{"doi":"10.3389/fneur.2022.1102484","title":"Dual ankyrinG and subpial autoantibodies in a man with well-controlled HIV infection with steroid-responsive meningoencephalitis: A case report","abstract":"Neuroinvasive infection is the most common cause of meningoencephalitis in people living with human immunodeficiency virus (HIV), but autoimmune etiologies have been reported. We present the case of a 51-year-old man living with HIV infection with steroid-responsive meningoencephalitis whose comprehensive pathogen testing was non-diagnostic. Subsequent tissue-based immunofluorescence with acute-phase cerebrospinal fluid revealed anti-neural antibodies localizing to the axon initial segment (AIS), the node of Ranvier (NoR), and the subpial space. Phage display immunoprecipitation sequencing identified ankyrinG (AnkG) as the leading candidate autoantigen. A synthetic blocking peptide encoding the PhIP-Seq-identified AnkG epitope neutralized CSF IgG binding to the AIS and NoR, thereby confirming a monoepitopic AnkG antibody response. However, subpial immunostaining persisted, indicating the presence of additional autoantibodies. Review of archival tissue-based staining identified candidate AnkG autoantibodies in a 60-year-old woman with metastatic ovarian cancer and seizures that were subsequently validated by cell-based assay. AnkG antibodies were not detected by tissue-based assay and/or PhIP-Seq in control CSF ( N = 39), HIV CSF ( N = 79), or other suspected and confirmed neuroinflammatory CSF cases ( N = 1,236). Therefore, AnkG autoantibodies in CSF are rare but extend the catalog of AIS and NoR autoantibodies associated with neurological autoimmunity.","journal":"Frontiers in Neurology","year":2023,"id":358944,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9529,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":393420,"name":"Thomas Ngo","orcid":"0000-0003-2504-1872","position":1,"is_corresponding":false},{"id":59109,"name":"Cathryn R. 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Kung","orcid":null,"position":10,"is_corresponding":false},{"id":1109284,"name":"Shailee Shah","orcid":"0000-0002-3451-0303","position":11,"is_corresponding":false},{"id":246851,"name":"Jeffrey M. Gelfand","orcid":"0000-0002-5121-3319","position":12,"is_corresponding":false},{"id":361101,"name":"Felicia C. Chow","orcid":"0000-0001-9440-9349","position":13,"is_corresponding":false},{"id":275200,"name":"Matthew N. Rasband","orcid":"0000-0001-8184-2477","position":14,"is_corresponding":false},{"id":720330,"name":"Divyanshu Dubey","orcid":"0000-0001-6865-9045","position":15,"is_corresponding":false},{"id":231254,"name":"Sean J. Pittock","orcid":"0000-0002-6140-5584","position":16,"is_corresponding":false},{"id":107235,"name":"Joseph L. DeRisi","orcid":"0000-0002-4611-9205","position":17,"is_corresponding":false},{"id":109296,"name":"Michael R. Wilson","orcid":"0000-0002-8705-5084","position":18,"is_corresponding":false},{"id":393421,"name":"Samuel J. Pleasure","orcid":"0000-0001-8599-1613","position":19,"is_corresponding":false},{"id":411545,"name":"Christopher M. Bartley","orcid":"0000-0002-1391-4130","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T01:13:48.379546Z","pmid":"36756346","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}