas por anticuerpos en pediatría

Palabras clave: Enfermedades autoinmunes, pediatría, diagnóstico de encefalitis, autoanticuerpos

Resumen

La encefalitis autoinmune (EA) en pediatría presentan un cuadro clínico de difícil diagnóstico, frecuentemente son confundidas con enfermedades psiquiátricas. Estas se caracterizan por provocar una inflamación mediada por la respuesta inmune humoral y en menor medida por una respuesta celular citotóxica. Se reporta una incidencia mínima de 10,5 pacientes pediátricos (1 mes-18 años) con encefalitis por cada 100,000 casos al año en países occidentales. Son padecimientos caracterizados por una inflamación del parénquima cerebral que causa síntomas similares a infecciones, síntomas psiquiátricos y manifestaciones neurológicas. El objetivo del presente trabajo fue desarrollar una actualización de la información a través de una revisión bibliográfica clínica que contribuya al diagnóstico oportuno de estos padecimientos. La identificación de autoanticuerpos específicos en la EA en la etapa pediátrica, contribuyen al desarrollo de nuevas técnicas de diagnóstico temprano de la enfermedad con mayor sensibilidad y especificidad.

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Achour, N., Younes, T., Rebai, I., Ahmed, M., Kraoua, I. & Youssef-Turki, I. (2018). Severe dysautonomia as a main feature of anti-GAD encephalitis: Report of paediatric case and literature review. European Journal of Paediatric Neurology, 22 (3), 548-551. DOI:10.1016/j.ejpn.2018.01.004

Brenton, J. N., & Goodkin, H. P. (2016). Antibody-Mediated Autoimmune Encephalitis in Childhood. Pediatric Neurology, 60,13–23. DOI: 10.1016/j.pediatrneurol.2016.04.004

Campos, A., Pérez, A., Luján, J., Zorzo, C., Blanco, A., Fernández, J., Montilla, S. & Jiménez, J. (2016). Encefalitis de tronco de Bickerstaff atípica: 2 casos pediátricos. Neurología Argentina, 8(3), 181-186. DOI: 10.1016/j.neuarg.2016.03.001

Carrasco, Á., Alarcón, I., González, C., & Graus, F. (2014). Identificación y utilidad clínica de los anticuerpos antineuronales. Inmunología, 33(4), 128–136. DOI: 10.1016/j.inmuno.2014.04.003

Dade, M., Berzero, G., Izquierdo, C., Giry, M., Benazra, M., Delattre, J. Y., Psimaras, D., & Alentorn, A. (2020). Neurological Syndromes Associated with Anti-GAD Antibodies. International Journal of Molecular Sciences, 21(10), 3701. https://doi.org/10.3390/ijms21103701

Daif, A., V Lukas, R., P Issa, N., Javed, A., VanHaerents, S., T Reder, A., X Tao, J., Warnke, P., Rose, S., L Towle, V. & Wu, S. (2018). Antiglutamic acid decarboxylase 65 (GAD65) antibody-associated epilepsy, 80, 331-336. DOI: 10.1016/j.yebeh.2018.01.021

Dalmau, J., Armangué, T., Planagumà, J., Radosevic, M., Mannara, F., Leypoldt, F., Geis, C., Lancaster, E., Titulaer, M. J., Rosenfeld, M. R., & Graus, F. (2019). An update on anti- NMDA receptor encephalitis for neurologists and psychiatrists: Mechanisms and models. The Lancet. Neurology, 18(11), 1045–1057. DOI: 10.1016/S1474-4422(19)30244-3

Dalmau, J., Gleichman, A. J., Hughes, E. G., Rossi, J. E., Peng, X., Lai, M., Dessain, S. K., Rosenfeld, M. R., Balice-Gordon, R., & Lynch, D. R. (2008). Anti-NMDA-receptor encephalitis: Case series and analysis of the effects of antibodies. The Lancet. Neurology, 7(12), 1091–1098. DOI:10.1016/S1474-4422(08)70224-2

Dalmau, J., Tüzün, E., Wu, E., Masjuan, J., Rossi, J. E., Voloschin, A., Baehring, J. M., Shimazaki, H., Koide, R., King, D., Mason, W., Sansing, L. H., Dichter, M. A. & Rosenfeld, M. R. (2007). Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Annals of Neurology, 61(1), 25-36. DOI: 10.1002/ana.21050

DeSena, A. D., Greenberg, B. M., & Graves, D. (2014). Three phenotypes of anti-N-methyl-D- aspartate receptor antibody encephalitis in children: Prevalence of symptoms and prognosis. Pediatric Neurology, 51(4), 542–549. DOI: 10.1016/j.pediatrneurol.2014.04.030

Florance, N. R., Davis, R. L., Lam, C., Szperka, C., Zhou, L., Ahmad, S., Campen, C. J., Moss, H., Peter, N., Gleichman, A. J., Glaser, C. A., Lynch, D. R., Rosenfeld, M. R., & Dalmau, J. (2009). Anti–N-Methyl-D-Aspartate Receptor (NMDAR) Encephalitis in Children and Adolescents. Annals of neurology, 66(1), 11–18. DOI: 10.1002/ana.21756

Garg, D., Mohammad, S. S., & Sharma, S. (2020). Autoimmune Encephalitis in Children: An Update. Indian Pediatrics, 57(7), 662–670. DOI: 10.1007/s13312-020-1896-5

Gil Ortega, M., Hernández Pardo, E., Gil Ortega, I., Gil Ortega, D., Quesada Córcoles, J., Gutiérrez Lara, G., & Fernández Reyes, J. L. (2004). Encefalitis límbica paraneoplásica y cáncer de pulmón. Anales de Medicina Interna, 21(3). DOI: 10.4321/S0212- 71992004000300007

Gole, S. y Anand, A. (2023). Autoimmune Encephalitis. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK578203/

Graus, F., Titulaer, M. J., Balu, R., Benseler, S., Bien, C. G., Cellucci, T., Cortese, I., Dale, R., Gelfand, J. M., Geschwind, M., Glaser, C. A., Honnorat, J., Höftberger, R., Iizuka, T., Irani, S. R., Lancaster, E., Leypoldt, F., Prüss, H., Rae-Grant, A., Reindl, M., Rosenfeld, M. R., Rostásy, K., Saiz, A., Venkatesan, A., Vincent, A., Wandinger, K. P., Waters, P. y Dalmau, J. (2016). A clinical approach to diagnosis of autoimmune encephalitis. The Lancet Neurology 15 (4), 391-404. DOI: 10.1016/S1474-4422(15)00401-9

Guasp, M., Arino, H., & Dalmau, J. (2018). [Autoimmune encephalitis]. Revista De Neurologia, 66(s02), S1–S6. ISSN: 1576-6578

Guo, C.-Y., Gelfand, J. M., & Geschwind, M. D. (2020). Anti-gamma-aminobutyric acid receptor type A encephalitis: A review. Current Opinion in Neurology, 33(3), 372–380. DOI: 10.1097/WCO.0000000000000814

Hacohen, Y., Wright, S., Waters, P., Agrawal, S., Carr, L., Cross, H., De Sousa, C., DeVile, C., Fallon, P., Gupta, R., Hedderly, T., Hughes, E., Kerr, T., Lascelles, K., Lin, J.-P., Philip, S., Pohl, K., Prabahkar, P., Smith, M., … Lim, M. J. (2013). Pediatric autoimmune encephalopathies: Clinical features, laboratory investigations and outcomes in patients with or without antibodies to known central nervous system autoantigens. Journal of Neurology, Neurosurgery, and Psychiatry, 84(7), 748–755. DOI: 10.1136/jnnp-2012-303807

Hammer, C., Stepniak, B., Schneider, A., Papiol, S., Tantra, M., Begemann, M., Sirén, A.-L., Pardo, L. A., Sperling, S., Mohd Jofrry, S., Gurvich, A., Jensen, N., Ostmeier, K., Lühder, F., Probst, C., Martens, H., Gillis, M., Saher, G., Assogna, F., Ehrenreich, H. (2014). Neuropsychiatric disease relevance of circulating anti-NMDA receptor autoantibodies depends on blood–brain barrier integrity. Molecular Psychiatry, 19(10), Art. 10. DOI: 10.1038/mp.2013.110

Hardy, D. (2022). Autoimmune Encephalitis in Children. Pediatric Neurology, 132: 56-66. DOI:10.1016/j.pediatrneurol.2022.05.004

Heine, J., Duchow, A., Rust, R., Paul, F., PrüB, H. y Finke, C. (2022). Autoimmune encephalitis-An update. Nervenarzt, 1-12. DOI: 10.1007/s00115-022-01411-1

Ho, A. C., Chan, S. H., Chan, E., Wong, S. S., Fung, S. T., Cherk, S. W., Fung, E. L., Ma, K., Tsui, K., Yau, E. K., & Wong, V. C. (2018). Anti-N-methyl-d-aspartate receptor encephalitis in children: Incidence and experience in Hong Kong. Brain and Development, 40(6), 473–479. DOI: 10.1016/j.braindev.2018.02.005

Hon, K., Leung, A., Au, C. & Torres, A. (2021). Autoimmune Encephalitis in Children: From Suspicion to Diagnosis. Cureus, 13(2), e13307. DOI: 10.7759/cureus.13307

Irani, S. R., Bera, K., Waters, P., Zuliani, L., Maxwell, S., Zandi, M. S., Friese, M. A., Galea, I., Kullmann, D. M., Beeson, D., Lang, B., Bien, C. G., & Vincent, A. (2010). N-methyl-D- aspartate antibody encephalitis: Temporal progression of clinical and paraclinical observations in a predominantly non-paraneoplastic disorder of both sexes. Brain: A Journal of Neurology, 133(Pt 6), 1655–1667. DOI: 10.1093/brain/awq113

Joubert, B., Saint-Martin, M., Noraz, N., Picard, G., Rogemond, V., Ducray, F., Desestret, V., Psimaras, D., Delattre, J., Antoine, J. & Honnorat, J. (2016). Characterization of Subtype of Autoimmune Encephalitis With Anti-Contactin-Associated Protein-like 2 Antibodies in the Cerebrospinal Fluid, Prominent Limbic Symptoms, and Seizures. JAMA Neurology, 73(3), 1115-1124. DOI:10.1001/jamaneurol.2016.1585

Kruer, M. C., Hoeftberger, R., Lim, K. Y., Coryell, J. C., Svoboda, M. D., Woltjer, R. L., Dalmau, J. (2014). Aggressive course in encephalitis with opsoclonus, ataxia, chorea, and seizures: The first pediatric case of γ-aminobutyric acid type B receptor autoimmunity. JAMA Neurology, 71(5), 620-623. DOI:10.1001/jamaneurol.2013.4786

Lancaster, E., Lai, M., Peng, X., Hughes, E., Constantinescu, R., Raizer, J., Friedman, D., Skeen, M. B., Grisold, W., Kimura, A., Ohta, K., Iizuka, T., Guzman, M., Graus, F., Moss, S. J., Balice-Gordon, R., & Dalmau, J. (2010). Antibodies to the GABA(B) receptor in limbic encephalitis with seizures: Case series and characterisation of the antigen. The Lancet. Neurology, 9(1), 67–76. DOI: 10.1016/S1474-4422(09)70324-2

Lancaster, E., Martinez-Hernandez, E., Titulaer, M. J., Boulos, M., Weaver, S., Antoine, J.-C., Liebers, E., Kornblum, C., Bien, C. G., Honnorat, J., Wong, S., Xu, J., Contractor, A., Balice-Gordon, R., y Dalmau, J. (2011). Antibodies to metabotropic glutamate receptor 5 in the Ophelia syndrome. Neurology, 77(18), 1698–1701. DOI: 10.1212/WNL.0b013e3182364a44

Li, F., & Tsien, J. Z. (2009). Memory and the NMDA Receptors. New England Journal of Medicine, 361(3), 302–303. DOI: 10.1056/NEJMcibr0902052

López-Sandoval, M. A. & Aldana-López, J.A. (2022). Síndromes neuropsiquiátricos asociados a encefalitis autoinmune. Revista Médico-Científica de la Secretaría de Salud Jalisco, 9(1), 35-44.

Lowas, S. R., y Lettieri, C. K. (2021). A Case of Anti-NMDA Receptor Encephalitis During Dinutuximab Therapy for Neuroblastoma. Journal of Pediatric Hematology/Oncology, 43(1), e127–e129. DOI: 10.1097/MPH.0000000000001632

Martinez-Hernandez, E., Horvath, J., Shiloh-Malawsky, Y., Sangha, N., Martinez-Lage, M., & Dalmau, J. (2011). Analysis of complement and plasma cells in the brain of patients with anti-NMDAR encephalitis. Neurology, 77(6), 589–593. DOI: 10.1212/WNL.0b013e318228c136

Mat, A., Adler, H., Merwick, A., Chadwick, G., Gullo, G., Dalmau, J. O., & Tubridy, N. (2013). Ophelia syndrome with metabotropic glutamate receptor 5 antibodies in CSF. Neurology, 80(14), 1349–1350. DOI: 10.1212/WNL.0b013e31828ab325

Menke, A. F., Ismail, F. S., Dornmair, K., Cerina, M., Meuth, S. G., & Melzer, N. (2022). GABAA Receptor Autoantibodies Decrease GABAergic Synaptic Transmission in the Hippocampal CA3 Network. International journal of molecular sciences, 23(7), 3707. https://doi.org/10.3390/ijms23073707

Menke, A. F., Ismail, F. S., Dornmair, K., Cerina, M., Meuth, S. G., & Melzer, N. (2022). GABAA Receptor Autoantibodies Decrease GABAergic Synaptic Transmission in the Hippocampal CA3 Network. International Journal of Molecular Sciences, 23(7), 3707. DOI: 10.3390/ijms23073707

Montojo, M., Petit-Pedrol, M., Graus, F. & Dalmau, J. (2015). Espectro clínico y valor diagnóstico de los anticuerpos contra el complejo proteico asociado a canales de potasio. Neuorología, 30(5), 295-301. DOI:10.1016/j.nrl.2013.12.007

Moscato, E. H., Peng, X., Jain, A., Parsons, T. D., Dalmau, J., & Balice-Gordon, R. J. (2014). Acute mechanisms underlying antibody effects in anti–N-methyl-D-aspartate receptor encephalitis. Annals of Neurology, 76(1), 108–119. DOI: 10.1002/ana.24195

Nutma, E., Willison, H., Martino, G., y Amor, S. (2019). Neuroimmunology – the past, present and future. Clinical y Experimental Immunology, 197(3), 278–293. DOI: 10.1111/cei.13279

O’Connor, K., Waters, P., Komorowski, L., Zekeridou, A., Guo, C.-Y., Mgbachi, V. C., Probst, C., Mindorf, S., Teegen, B., Gelfand, J. M., Geschwind, M. D., Lennon, V., Pittock, S. J., & McKeon, A. (2019). GABAA receptor autoimmunity. Neurology® Neuroimmunology y Neuroinflammation, 6(3), e552. DOI: 10.1212/NXI.0000000000000552

Ohkawa, T., Satake, S., Yokoi, N., Miyazaki, Y., Ohshita, T., Sobue, G., Takashima, H., Watanabe, O., Fukata, Y., & Fukata, M. (2014). Identification and Characterization of GABAA Receptor Autoantibodies in Autoimmune Encephalitis. The Journal of Neuroscience, 34(24), 8151–8163. DOI: 10.1523/JNEUROSCI.4415-13.2014

Pantoja‐Ruiz, C., Santucci, C., Arenas, L., Casallas, L., & Castellanos, G. (2019). Autoimmune encephalitis: What has changed during the past 15 years? Clinical and Experimental Neuroimmunology, 10(4), 291–300. DOI: 10.1111/cen3.12536

Petit-Pedrol, M., Armangue, T., Peng, X., Bataller, L., Cellucci, T., Davis, R., McCracken, L., Martinez-Hernandez, E., Mason, W. P., Kruer, M. C., Ritacco, D. G., Grisold, W., Meaney, B. F., Alcalá, C., Sillevis-Smitt, P., Titulaer, M. J., Balice-Gordon, R., Graus, F., & Dalmau, J. (2014). Encephalitis with refractory seizures, status epilepticus, and antibodies to the GABAA receptor: A case series, characterisation of the antigen, and analysis of the effects of antibodies. The Lancet. Neurology, 13(3), 276–286. DOI: 10.1016/S1474- 4422(13)70299-0

Pradhan, S., Das, A., Das, A. & Mulmuley, M. (2019). Antibody Negative Autoimmune Encephalitis- Does it Differ from Definite One?.Annals of Indian Academy of Neurology, 22 (4), 401-408. DOI: 10.4103/aian.AIAN_206_19

Qin, X., Yang, H., Zhu, F., Wang, Q. & Shan, W. (2021). Clinical Character of CASPR2 Autoimmune Encephalitis: AMultiple Center Retrospective Study. Frontiers in Immunology, 12, 652864. DOI:10.3389/fimmu.2021.652864

Rutatangwa, A., Mittal, N., Francisco, C., Nash, K., & Waubant, E. (2020). Autoimmune Encephalitis in Children: A Case Series at a Tertiary Care Center. Journal of Child Neurology, 35(9), 591–599. DOI: 10.1177/0883073820923834

Saint-Martin, M., Joubert, B., Pellier-Monnin, V., Pascual, O. Noraz, N. & Honnorat, J. (2018). Contactin-associated protein-like 2, a protein of the neurexin family involved in several human diseases. European Journal of Neuroscience, 8(3), 1906-1923. DOI: 10.1111/ejn.14081

Saiz, A., Blanco, Y., Sabater, L., González, F., Bataller, L., Casamitjana, R., Ramá-Torrentá, L. & Graus, F. (2008). Espectro de síndromes neurológicos asociados con anticuerpos de descarboxilasa de ácido glutámico: pistas de diagnóstico para esta asociación. Cerebro, 131(10), 2553-2563. DOI: 10.1093/brain/awn183

Sakimoto, Y., Oo, P. M.-T., Goshima, M., Kanehisa, I., Tsukada, Y., & Mitsushima, D. (2021). Significance of GABAA Receptor for Cognitive Function and Hippocampal Pathology. International Journal of Molecular Sciences, 22(22), 12456. DOI:10.3390/ijms222212456

Sanabria-Sanchinel, A., Escobar-Pineda, E., Gramajo-Juárez, A., León-Aldana, J. & Lara-Girón, J. (2021). Encefalitis límbica autoinmune asociada a anticuerpos LGI1 con respuesta a rituximab. Elservier, 1(1), 98-100. DOI: 10.1016/j.neurop.2021.01.001

Sánchez-Ordúz, L., Pérez-Larraya, G., Grisanti, F., Centeno, M. & Arbizu, J. (2020). Caspr2 antibody-associated limbic encephalitis: contribution of visual aided analysis of 18 F-FDG PET images using normal database comparison. Revista Española de Medicina Nuclear e Imagen Molecular, 39(2), 92-95. DOI:10.1016/j.remnie.2019.11.003

Sansing, L. H., Tüzün, E., Ko, M. W., Baccon, J., Lynch, D. R., & Dalmau, J. (2007). A patient with encephalitis associated with NMDA receptor antibodies. Nature Clinical Practice Neurology, 3(5), 291–296. DOI: 10.1038/ncpneuro0493

Sarigecili, E., Cobanogullari, M. D., Komur, M., & Okuyaz, C. (2019). A rare concurrence: Antibodies against Myelin Oligodendrocyte Glycoprotein and N-methyl-d-aspartate receptor in a child. Multiple Sclerosis and Related Disorders, 28, 101–103. DOI: 10.1016/j.msard.2018.12.017

Seery, N., Butzkueven, H., O'Brien, T. J., & Monif, M. (2022). Contemporary advances in anti-NMDAR antibody (Ab)-mediated encephalitis. Autoimmunity Reviews, 21(4), 103057. https://doi.org/10.1016/j.autrev.2022.103057

Shekunov, J., Blacker, C. J., Vande Voort, J. L., Tillema, J. M., Croarkin, P. E., & Romanowicz, M. (2020). Immune mediated pediatric encephalitis - need for comprehensive evaluation and consensus guidelines. BMC neurology, 20(1), 44. https://doi.org/10.1186/s12883-020-1605-yShiwaku, H., Nakano, Y., Kato, M., & Takahashi, H. (2020). Detection of autoantibodies against GABAARα1 in patients with schizophrenia. Schizophrenia Research, 216, 543–546. DOI: 10.1016/j.schres.2019.10.007

Spatola, M., Petit-Pedrol, M., Simabukuro, M. M., Armangue, T., Castro, F. J., Barcelo Artigues, M. I., Julià Benique, M. R., Benson, L., Gorman, M., Felipe, A., Caparó Oblitas, R. L., Rosenfeld, M. R., Graus, F., & Dalmau, J. (2017). Investigations in GABAA receptor antibody-associated encephalitis. Neurology, 88(11), 1012–1020. DOI: 10.1212/WNL.0000000000003713

Steiner, I., Budka, H., Chaudhuri, A., Koskiniemi, M., Sainio, K., Salonen, O., & Kennedy, P. G. E. (2005). Viral encephalitis: A review of diagnostic methods and guidelines for management. European Journal of Neurology, 12(5), 331–343. DOI: 10.1111/j.1468-1331.2005.01126.x

Sun, Y., Qin, X., Huang, D., Zhou, Z., Zhang, Y., & Wang, Q. (2023). Anti-amphiphysin encephalitis: Expanding the clinical spectrum. Frontiers in Immunology, 14, 1084883. https://doi.org/10.3389/fimmu.2023.1084883

Tanaka, K., Kawamura, M., Sakimura, K., & Kato, N. (2020). Significance of Autoantibodies in Autoimmune Encephalitis in Relation to Antigen Localization: An Outline of Frequently Reported Autoantibodies with a Non-Systematic Review. International Journal of Molecular Sciences, 21(14), 4941. DOI: 10.3390/ijms21144941

Temboury Molina, M.A., Ruiz-Franco, M.A., Palmi, I. & Villamor, R. (2016). Encefalitis límbica autoinmune en una niña con diabetes tipo I. Hallazgos clínicos y evolución. Endocrinología y Nutrición, 63(6), 308-310. DOI: 10.1016/j.endonu.2016.03.004

Uy, C. E., Binks, S., & Irani, S. R. (2021). Autoimmune encephalitis: Clinical spectrum and management. Practical Neurology, 21(5), 412–423. DOI: 10.1136/practneurol-2020-002567

Valle, D. A. do, Santos, M. L. S. F., Spinosa, M. J., Telles, B. A., Prando, C., & Cordeiro, M. L. (2021). GABAA receptor encephalitis associated with human parvovirus B19 virus infection: Case report. Medicine, 100(23), e26324. DOI: 10.1097/MD.0000000000026324

Van Sonderen,A., Ariño, H., Petit-Pedrol, M., Leypoldt, F., Kötvélyessy, P. Wandinger, K., Lancaster, E., Wirtz, P., Schreurs, M., Sillevis, P., Graus, F., Dalmau, J. & Titulaer, M. (2016). The clinical spectrum of Caspr2 antibody-associated disease. Neurology, 87(5), 521-528. DOI: 10.1212/WNL.0000000000002917

Venkatesan, A., & Adatia, K. (2017). Anti-NMDA-Receptor Encephalitis: From Bench to Clinic. ACS Chemical Neuroscience, 8(12), 2586–2595. DOI: 10.1021/acschemneuro.7b00319

Wu, L., Cai, F., Zhuo, Z., Wu, D., Zhang, T., Yang, H., Fang, H. & Xiao, Z. (2023). CASPR2 antibody associated neurological syndromes in children. Scientific Reports, 13, 2073. DOI: 10.1038/s41598-023-28268-x

Wu, P.-M., Teng, C.-K., Chou, Y.-Y., & Tu, Y.-F. (2021). Precocious puberty as a consequence of anti-NMDA receptor encephalitis in children. Pediatrics and Neonatology, 62(4), 361–368. DOI: 10.1016/j.pedneo.2021.03.004

Zhang, T.-Y., Cai, M.-T., Zheng, Y., Lai, Q.-L., Shen, C.-H., Qiao, S., & Zhang, Y.-X. (2021). Anti-Alpha-Amino-3-Hydroxy-5-Methyl-4-Isoxazolepropionic Acid Receptor Encephalitis: A Review. Frontiers in Immunology, 12, 652820. DOI: 10.3389/fimmu.2021.652820

Zhu, S., Noviello, C. M., Teng, J., Walsh, R. M., Kim, J. J., & Hibbs, R. E. (2018). Structure of a human synaptic GABA-A receptor. Nature, 559(7712), 67–72. DOI: 10.1038/s41586-018-0255-3

Zuliani, L., Graus, F., Giometto, B., Bien, C. y Vincent, A. (2016). Central nervous system neuronal Surface antibody associated síndromes: review and guidelines for recognition. Neurology, Neurosurgery & Psychiatry. 83 (6), 638-645. DOI: 10.1136/jnnp-2011-301237

Publicado
2024-01-05
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Barona-Flores, M. F., Hernández-González, J. C., Olave-Leyva, J. I., & Castrejón-Jiménez, N. S. (2024). Actualidades en encefalitis autoinmunes mediadas por anticuerpos en pediatría. Pädi Boletín Científico De Ciencias Básicas E Ingenierías Del ICBI, 11(22), 52-58. https://doi.org/10.29057/icbi.v11i22.11051
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