Clinical, diagnostic and therapeutic challenges and pitfalls in AIE
| Clinical challenges | Diagnostic pitfalls | Therapeutic challenges |
|---|---|---|
| 1. Lack of comprehensive clinical data; Insufficient data can hinder accurate diagnosis. 2. Diagnostic challenges for atypical cases; Unusual presentations may delay or complicate diagnosis. 3. Overlapping symptoms with other disorders; Symptoms may resemble other neurological conditions. 4. Variability in disease progression; The disease can manifest differently in different individuals. |
1. Inaccessible antibody testing; Results may take several weeks to obtain in many institutions. 2. Lack of autoantibodies does not exclude immune-mediated disorders; The absence of autoantibodies does not rule out an immune cause. 3. Positive autoantibody test does not guarantee accurate diagnosis; A positive test does not always mean the disorder is present. 4. Lack of specific biomarkers; Current biomarkers may not be definitive for all cases. |
1. Difficulty in early diagnosis; The initial symptoms can be nonspecific and may mimic other neurological or psychiatric diseases. 2. First-like vs. second-like therapies: While first-line therapies (steroids, IVIG, and plasmapheresis) can be effective for many, more aggressive second-line therapies, such as rituximab or cyclophosphamide is required in some patients. 3. Treatment resistance; some patients may not respond adequately to standard therapies. 4. Relapse and side effect; Even after successful initial treatment, AIE can relapse and potential side effects ranging from infections to organ toxicities. |
IVIG, intravascular immunoglobin treatment.