Journal of neuroimmunology · 2026
Antibodies in Creutzfeldt-Jakob disease: A systematic review of patient characteristics, diagnostics, and clinical implications.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Bilavu Raluca, Benta Marius, Cornea Amalia, Vasiluta Lucian, Rosca Elena Cecilia
Аннотация
BACKGROUND: Creutzfeldt-Jakob disease (CJD) is a rare, rapidly progressive prion neurodegenerative disorder causing fatal dementia. Recently, reports have identified various autoantibodies in confirmed CJD patients, raising questions about their significance. We performed a scoping review of published CJD cases with co-occurring antibodies, including antineuronal (e.g., NMDAR, LGI1, CASPR2, VGKC, GAD65, GlyR), anti-thyroid peroxidase, antinuclear, and infection-related antibodies, to characterize patient demographics, clinical and diagnostic features, and outcomes, and explore the pathophysiological implications of this association.
METHODS: We searched PubMed and Scopus databases up to June 2024, following a published protocol. We included definite/probable CJD cases in which serum/CSF testing detected autoantibodies. Demographic information, clinical presentations, diagnostic findings, treatments, and outcomes were analyzed.
RESULTS: We identified 65 CJD patients with co-occurring antibodies and reported an additional case of a 58-year-old woman with genetic CJD and co-existing anti-TPO and weakly positive CASPR2 antibodies. The median age was 61 years (range 28-82), with NMDAR-Ab patients older and LGI1/CASPR2-Ab cases younger. Most were diagnosed with sporadic CJD (86%) and confirmed by CJD biomarkers (RT-QuIC 100%, 14-3-3 92.6%, Tau 91.7%). Antibodies were mainly found in serum (87.2% vs. 29.8% in CSF). Rapidly progressive dementia was universal, with gait impairment (71.9%) and movement disorders (59.4%) being common. Most cases showed no improvement with immunotherapy, indicating that antibodies may be an epiphenomenon. However, a few cases had transient or partial improvement, suggesting a possible modulatory role or dual pathology.
CONCLUSION: Antibodies are increasingly noted in CJD as a secondary effect of neurodegeneration. They complicate diagnosis and rarely suggest treatable aspects of the disease. More research is needed to clarify their complex role.
METHODS: We searched PubMed and Scopus databases up to June 2024, following a published protocol. We included definite/probable CJD cases in which serum/CSF testing detected autoantibodies. Demographic information, clinical presentations, diagnostic findings, treatments, and outcomes were analyzed.
RESULTS: We identified 65 CJD patients with co-occurring antibodies and reported an additional case of a 58-year-old woman with genetic CJD and co-existing anti-TPO and weakly positive CASPR2 antibodies. The median age was 61 years (range 28-82), with NMDAR-Ab patients older and LGI1/CASPR2-Ab cases younger. Most were diagnosed with sporadic CJD (86%) and confirmed by CJD biomarkers (RT-QuIC 100%, 14-3-3 92.6%, Tau 91.7%). Antibodies were mainly found in serum (87.2% vs. 29.8% in CSF). Rapidly progressive dementia was universal, with gait impairment (71.9%) and movement disorders (59.4%) being common. Most cases showed no improvement with immunotherapy, indicating that antibodies may be an epiphenomenon. However, a few cases had transient or partial improvement, suggesting a possible modulatory role or dual pathology.
CONCLUSION: Antibodies are increasingly noted in CJD as a secondary effect of neurodegeneration. They complicate diagnosis and rarely suggest treatable aspects of the disease. More research is needed to clarify their complex role.