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Greguletz, P; Plötz, M; Baade-Büttner, C; Bien, CG; Eisenhut, K; Geis, C; Handreka, R; Klausewitz, J; Körtvelyessy, P; Kovac, S; Kraft, A; Lewerenz, J; Malter, M; Nagel, M; von, Podewils, F; Prüß, H; Rada, A; Rau, J; Rauer, S; Rößling, R; Seifert-Held, T; Siebenbrodt, K; Sühs, KW; Tauber, SC; Thaler, F; Wagner, J; Wickel, J; Leypoldt, F; Rittner, HL; Sommer, C; Villmann, C; Doppler, K, , GENERATE, study, group.
Different pain phenotypes are associated with anti-Caspr2 autoantibodies.
J Neurol. 2024; Doi: 10.1007/s00415-024-12224-4 [OPEN ACCESS]
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Co-authors Med Uni Graz: Seifert-Held Thomas
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Abstract:: Autoantibodies against contactin-associated protein 2 (Caspr2) not only induce limbic autoimmune encephalitis but are also associated with pain conditions. Here, we analyzed clinical data on pain in a large cohort of patients included into the German Network for Research in Autoimmune Encephalitis. Out of 102 patients in our cohort, pain was a frequent symptom (36% of all patients), often severe (63.6% of the patients with pain) and/or even the major symptom (55.6% of the patients with pain). Pain phenotypes differed between patients. Cluster analysis revealed two major phenotypes including mostly distal-symmetric burning pain and widespread pain with myalgia and cramps. Almost all patients had IgG4 autoantibodies and some additional IgG1, 2, and/or 3 autoantibodies, but IgG subclasses, titers, and presence or absence of intrathecal synthesis were not associated with the occurrence of pain. However, certain pre-existing risk factors for chronic pain like diabetes mellitus, peripheral neuropathy, or preexisting chronic back pain tended to occur more frequently in patients with anti-Caspr2 autoantibodies and pain. Our data show that pain is a relevant symptom in patients with anti-Caspr2 autoantibodies and support the idea of decreased algesic thresholds leading to pain. Testing for anti-Caspr2 autoantibodies needs to be considered in patients with various pain phenotypes.
Find related publications in this database (Keywords): Caspr2; Pain; Autoantibody; IgG subclass; IgG4