PMID- 37002555 OWN - NLM STAT- MEDLINE DCOM- 20230523 LR - 20230523 IS - 1950-6945 (Electronic) IS - 1294-9361 (Linking) VI - 25 IP - 1 DP - 2023 Feb TI - Different relationships between epilepsy syndromes and autoimmune diseases. PG - 33-44 LID - 10.1002/epd2.20048 [doi] AB - OBJECTIVE: 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-HS). The contribution of the human leukocyte antigen (HLA) system to this relationship was analyzed. METHODS: Adult patients with IGEs and MTLE-HS at a tertiary epilepsy center were consecutively enrolled between January 2016 and December 2020. RESULTS: A total of 664 patients, 422 with IGEs and 242 with MTLE-HS, were included. Patients with IGEs were 15 years younger, on average, than patients with MTLE-HS (p < .001). The frequency of autoimmune diseases was 5.5% (n = 23) and 4.5% (n = 11) in patients with IGEs and MTLE-HS, respectively (p = .716). The mean age of autoimmune disease onset was 20 +/- 15.6 years in patients with IGEs and 36.7 +/- 16.5 years in patients with MTLE-HS (p < .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-HS and autoimmune diseases, the autoimmune diseases appeared after epilepsy onset from adolescence onward. SIGNIFICANCE: Our study indicates two relationship patterns: a bidirectional association between IGEs and autoimmune diseases and a unidirectional relationship between MTLE-HS 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. CI - (c) 2023 International League Against Epilepsy. FAU - Chaves, Joao AU - Chaves J AUID- ORCID: 0000-0001-8399-2671 AD - Neurology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal. AD - UMIB - Biomedical Investigation Multidisciplinary Unit, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. FAU - Leal, Barbara AU - Leal B AUID- ORCID: 0000-0003-0936-4719 AD - UMIB - Biomedical Investigation Multidisciplinary Unit, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. AD - Immunogenetics Laboratory, Pathology and Molecular Immunology Department, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. FAU - Sardoeira, Ana AU - Sardoeira A AD - Neurology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal. FAU - Carvalho, Vanessa AU - Carvalho V AD - Department of Neurosciences and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitario de Lisboa Norte, Lisbon, Portugal. FAU - Samoes, Raquel AU - Samoes R AD - Neurology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal. AD - UMIB - Biomedical Investigation Multidisciplinary Unit, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. FAU - Freitas, Joel AU - Freitas J AD - Neurophysiology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal. FAU - Chorao, Rui AU - Chorao R AD - Neurophysiology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal. FAU - Ferreira, Ana Marta AU - Ferreira AM AD - UMIB - Biomedical Investigation Multidisciplinary Unit, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. FAU - Bras, Sandra AU - Bras S AD - UMIB - Biomedical Investigation Multidisciplinary Unit, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. FAU - Lopes, Joao AU - Lopes J AD - Neurophysiology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal. FAU - Ramalheira, Joao AU - Ramalheira J AD - Neurophysiology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal. FAU - Lemos, Carolina AU - Lemos C AD - UnIGENe, IBMC - Institute for Molecular and Cell Biology, i3S - Instituto de Investigacao e Inovacao em Saude, University of Porto, Porto, Portugal. AD - Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal. FAU - Costa, Paulo Pinho AU - Costa PP AD - UMIB - Biomedical Investigation Multidisciplinary Unit, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. AD - Immunogenetics Laboratory, Pathology and Molecular Immunology Department, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Instituto Nacional Saude Ricardo Jorge - Delegacao Norte, Porto, Portugal. FAU - Marinho, Antonio AU - Marinho A AD - UMIB - Biomedical Investigation Multidisciplinary Unit, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. AD - Clinical Immunology Unit, Centro Hospitalar Universitario do Porto, Porto, Portugal. FAU - da Silva, Berta Martins AU - da Silva BM AD - UMIB - Biomedical Investigation Multidisciplinary Unit, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. AD - Immunogenetics Laboratory, Pathology and Molecular Immunology Department, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. FAU - da Silva, Antonio Martins AU - da Silva AM AD - UMIB - Biomedical Investigation Multidisciplinary Unit, Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal. AD - Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. AD - Neurophysiology Department, Centro Hospitalar Universitario do Porto, Porto, Portugal. LA - eng GR - Fundacao Ciencia e Tecnologia/ GR - Unit for Multidisciplinary Research in Biomedicine (UMIB)/ PT - Journal Article DEP - 20230417 PL - United States TA - Epileptic Disord JT - Epileptic disorders : international epilepsy journal with videotape JID - 100891853 RN - Epilepsy, Idiopathic Generalized SB - IM MH - Child, Preschool MH - Adult MH - Adolescent MH - Humans MH - Female MH - Child MH - Young Adult MH - *Epilepsy, Temporal Lobe/complications MH - *Epilepsy/complications/pathology MH - *Epilepsy, Generalized/complications MH - Genetic Predisposition to Disease MH - Hippocampus/pathology MH - Sclerosis/pathology MH - Magnetic Resonance Imaging OTO - NOTNLM OT - autoimmune diseases OT - idiopathic generalized epilepsies OT - mesial temporal lobe epilepsy with hippocampal sclerosis EDAT- 2023/04/02 06:00 MHDA- 2023/05/23 06:42 CRDT- 2023/04/01 00:22 PHST- 2023/03/07 00:00 [revised] PHST- 2022/08/11 00:00 [received] PHST- 2023/03/14 00:00 [accepted] PHST- 2023/05/23 06:42 [medline] PHST- 2023/04/02 06:00 [pubmed] PHST- 2023/04/01 00:22 [entrez] AID - 10.1002/epd2.20048 [doi] PST - ppublish SO - Epileptic Disord. 2023 Feb;25(1):33-44. doi: 10.1002/epd2.20048. Epub 2023 Apr 17.