There is no known biomarker that predicts the response to immune therapy in autoimmune synaptic encephalitis. Thus, we investigated serum albumin as a prognostic biomarker of early immune therapies in patients with autoimmune encephalitis. We enrolled patients who were diagnosed with definite autoimmune encephalitis and underwent IVIg treatment at Seoul National University Hospital from 2012 to 2017. Patients were dichotomized according to serum albumin prior to IVIg administration with a cut-off level of 4.0 g/dL, which was the median value of 50% of patients. Seventeen (53.1%) of the 32 patients with definite autoimmune encephalitis who received IVIg treatment in our hospital had low serum albumin (<4.0 g/dL). The initial disease severity (mRS ≥ 4) was the sole factor that predicted low albumin in autoimmune encephalitis patients using multivariate analysis (P = 0.013). The low albumin group exhibited a worse response to immune therapy at the third and fourth weeks from IVIg administration (P < 0.01 and P = 0.012, respectively), and recovery to activities of daily life without assistance was faster in the high albumin group (log-rank test for trend, P < 0.01). Our study found that pretreatment low serum albumin was a significant indicator of autoimmune encephalitis prognosis in the short-term and long-term.

中文翻译：

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高白蛋白水平预示着自身免疫性脑炎对免疫治疗反应良好。

没有已知的生物标记可以预测自身免疫性突触性脑炎对免疫治疗的反应。因此，我们调查了血清白蛋白作为自身免疫性脑炎患者早期免疫治疗的预后生物标志物。我们纳入了2012年至2017年在首尔国立大学医院被确诊为自身免疫性脑炎并接受过IVIg治疗的患者。在给予IVIg之前，根据血清白蛋白将患者分为两部分，最低水平为4.0 g / dL，即患者中位数为50％。在我院接受IVIg治疗的32例自身免疫性脑炎确诊患者中，有17例（53.1％）的血清白蛋白低（<4.0 g / dL）。最初的疾病严重程度（mRS≥4）是使用多因素分析预测自身免疫性脑炎患者白蛋白低的唯一因素（P = 0.013）。低白蛋白组在IVIg给药后第3周和第4周对免疫疗法的反应较差（分别为P <0.01和P = 0.012），高白蛋白组在没有帮助的情况下恢复日常生活的活动更快（log趋势的等级检验，P <0.01）。我们的研究发现，在短期和长期内，低血清白蛋白预处理是自身免疫性脑炎预后的重要指标。高白蛋白组患者在没有帮助的情况下恢复日常生活活动的速度更快（趋势的log-rank检验，P <0.01）。我们的研究发现，在短期和长期内，低血清白蛋白预处理是自身免疫性脑炎预后的重要指标。高白蛋白组患者在没有帮助的情况下恢复日常生活活动的速度更快（趋势的log-rank检验，P <0.01）。我们的研究发现，在短期和长期内，低血清白蛋白预处理是自身免疫性脑炎预后的重要指标。