Talk:Anti-Hu associated encephalitis

Untitled

Division of labor and Work Plan Introduction (Matthew Peters)

Signs and symptoms or Characteristics (subsection complications) (Walker Keenan)

Causes: Includes Risk factors, triggers, Genetics or genome, Virology (e.g., structure/morphology and replication). (Matthew Peters)

Mechanism: For information about pathogenesis and pathophysiology. (Matthew Peters)

Diagnosis: Includes characteristic biopsy findings and differential diagnosis. (Walker Keenan)

Prevention or Screening (if the section only discusses secondary prevention it should follow the treatment section) (Matthew Peters)

Treatment: Since the underlying cause of Anti-Hu encephalitis is usually cancer, often times tumor resection and treatment of malignancy is the best way to go about this. Other therapies that are less efficacious are steroids and antibodies, or cells that help neutralize other pathogenic cells in the body (To be continued.) (Walker Keenan)

Outcomes or Prognosis. May also be labeled "Possible outcomes" or "Outlook". (Walker Keenan)

Epidemiology: factors such as incidence, prevalence, age distribution, and sex ratio. (Matthew Peters)

History: Early discoveries, historical figures, and outdated treatments (not patient history) (Matthew Peters)

Society and culture: This might include social perceptions, cultural history, stigma, economics, religious aspects, awareness, legal issues, notable cases (Walker Keenan)

Research directions: Include only if addressed by significant sources. See Trivia, and avoid useless statements like "More research is needed". Wikipedia is not a directory of clinical trials or researchers. (Matthew Peters)

Special populations, such as Geriatrics or Pregnancy or Children (Walker Keenan)

Other animals (Matthew Peters)

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Hylas89, Wdkeenan. Peer reviewers: Akinesia, Nfm123.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 17:24, 17 January 2022 (UTC)

work in progress

Will flesh out and improve subsections and citations during Dec 2017! -MWP and WK. We are both medical students at the University of California, San Francisco.

Peer review

Dear MWP and WK,

Overall, it is an amazing article! It is written clearly and will be accessible to a variety of audiences. There are a few instances where wording could be more clear. I’ve made some suggestions below - which are all very nitpicky and only serve to strengthen an already excellent article.

Akinesia

Specific comments:

LEAD
- Clear, well-written, comprehensive but not overwhelming
- Great use of non-jargon terms such as “immune system attack” with appropriate linking to more jargon-filled articles if reader is interested. - “the most common hypothesis” sounds odd to me. Perhaps “leading hypothesis.”
- “ immune system attack is linked to cancer.” Link may not be a clear term - more of an epidemiological term. Perhaps “thought to be due to cancer”

SIGNS AND SYMPTOMS
- Very clear and simple
- “—possibly to the point of respiratory failure” seems a bit informal wording. Perhaps “decreased breathing, with can progress to respiratory failure”

CAUSE
- “Primarily adults contract this illness” might sound better as “This illness is primarily found in adults” or something similar
- “Small cell lung cancer is a particularly aggressive cancer more common in smokers and is associated with anti-Hu encephalitis” might sound better as “Small cell lung cancer, the cancer most associated with anti-Hu HE, is a particularly aggressive cancer found in smokers.”

PATHOPHYS
- “serum” maybe could be “blood” with a link to serum
- “Older studies suggested THAT the antibodies caused the disease, pointing to the discovery of antibody deposition in the brain tissue of patients at autopsy. “ Also, needs citation for the “older studies”
- For the sentence that introduces the “newer studies,” I would put the citations (currently 10 & 11) at the end of that sentence instead of after the following sentence
- “In a paraneoplastic syndrome, a cancer cell can create proteins that are normally only found as naturally-occurring proteins in other cell types in other parts of the body” — does this occur in all paraneoplastic conditions? If not, maybe reword

DIAGNOSIS
- “If these signs and symptoms occur in a person who is found to have cancer, then anti-Hu associated encephalitis is suspected.” Maybe avoid strong wording with “is” and replace with “may be suspected.” Never wrong to be too cautious with wording.
- “Because small cell lung cancer commonly occurs together with this condition, a diagnosis of this particular cancer carries an even higher suspicion” a bit awkward given discussing two conditions. Might be better as “Because small cell lung cancer commonly occurs together with Anti-Hu HE, a diagnosis of small-cell lung cancer confers an even greater suspicion”

TREATMENT
- Would be nice to have a citation for the first sentence
- “Some treatments may directly combat the mechanisms by which the disease may be caused” is a bit clunky.
- “ Steroids such as dexamethasone can help reduce disease burden by reducing the antibody-building activity of the disease.” Might replace “can” with “may.” Also, avoid duplicate words in the same sentence

PROGNOSIS
- “less than a year, from the time of diagnosis” does not need a comma

EPIDEMIOLOGY
- I feel that some of this information would be helpful in the lead, especially the % with cancer.

HISTORY
- No comments

SPECIAL POPULATIONS
- First sentence has a spelling error “cen"

Overall, excellent job. Was a pleasure getting to know more about this interesting and important disease.

Akinesia (talk) 07:49, 15 December 2017 (UTC)

Peer review #2

Overall impressions: Excellent overview of this disease! Great topic that is poorly understood, so I'm glad you guys chose this for editing. I particularly appreciated how readable this article was - the sentences were concise and felt accessible for different levels of medical knowledge. Here are my comments

By section:

CAUSE

- Would suggest having a leading statement hinting that the cause of this condition is under debate and relatively poorly understood (which you will describe further in the "Pathogenesis" section). This prompts the reader to think of this disease as rare and still under investigation.

PATHOPHYSIOLOGY

- Great job outlining the different sides of the debate!!

- "There is a debate about whether the antibody is a cause of, or rather an effect of, the disease process" - would clarify "disease process" as "anti-Hu encephalitis"

- I would add a sentence or two linking the pathophysiology back to the signs and symptoms. The pathophys section talks about biological mechanisms of disease - why/how would an immune attack led by proteins and T cells causes things like psychiatric disturbances? You could have a brief statement about how the varied symptoms are caused by different parts of the brain being attacked (and that we may not know much further than that).

DIAGNOSIS

- NICE descriptions of how MRI and EEG help in diagnosis

- "In suspected cases, physicians perform diagnostic testing using a protein-detecting test that identify anti-Hu antibodies" - what fluid is being tested here? CSF? would clarify this

- "but are not limited to—problems with metabolism, a brain tumor, inflammation of tissue coating around the brain" - typo: insert "or" before "inflammation"

TREATMENT

- Add a period to the end of the last sentence of the 2nd paragraph of this section

- Might add a brief note about why ACTH is useful treating this disease - otherwise it seems a bit random that a hormone that helps control BP and stress levels can improve an autoimmune encephalitis

EPIDEMIOLOGY

- consider moving this section up? after or as part of the lead section?

Nfm123 (talk) 00:44, 14 December 2017 (UTC)