Racial and ethnic disparities in pediatric autoimmune encephalitis: A systematic review

Authors

Jennifer H. Yang, Department of Neurosciences, University of California San Diego, San Diego, CA USA. Electronic address: jhy045@health.ucsd.edu.
Kristen S. Fisher, Department of Pediatrics, Division of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine and Texas Children's Hospital, USA.
Julia Dumcum, Department of Undergraduate Studies, University of California San Diego, San Diego, CA USA.
Sophie Zacharek, Department of Neurosciences, University of California San Diego, San Diego, CA USA.
Alexandra B. Kornbluh, Division of Neurology, Children's National Hospital, George Washington University Medical School, WA, District of Columbia, USA.
Kelsey Poisson, Department of Pediatrics, Division of Neurology, Nationwide Children's, Columbus, OH, USA.
Mary C. Karalius, Department of Neurology and Pediatrics, University of California San Francisco, San Francisco, CA,USA.
Leigh Sepeta, Division of Neurology, Children's National Hospital, George Washington University Medical School, WA, District of Columbia, USA.

Document Type

Journal Article

Publication Date

10-4-2025

Journal

Multiple sclerosis and related disorders

Volume

104

DOI

10.1016/j.msard.2025.106789

Keywords

Autoimmune encephalitis; Health disparity; Pediatric; Systematic review

Abstract

OBJECTIVES: Health disparities and social determinants of health are increasingly recognized as important predictors for clinical outcomes in autoimmune disease. However, this is poorly studied in pediatric autoimmune encephalitis (AE). METHODS: We conducted a systematic literature review in accordance with PRISMA guidelines. Searches included Medline (Pubmed), EMBASE, and Web of Science databases from inception years to October 4, 2024. Inclusion criteria were: 1) Patients diagnosed with AE ≤ 18 years old; 2) any report of race and/or ethnicity, 3) report of specific diagnostics and disease outcomes, 4) observational cohort studies, epidemiological studies or case series/ cohort studies of n ≥ 5 participants. We excluded studies describing only AE associated with viral encephalitis, case reports or case series with <5 cases, papers without clear racial or ethnicity demographics, no report of clinical outcomes, and non-English studies. Study screening, scoring, and data extraction used the Covidence platform. Study quality utilized the Newcastle-Ottawa scale for case-control and cohort studies, and the Joanna Briggs Institute Critical Appraisal Checklist for epidemiological studies. Descriptive analyses were used to summarize study findings. RESULTS: A total of 35 studies were included in the study: 74 % retrospective cohort, 14 % prospective cohort, 8.6 % epidemiological, and 1 case-control study. Study quality fell mostly into "good" (45.7 %) or "fair" (37 %), and the remaining 17 % were given "poor" quality scores. Among the included studies, 94 % of the studies had pediatric-specific data from which demographic and clinical information could be extracted. Only 12 (34 %) of studies reported outcomes specific to a racial and/or ethnic group - 7 cohort studies from homogenous populations, 3 epidemiological studies, and 2 reported racial frequencies in cognitive outcomes only. No studies compared clinical outcomes among different racial or ethnic groups. DISCUSSION: There is an overall paucity in rigorous studies on health disparities in pediatric AE. Future studies should be aimed at determining individual, social, and structural risk factors that may impact treatment and long-term outcomes.

APA Citation

Yang, Jennifer H.; Fisher, Kristen S.; Dumcum, Julia; Zacharek, Sophie; Kornbluh, Alexandra B.; Poisson, Kelsey; Karalius, Mary C.; and Sepeta, Leigh, "Racial and ethnic disparities in pediatric autoimmune encephalitis: A systematic review" (2025). GW Authored Works. Paper 8314.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8314

Department

Neurology