{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:20:23Z","timestamp":1774952423597,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Autoimmune encephalitis (AE) encompasses a broad group of inflammatory encephalopathies mediated by immune responses against central nervous system (CNS) antigens. With the expanding spectrum of identified anti-neuronal antibodies and their increasing clinical recognition, the number of confirmed AE cases has risen. Notably, cases involving concurrent positivity for multiple anti-neuronal antibodies have emerged, complicating both diagnosis and treatment. To date, no published reports have described the co-occurrence of anti-leucine-rich glioma-inactivated 1 (LGI1) antibody and anti-metabotropic glutamate receptor 2 (mGluR2) antibody in AE patients. We report a case of a 61-year-old woman presenting with impaired responsiveness, gait disturbance, and language disorders. Serological and cerebrospinal fluid (CSF) analyses revealed positivity for both LGI1 and mGluR2 antibodies. The anti-LGI1 antibody titers were 1:32+ (serum) and 1:1+ (CSF), while anti-mGluR2 antibody titers were 1:100+ (serum) and 1:10+ (CSF). Based on clinical manifestations and diagnostic findings, the patient was diagnosed with AE with concurrent anti-LGI1 and anti-mGluR2 antibody positivity. The patient received intravenous immunoglobulin (IVIG) and methylprednisolone pulse therapy (500 mg\/day), resulting in symptomatic improvement. Following discharge, maintenance therapy with oral prednisone acetate and mycophenolate mofetil was initiated. At the one-week follow-up, her condition remained stable; however, she succumbed to death at the two-week follow-up due to complications from poor oral intake.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1609389","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T05:46:58Z","timestamp":1748584018000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case Report: Coexistence of anti-LGI1 and anti-mGluR2 antibodies in an autoimmune encephalitis patient"],"prefix":"10.3389","volume":"16","author":[{"given":"Xudong","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingqing","family":"Geng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changjiang","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuanqiang","family":"Qu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e26659","article-title":"Coexistence of anti-NMDAR and anti-IgLON5 antibodies in an autoimmune encephalitis patient: The first case report","volume":"10","author":"Tian","year":"2024","journal-title":"Heliyon"},{"key":"B2","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/S1474-4422(15)00401-9","article-title":"A clinical approach to diagnosis of autoimmune encephalitis","volume":"15","author":"Graus","year":"2016","journal-title":"Lancet Neurol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70137-X","article-title":"Investigation of LGI1 as the antigen in limbic encephalitis previously attributed to potassium channels: a case series","volume":"9","author":"Lai","year":"2010","journal-title":"Lancet Neurol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003173","article-title":"Anti-LGI1 encephalitis: Clinical syndrome and long-term follow-up","volume":"87","author":"Van Sonderen","year":"2016","journal-title":"Neurology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbae155","article-title":"Anti-LGI1 antibody-associated encephalitis misdiagnosed as schizophrenia: A case report","volume":"50","author":"Zhang","year":"2024","journal-title":"Schizophr Bull"},{"key":"B6","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12883-019-1251-4","article-title":"Antibody-LGI 1 autoimmune encephalitis manifesting as rapidly progressive dementia and hyponatremia: a case report and literature review","volume":"19","author":"Li","year":"2019","journal-title":"BMC Neurol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.1942-23","article-title":"Anti-leucine-rich glioma-inactivated 1 protein-antibody positive encephalitis with extensive unilateral cerebral cortex and white matter lesions","volume":"63","author":"Kihara","year":"2024","journal-title":"Intern Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1212\/nxi.0000000000001088","article-title":"Rituximab treatment and long-term outcome of patients with autoimmune encephalitis: real-world evidence from the GENERATE registry","volume":"8","author":"Thaler","year":"2021","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2025.e41747","article-title":"Efficacy of rituximab as second-line therapy for autoimmune encephalitis: A systematic review and meta-analysis","volume":"11","author":"Zhang","year":"2025","journal-title":"Heliyon"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207746","article-title":"Survival analysis of immunotherapy effects on relapse rate in pediatric and adult autoimmune encephalitis","volume":"101","author":"Yang","year":"2023","journal-title":"Neurology"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.21037\/qims-22-1185","article-title":"Anti-metabotropic-glutamate-receptor 2-related encephalitis with cerebellar ataxia: a case description","volume":"13","author":"Li","year":"2023","journal-title":"Quant Imaging Med Surg"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-9077-1_15","article-title":"Glutamate receptor antibodies in autoimmune central nervous system disease: basic mechanisms, clinical features, and antibody detection","volume":"1941","author":"Scotton","year":"2019","journal-title":"Methods Mol Biol"},{"key":"B13","article-title":"A case of anti-mGluR2 encephalitis mainly presenting as mental disorder and literature review [J]","volume":"32","author":"Liang","year":"2025","journal-title":"Chin J Neuroimmunol Neurol."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000658","article-title":"Paraneoplastic cerebellar ataxia and antibodies to metabotropic glutamate receptor 2","volume":"7","author":"Ruiz-Garc\u00eda","year":"2020","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.772763","article-title":"Case report: prominent brainstem involvement in two patients with anti-CASPR2 antibody-associated autoimmune encephalitis","volume":"12","author":"Liu","year":"2021","journal-title":"Front Immunol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011297","article-title":"Bilateral thalamic lesions associated with atezolizumab-induced autoimmune encephalitis","volume":"96","author":"Nishijima","year":"2021","journal-title":"Neurology"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1609389\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T05:46:59Z","timestamp":1748584019000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1609389\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":16,"alternative-id":["10.3389\/fimmu.2025.1609389"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1609389","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]},"article-number":"1609389"}}