OBJECTIVE To determine the prevalence of cerebrospinal fluid (CSF) markers associated with inflammation (i.e., elevated white blood cell count, protein concentration, and CSF-specific oligoclonal bands) in patients with early active autoimmune encephalitis (AE). METHODS CSF characteristics, including WBC count, protein concentration, and oligoclonal banding, were analyzed in patients diagnosed with AE at two tertiary care centers. RESULTS Ninety-five patients were included in the study. CSF white blood cell counts and protein levels were within normal limits for 27% (CI95%: 19-37) of patients with AE. When results of oligoclonal banding were added, 14% (CI95%: 6-16) of patients with AE had "normal" CSF. The median CSF white blood cell count was 8 cells/mm3 (range: 0-544) and the median CSF protein concentration was 0.42 g/L (range: 0.15-3.92). CONCLUSIONS White blood cell counts and protein levels were within normal limits in the CSF of a substantial proportion of patients with early active AE. Inclusion of CSF oligoclonal banding identified a higher proportion of patients with an inflammatory CSF profile, especially when CSF was sampled early in the disease process.

中文翻译：

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寻找自身免疫性脑炎：小心脑脊液正常

目的 确定早期活动性自身免疫性脑炎 (AE) 患者中与炎症相关的脑脊液 (CSF) 标志物（即升高的白细胞计数、蛋白质浓度和 CSF 特异性寡克隆带）的患病率。方法 对两个三级医疗中心诊断为 AE 的患者的 CSF 特征进行分析，包括 WBC 计数、蛋白质浓度和寡克隆带。结果 研究中包括 95 名患者。27% (CI95%: 19-37) 的 AE 患者的脑脊液白细胞计数和蛋白质水平在正常范围内。当加入寡克隆条带结果时，14% (CI95%: 6-16) 的 AE 患者的脑脊液“正常”。脑脊液白细胞计数中位数为 8 个细胞/mm3（范围：0-544），脑脊液蛋白浓度中位数为 0.42 g/L（范围：0. 15-3.92)。结论 相当大比例的早期活动性 AE 患者的脑脊液中的白细胞计数和蛋白质水平在正常范围内。包含 CSF 寡克隆带确定了更高比例的具有炎症性 CSF 特征的患者，尤其是在疾病过程的早期对 CSF 进行采样时。