{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T03:51:49Z","timestamp":1771300309874,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":75,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Our objective was to study the relationship between epilepsy and autoimmune diseases in two different types of epilepsy: idiopathic generalized epilepsies (IGEs) and mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE\u2010HS). The contribution of the human leukocyte antigen (HLA) system to this relationship was analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients with IGEs and MTLE\u2010HS at a tertiary epilepsy center were consecutively enrolled between January 2016 and December 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 664 patients, 422 with IGEs and 242 with MTLE\u2010HS, were included. Patients with IGEs were 15\u2009years younger, on average, than patients with MTLE\u2010HS (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The frequency of autoimmune diseases was 5.5% (<jats:italic>n<\/jats:italic>\u2009=\u200923) and 4.5% (<jats:italic>n<\/jats:italic>\u2009=\u200911) in patients with IGEs and MTLE\u2010HS, respectively (<jats:italic>p<\/jats:italic>\u2009=\u2009.716). The mean age of autoimmune disease onset was 20\u2009\u00b1\u200915.6\u2009years in patients with IGEs and 36.7\u2009\u00b1\u200916.5\u2009years in patients with MTLE\u2010HS (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Clinical manifestations of autoimmune diseases preceded epilepsy onset in 30.4% of patients with IGEs (i.e., in early childhood); in the other patients, epilepsy appeared before autoimmune disease onset. In all but one patient with MTLE\u2010HS and autoimmune diseases, the autoimmune diseases appeared after epilepsy onset from adolescence onward.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Our study indicates two relationship patterns: a bidirectional association between IGEs and autoimmune diseases and a unidirectional relationship between MTLE\u2010HS and autoimmune diseases. The involvement of genetic susceptibility factors (such as the HLA system), autoinflammatory mechanisms, female sex, and antiseizure medications in these relationships are discussed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epd2.20048","type":"journal-article","created":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T04:16:10Z","timestamp":1680322570000},"page":"33-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Different relationships between epilepsy syndromes and autoimmune diseases"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8399-2671","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Chaves","sequence":"first","affiliation":[{"name":"Neurology Department Centro Hospitalar Universit\u00e1rio do Porto  Porto Portugal"},{"name":"UMIB \u2013 Biomedical Investigation Multidisciplinary Unit, Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar Universidade do Porto  Porto Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR)  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0936-4719","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Leal","sequence":"additional","affiliation":[{"name":"UMIB \u2013 Biomedical Investigation Multidisciplinary Unit, Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar Universidade do Porto  Porto Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR)  Porto Portugal"},{"name":"Immunogenetics Laboratory, Pathology and Molecular Immunology Department, Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar Universidade do Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Sardoeira","sequence":"additional","affiliation":[{"name":"Neurology Department Centro Hospitalar Universit\u00e1rio do Porto  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