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Background and objective <p>Autoimmune encephalitis (AE) is an increasingly recognized inflammatory disorder of the central nervous system associated with autoantibodies against intracellular and surface membrane autoantigens. However, longitudinal studies for describing changes about diagnosis, therapeutic approaches, and economic burden of AE in China remain limited.</p> Methods <p>We conducted a retrospective multi-center study, including 436 patients with definite AE diagnosed between January 2015 and December 2024 across five tertiary medical centers in eastern China. Evolution of demographic characteristics, diagnostic approaches, immunotherapies, clinical outcomes, and inpatient costs were systematically reviewed.</p> Results <p>The annual number of diagnosed AE cases increased steadily over the past decade, accompanied by a diversification of AE subtypes. Anti-NMDAR and anti-LGI1 encephalitis remained the most common forms, while cases with novel antibodies and antibody-negative AE increased notably after 2019, paralleling expanded antibody testing and PET imaging. Median diagnostic delay decreased significantly from 87&#xa0;days in 2015 to 22&#xa0;days in 2024. The use of second-line treatment rose substantially, reaching 46.4% in 2024. Correspondingly, the proportion of patients achieving good favorable outcome (mRS ≤ 2) significantly increased over time. Inpatient costs showed an overall upward trend across all AE subtypes, particularly after 2020, reflecting broader application of advanced diagnostics and immunotherapies.</p> Conclusions <p>This study reveals the evolution of diagnosis, treatment, and economic burden of AE in Eastern China, characterized by earlier diagnosis, expanded therapeutic strategies, and improved clinical outcomes. Rising inpatient costs underscore the need to balance healthcare expenditures with therapeutic benefits, particularly across heterogeneous AE subtypes.</p>

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Autoimmune encephalitis in eastern China over last decade: a multi-center retrospective study

  • 期刊论文

  • 发表日期：

    2026年7月23日

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  • Jingguo Wang,
  • Xilong Wang,
  • Qinming Zhou,
  • Lu He,
  • Huanyu Meng,
  • Siyu Dong,
  • Yong Hao,
  • Yanlin Zhang,
  • Yajun Lian,
  • Shengjun Wang,
  • Sheng Chen

摘要

Background and objective

Autoimmune encephalitis (AE) is an increasingly recognized inflammatory disorder of the central nervous system associated with autoantibodies against intracellular and surface membrane autoantigens. However, longitudinal studies for describing changes about diagnosis, therapeutic approaches, and economic burden of AE in China remain limited.

Methods

We conducted a retrospective multi-center study, including 436 patients with definite AE diagnosed between January 2015 and December 2024 across five tertiary medical centers in eastern China. Evolution of demographic characteristics, diagnostic approaches, immunotherapies, clinical outcomes, and inpatient costs were systematically reviewed.

Results

The annual number of diagnosed AE cases increased steadily over the past decade, accompanied by a diversification of AE subtypes. Anti-NMDAR and anti-LGI1 encephalitis remained the most common forms, while cases with novel antibodies and antibody-negative AE increased notably after 2019, paralleling expanded antibody testing and PET imaging. Median diagnostic delay decreased significantly from 87 days in 2015 to 22 days in 2024. The use of second-line treatment rose substantially, reaching 46.4% in 2024. Correspondingly, the proportion of patients achieving good favorable outcome (mRS ≤ 2) significantly increased over time. Inpatient costs showed an overall upward trend across all AE subtypes, particularly after 2020, reflecting broader application of advanced diagnostics and immunotherapies.

Conclusions

This study reveals the evolution of diagnosis, treatment, and economic burden of AE in Eastern China, characterized by earlier diagnosis, expanded therapeutic strategies, and improved clinical outcomes. Rising inpatient costs underscore the need to balance healthcare expenditures with therapeutic benefits, particularly across heterogeneous AE subtypes.