Published case descriptions of VGKCC antibodies with predominantly psychiatric presentations
| Authors | Age, gender | VGKCC antibodies, highest titre (pmol/L), LGI1/Caspr2 antibody | Psychiatric presentation | Encephalopathic symptoms | Immunotherapy treatment and response |
|---|---|---|---|---|---|
| Parthasarathy et al37 | 1, 58 M | >2000 n/k | 3 months Thought disorder, paranoid delusions, auditory, visual hallucinations | Seizures, hyponatraemia | IVIG, steroids, limited improvement, PLEX substantial improvement |
| Zandi et al38 | 1, 22 F | 1435 n/k | 10 months Paranoid delusions, insomnia | No | Not treated |
| Ganguli et al39 | 1, 56 M | 506 n/k | 2 years Depression, self-harm, paranoid delusions, auditory, visual hallucinations | Amnesia, epilepsy, hyponatraemia | PLEX, IVIG, steroids, limited cognitive improvement |
| Gotkine et al40 | 21 F | 444 LGI1 | 10 weeks Anxiety, panic, restlessness | Seizure, low sodium | PLEX, steroids, complete improvement |
| Iyer et al41 | 1, 13 F | 344 Negative to Caspr2/LGI1 | 8 weeks Agitated depression, neuroleptic malignant syndrome | No | 3 days methylprednisolone, complete improvement |
| Kruse et al*35 | 63 F | 170 LGI1 | Depression, insomnia, agitation | Cognitive decline | Not treated |
| 77 F | 80 Negative to LGI1/Caspr2 | Depression, anxiety, hallucinations, agitation, insomnia | Confusion, cognitive decline | Not treated | |
| 60 M | 640 LGI1 | Thought disorder, psychosis, agitation | Confusion, dyskinesia | 5 days methylprednisolone, marked improvement | |
| 77 M | 90 Negative to LGI1/Caspr2 | Agitation, aggression, disinhibition | Subacute worsening of chronic cognitive disorder | 5 days methylprednisolone, more agitated | |
| 57 M | 150 Negative to LGI1/Caspr2 | Depression, anxiety | Cognitive decline | 5 days methylprednisolone, improved |
*A further two cases of VGKC antibodies with a psychiatric presentation are referred to, but details are not given.
Caspr2, contactin-associated protein 2; IVIG, intravenous immunoglobulin; LGI1, leucine-rich, glioma-inactivated protein 1; n/k, not known, usually when study predates 2010 and availability of LGI1 and Caspr2 testing; PLEX, plasma exchange; VGKCC, voltage-gated potassium channel complex.