P ENCEPHALITIS X FAARP

 P

• Study Title: Comparison of Serum Fibrinogen-Albumin Ratio Among Children with Autoimmune and Infectious Encephalitis Aged 1–14 Years

• Authors: Kodamana H, Panda P, Sharawat I, Elwadhi A, Gupta D, Palayullakandi A, Tiwari L

• Institution: All India Institute of Medical Sciences, Rishikesh

---

Background

• Pediatric encephalitis (infectious or autoimmune) is heterogeneous and carries risk of severe neurological outcomes.

• Early biomarkers for diagnosis and prognosis are limited.

• Fibrinogen: pro-inflammatory protein, elevated in CNS disease

• Albumin: reflects nutritional status and better prognosis

• Fibrinogen/Albumin Ratio Percentage (FARP) may serve as a diagnostic and prognostic marker.

---

Objectives

• Compare serum FARP in children (1–14 years) with infectious encephalitis (IE) vs autoimmune encephalitis (AE)

• Evaluate prognostic value of FARP for functional outcomes

---

Methods

• Participants: 50 children (1–14 years) with clinically and radiologically confirmed/probable AE or IE

• Measurement:

  • FARP = (Fibrinogen / Albumin) × 100, measured within 6 hours

• Outcomes:

  • PCPC (Pediatric Cerebral Performance Category) for all cases

  • CASE (Clinical Assessment Scale in Autoimmune Encephalitis) for AE cases

  • Outcomes classified as:

    • Favorable: PCPC 1–3

    • Poor: PCPC ≥4

• Analysis: t-tests, non-parametric tests, multivariate analysis (p < 0.05 significant)

---

Results

• Demographics:

  • AE patients younger: 6.3 vs 9.1 years (p < 0.001)

  • Fewer males in AE: 8/21 vs 20/29 (p < 0.001)

  • Longer illness duration in AE: 11 vs 3 days (p < 0.001)

• Clinical features: IE had higher rates of:

  • Seizures, fever, vomiting, headache, neuropsychiatric & extrapyramidal features (all p < 0.001)

• FARP levels:

  • IE: 8.9 ± 4.1

  • AE: 6.2 ± 3.4 (p < 0.001)

• Association with outcomes:

  • Poor outcome groups had higher FARP:

    • AE: 7.1 vs 5.9 (p = 0.02)

    • IE: 9.1 vs 8.0 (p = 0.03)

---

Conclusion

• FARP is higher in infectious encephalitis than autoimmune encephalitis in children.

• Elevated FARP is associated with poor functional outcomes in both AE and IE.

• FARP may serve as a useful early diagnostic and prognostic biomarker in pediatric encephalitis.