{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:12:12Z","timestamp":1783357932356,"version":"3.54.6"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      \u03b3\u2010Aminobutyric acid B receptor (GABA\n                      <jats:sub>B<\/jats:sub>\n                      R)\u2010IgG (immunoglobulin G) is an intermediate\u2010risk paraneoplastic autoantibody often associated with seizures. We aimed to assess the clinical and oncological features of GABA\n                      <jats:sub>B<\/jats:sub>\n                      R\u2010IgG autoimmune encephalitis (AE) and evaluate the performance of antibody testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients testing positive for GABA\n                      <jats:sub>B<\/jats:sub>\n                      R\u2010IgG in serum\/cerebrospinal fluid (CSF) at Mayo Clinic Neuroimmunology Laboratory were identified. Archived sera were retested by cell\u2010based assay (CBA) at 1:100 and 1:200 dilutions. A live\u2010cell flow cytometry\u2013based assay (LCFBA) was developed and validated using archived sera and CSF. True positivity included patients with classic presentations of GABA\n                      <jats:sub>B<\/jats:sub>\n                      R\u2010IgG AE or oncological explanations for antibody presence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010six patients (median age 63\u2009years; 43 female) presented with classic presentations of GABA\n                      <jats:sub>B<\/jats:sub>\n                      R\u2010IgG AE: encephalopathy with prominent seizures (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955), status epilepticus (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923), and rapidly progressive dementia (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098). In addition, 44 patients (33%) had a false\u2010positive result for GABA\n                      <jats:sub>B<\/jats:sub>\n                      R\u2010IgG characterized by non\u2010specific symptoms\/alternate diagnoses. Malignancy was identified in 78% of true\u2010positive patients, predominantly small cell lung carcinoma (SCLC). Testing serum at 1:100 dilution on CBA and using tissue immunofluorescence assay (IFA) in serum and CSF improved the identification of true\u2010positive patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). CBA at 1:100 dilution performed better than conventional CBA (at 1:10 dilution,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and tissue IFA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031). An in\u2010house LCFBA showed 100% sensitivity and specificity in CSF, performing similarly to conventional CBA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.125) in CSF, but better than tissue IFA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031). Furthermore, serum LCFBA performed better than conventional CBA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022) and tissue IFA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). LCFBA had the highest diagnostic accuracy and was closely followed by CBA at 1:100 dilution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>\n                      GABA\n                      <jats:sub>B<\/jats:sub>\n                      R\u2010IgG AE often presents as encephalopathy with seizures or status epilepticus in the context of an underlying SCLC. Multimodal evaluation using tissue IFA and fixed CBA at higher dilutions improves detection of true cases. LCFBA performs very well as a diagnostic test with very high sensitivity and specificity.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.18654","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T15:09:18Z","timestamp":1759244958000},"page":"187-198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Anti\u2010\u03b3\u2010aminobutyric acid B receptor autoimmune encephalitis: Clinical presentation and diagnostic insights"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2185-4385","authenticated-orcid":false,"given":"Naveen K.","family":"Paramasivan","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9581-5090","authenticated-orcid":false,"given":"Jennifer A.","family":"McCombe","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0999-215X","authenticated-orcid":false,"given":"Andrea","family":"Stabile","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"},{"name":"Epilepsy Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"Fryer","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2269-546X","authenticated-orcid":false,"given":"Abhigyan","family":"Datta","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Rezk","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihar","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0147-8159","authenticated-orcid":false,"given":"Jeffrey W.","family":"Britton","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6661-2910","authenticated-orcid":false,"given":"Eoin P.","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6856-8143","authenticated-orcid":false,"given":"Andrew","family":"McKeon","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1025-4760","authenticated-orcid":false,"given":"John 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