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Case Report | DOI: https://doi.org/10.31579/2690-1919/596
1 Department of Neurology, Hainan General Hospital, Haikou, China.
2 Health Management Center, Binzhou People's Hospital, Binzhou, China.
3 Department of Neurology, Sanya Central Hospital, Sanya, China.
4 Division of Nephrology and Hypertension, Department of Medicine, NYU Winthrop Hospital, Mineola, New York, USA.
5 Innovation center for neurological disorders, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.
★ Indicated Correspondence author
*Corresponding Author: Yan Lv., Department of Neurology, Hainan General Hospital, Haikou, China.
Citation: Yan Lv, Zhichuan Lin, Fang Gao, Jing Wang, Shixiong Huang., et al, (2025), Neuro-Psycho Disorders and Hyponatremia in a Renal Carcinoma Patient Revealed as Anti-LGI1 Encephalitis and Renal Salt Wasting, J Clinical Research and Reports, 22(1); DOI: 10.31579/2690-1919/596
Copyright: © 2025, Yan Lv. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 27 October 2025 | Accepted: 12 November 2025 | Published: 19 December 2025
Keywords: anti-LGI1 encephalitis; renal carcinoma; hyponatremia; renal salt wasting
Background: LGI1(leucine-rich-anti-glioma1protein 1) is one of the latest identified voltage-gated potassium channels related antigens. Anti-LGI1 encephalitis is one of the autoimmune encephalitis and characterized with neurological symptoms and hyponatremia. The anti-LGI1 encephalitis was thought to be non-malignancy related. And the hyponatremia of anti-LGI1 encephalitis was considered as inappropriate secretion of antidiuretic hormone.
Case description: Here, we firstly report a 71-year-old female diagnosed with anti-LGI1 encephalitis with renal clear cell carcinoma and renal salt wasting. The old female was discovered a renal mass identified as renal clear cell carcinoma. Two months after the renal carcinoma resection, the patient fell frequently and showed discontinuous neuro-psychiatric disorders manifested as memory decline, disorientation, and unintentional upper limb movements as typical faciobrachial dystonic seizure episode. She also had hyponatremia. The combination of her clinical presentations and laboratory assessments supported a diagnosis of anti-LGI1 encephalitis and renal salt wasting. The Immunohistochemistry studies of the kidney resection indicated circulating LGI1 antibodies in sera might be binding to extracellular LGI1 predominantly in the proximal tubule where the major defect in solute transport exists in renal salt wasting.
Conclusion: Anti-LGI1 encephalitis with renal carcinoma indicated its paralimbic pathology origin. The early diagnosis and immune-modulation therapy could lead to a good outcome. The hyponatremia in anti-LGI1 encephalitis was renal salt wasting instead of syndrome of inappropriate secretion of antidiuretic hormone.
Anti-LGI1 encephalitis affects the limbic systems and presents with subacute onset of progressive neurological, cognitive, psychiatric disturbance and obstinate hyponatremia [1, 2]. Anti-LGI1 encephalitis is mostly considered to be non-malignancy related [3, 4]. We reported a case of anti-LGI1 encephalitis presented cognitive disorder and FBDS (faciobrachial dystonic seizure) after resection of her renal carcinoma for the first time. The unique relationship between serum sodium and fractional excretion of uric acid FEurate (fractional excretion of uric acid) determined that the hyponatremia was due to CRSW (cerebral/renal salt wasting) or more appropriately RSW (renal salt wasting) instead of the SIADH (syndrome of inappropriate secretion of antidiuretic hormone). The IHC (Immunohistochemistry) studies of the kidney indicated that circulating LGI1 antibodies in sera might be binding to extracellular LGI1 predominantly in the proximal tubule where the primary defect in solute transport exists in RSW.
Clinical manifestation
A 71 years old female had a renal mass surgically removed, which was identified as renal clear cell carcinoma by pathological and immunological evaluation. Almost two months after surgery, the patient complained about fatigue, fell frequently, unstable gait, and reported unintentional upper limb movements. Her family also noticed cognitive defects as short term memory, inability to recognize family members, and being unaware of home circumstances or time in the patient. There was no family history of psychiatric disorders or dementias. She did not take medicines and denied the use of tobacco or alcohol.
The symptom evolution of the patient presented typical neurophysiological symptoms during the development instead of at the very beginning of the disease. She also reported FBDS (faciobrachial dystonic seizure) episode (supplementary file1). Her MMSE (minimental state examination) was 3/30 (orientation 1, memory 1, language 1). Detailed neurological examination showed a lack of coordination, including normal cranial nerves, predicted IV symmetric strength throughout, active reflexes, incorporated finger-to-nose testing. On physical examinations, she had a normal cardiovascular, respiratory, abdominal, and pulmonary examination during the reported medical history.
Laboratory results
Serum and CSF from the patient was qualitatively tested for neuropil antibodies associated with autoimmune encephalitis including antibodies to glutamate receptors type NMDA, type AMPA1 and type AMPA2, LGI1, CASPR2 and GABARB1/B2using the indirect immunofluorescence test (IIFT) (EUROIMMUN, FA 112d-1005-1, Germany). Cellbased assays (CBAs) for those antibodies were performed using EU90 cells (EUROIMMUN) transfected with cDNAs encoding the relevant proteins. Combinations of substrates were incubated with patient serum (1:10 dilution) or undiluted CSF sample. In a second step, the attached antibodies were stained with fluorescein-labelled anti-human antibodies (EUROIMMUN) and made visible with a fluorescence microscope. Fluorescence intensity level was used to describe the intensity of the specific fluorescence as a numeric value, reaching from “0” or “−” (no specific fluorescence) to “5” or “+++++” (extremely strong specific fluorescence). The deviation in the fluorescence intensity of the IIFT amounted to no more than±1 fluorescence intensity level for all samples[36]. A cell-based assay showed serum VGKC (voltage-gated potassium channels) complex proteins (EUROIMMUN, Germany) serum LGI1-Ab to be positive+++(1:100) while the CSF LGI1-Ab was negative; other autoimmune encephalitis antibodies including AMPA1 (glutamate receptor, ionotropic, alpha1), AMPA2 (glutamate receptor, ionotropic, alpha2), Casp2, cerebellum-1, GABAR (gamma-aminobutyric acid receptors), NMDAR (N-methyl-D-aspartate receptors) in serum and CSF were all negative, which established the diagnosis of anti-LGI1 encephalitis.
CSF (Cerebral spinal fluid) tests for protein, cells, glucose, chloride, and culture were normal. Serum sodium ranged between 118-148mmol/L during the reported medical history. The cortisol, FT4 and TSH were normal, which excluded hypothyroidism and Addison’s disease. Autoimmune, infectious, endocrinologic, neoplastic and paraneoplastic screenings were unremarkable. FEurate was increased after correction of her hyponatremia (Supplementary Table 1), which is in consistent with RSW and not SIADH[5] (Supplementary Table 2). The increased aldosterone during the period of hyponatremia was in consistent with RSW;
Na mmol/L | K mmol/L | PosmmOsm /KgH2O | UA μmol/L | Creat μmol/L | Renin ng/ml/Hr | Aldo pg/ml | AII pg/ml | Cortisol nmol/L |
| 141.0 | 3.86 | 308 | 224 | 83 | 0.15 | 129.18 | 39.36 | 404 |
FRT3 pmol/L | FRT4 pmol/L | TSH mIU/L | Na(Urine) mmol/24hrs | K(Urine) mmol/ 24hrs | Uosm mOsm/KgH2O | UA μmol/24hrs | Creat μmol/ 24hrs | FEurate % |
| 4.09 | 9.82 | 3.980 | 28.80 | 25.22 | 687 | 3655 | 5296 | 26.93 |
Posm (plasma osmolality); Uosm (Urine osmolality); AII, (angiotensin II); Aldo (aldosterone); creat (creatinine); UA (uric acid); FRT4 (free T4); FRT3 (free T3); TSH (thyroid stimulating hormone); FEurate (fractional excretion of uric acid, FEurate=(serum creatine X urine UA(24hrs))/(serum UA X urine creatin(24hrs))X100%).
Supplementary Table 1: Patient's laboratory findings of hyponatremia correction.
| RSW | SIADH | |
| ECV | ↓ | N-↑ |
| UNa | N-↑ | N-↑ |
| Renin | ↑ | ±↓ |
| Aldosterone | ↑ | ±↓ |
| Serum urate | ↓-↓ | ↓-N |
| FEurate | ↑-↑ | ↑-N |
Supplementary Table 2: Differentiation of SIADH from RSW
ECV, extracellular volume; RSW, renal salt wasting; SIADH, secretion of antidiuretic hormone; UNa, urinary sodium concentration.Table comparing laboratory expectations for RSW and SIADH. UNa can be normal or often＞20mmol/l; serum urate and FEurate are increased during hyponatremia in both RSW and SIADH but differ when serum is normal. Serum urate and FEurate remain abnormal in RSW and normalize in SIADH when serum sodium is normal.
Expression of LGI1 by patient’s carcinoma. The IHC staining of LGI1 protein expression in kidney, and renal cell carcinoma to explore the underlying LGI1 related RSW mechanism (Figure 2). Paraffin embedded tumor junction tissue sections of the patient’s renal clear cell carcinoma from a patient with serum LGI1 antibodies (A tumor junction, B normal tissue, C carcinoma tissue), another patient with only renal clear cell carcinoma without serum LGI1 antibodies(D tumor junction, E normal tissue, F carcinoma tissue), a commercial antibody against LGI1 (rabbit polyclonal anti-LGI1, Abcam, ab137045, diluted 1:50) was used. Note the expression of LGI1 in normal renal tubule (B, E) and absent in carcinoma tissue (D, F), and the more robust expression pattern in the patient without LGI1 serum antibody (B, E). () Note expression of LGI1 in normal renal tubule (C, D) and absence in renal carcinoma tissue (E, F). There was reduced expression of the LGI1 in the patient when the circulating LGI1 antibody was present as compared to the absence of LGI1 antibody(C, D). There was a higher expression of LGI1 in proximal as compared to distal convoluted tubules both in the patients with or without circulating LGI1 antibodies(C, D).
Imaging results
Cerebral MRI (magnetic resonance imaging) (Figure 1 A, B) scans, including T2 flare (Figure 1 A), DWI(Figure 1 B) were normal. EEG (electroencephalogram) showed accidental sharp and slow wave complex in bifrontal and biparietal leads (Figure 1 E) with diffuse theta and delta wave background during FBDS. sLORETA (Standardized low-resolution brain electromagnetic tomography) spike source analysis by ASA 4.9 software showed the sharp and slow wave complex were sourced in frontal lobe (Figure 1 C, D).
Figure 1: MRI, EEG and spike sLORETA analysis presentations of the patient. The patient presented normal MRI in T2 flare and DWI sans(A, B); slow and accidental sharp and slow wave complex inbifrontal and biparietal leads with diffuse theta and delta wave background during FBDS (E), sLORETA (Standardized low-resolution brain electromagnetic tomography) spike source analysis by ASA 4.9 software showed the sharp and slow wave complex were sourced in frontal lobe (C, D).
Figure 2: Expression of LGI1 by patient’s carcinoma. Tumor junction tissue sections of the patient’s renal clear cell carcinoma from a patient with serum LGI1 antibodies (A, C, E), another patient with only renal clear cell carcinoma without serum LGI1 antibodies (B, D, F). A commercial antibody against LGI1 (rabbit polyclonal anti-LGI1, abcam, ab137045, diluted 1:50) was used for IHC. Note the expression of LGI1 in normal renal tubule (C,D) and absent in carcinoma tissue (E,F), and the reduced expression pattern in the patient with LGI1 serum antibody (C,D), and higher expression in proximal than distal convoluted tubules (C,D). (The bar presented 20mm, 10mm, 10mm for A,C,E,respectively).
Figure 3: Sodium level with according treatment. IVMP intravenous methylprednisolone; IVIG intravenous immunoglobulin.
Diagnosis, treatment and prognosis
The treatments were given and modulated according to the evolution of diagnosis and evaluation of the main symptoms (Supplementary Figure 1). When the LGI1 antibody encephalitis diagnosis was established, treatment with IVMP (intravenous methylprednisolone) 1.0/day for 5 days, 0.5/day for 3 days, 0.125/day for 5 days, followed with IVIG (intravenous immunoglobulin) at a dose of0.4 g/kg/day for 5 days 0.4 g/kg/day for 5 days and continued oral prednisolone 40 mg/day treatment for a month declined to 8mg/day maintained. VPA (valproic acid sodium)0.5 oral bid combined OXC (oxcarbazepine) 0.3 oral bid were administered to prevent epilepsy recurrence. The patient’s neurological dysfunction responded well to immunoglobulin with diminution of facial muscle jerk as FBDS and improved MMSE scores during the IVIG and consisted afterward, which increased to 15/30(orientation 6, memory and recall ability 2, attention and calculation 2, language 3, executive function 2, visual spatial 0) after IVIG therapy, and jump to 22/30(orientation 8, memory and recall ability 4, attention and calculation 4, language 3, executive function 3, visual spatial 0) at 6-month follow up, 27/30(orientation 10, memory and recall ability 6, attention and calculation 4, language 3, executive function 3, visual spatial 1) at 2-year follow up. For hyponatremia, the patient received saline supplementary as 10% sodium chloride solution intravenous1.5% sodium chloride 250ml qd-bid plus 20ml oral bid-qid according to the serum sodium level. Hypersaline supplementary and toveptan was given in a combination of immunomodulation therapy, and the relationship of sodium level between the therapy showed good effectiveness of IVMP and hyper saline supplementary treatment (Figure 3). The elevated FEurate indicated the diagnosis of RSW instead of SIADH. No hyponatremia and other complaints were observed at the 6 months and 2 years follow up.
Supplementary Figure 1: Evolution of diagnosis and evaluation of the main symptoms.
The diagnosis of encephalitis was not initially entertained when the patient presented with fatigue and found to have hyponatremia, but the development of more obvious symptoms such as repeated falls and FBDS episodes were highly suggestive of a paraneoplastic condition associated with LGI1 encephalitis. There has been a growing interest and understanding of paraneoplastic encephalitis and autoimmune encephalitis. Since the 1980s, there has been investigations which identified two major groups of antigens that categorize paraneoplastic autoimmune encephalitis, the classic onco-neuronal antigens that include Yo, Hu, Ri, Tr, CRMPs (Amphiphysin, collapsin response mediator proteins), Recoverin, Ma; autoimmune synaptic antigens including NMDAR, AMPAR, LGI1, Casp2, GABAR and unknown antigens[6].Paraneoplastic autoimmune encephalitis has been reported in patients with lung small cell carcinoma, adenocarcinoma of breast, ovarian teratoma, lung cancer etc.[3]. We present a rare case of renal carcinoma related paraneoplastic encephalitis, which has been reported previously in 3 cases over the last two decades, the diagnosis being hampered in most by a lack of specific antigens[7-9]. For example, a hallucinating 66-year-old with renal cell carcinoma had a diagnosis of limbic encephalitis made based on tests for intracellular autoimmune encephalitis that included Hu, Yo antibody but failed to identify antibodies in serum or CSF extracellular antibodies including NMDAR, AMPAR, LGI1, Casp2, GABAR[7], which would be possible autoimmune encephalitis antigens. On the other hand, the anti-IGI1 antibody was first reported in 2010 as an extracellular autoimmune factor that targeted the nervous system playing a role in paraneoplastic autoimmune encephalitis[10]. In time LGI1 paraneoplastic encephalitis or anti-LGI1 encephalitis have been reported in lung cancer[11], and thymoma[12]. The diagnosis of this rare condition can thus be challenging for primary care physicians, and we hope that this report will raise awareness and highlight the unique presentation of patients with paraneoplastic anti LGI1 encephalitis. Despite the lack of a clear line to distinguish the paraneoplastic encephalitis and anti-LGI1 encephalitis, the main characteristic presentations of anti-LGI1 encephalitis could be summarized as follows:1. Serum or CSF LGI1 antibody; 2. Neuropsychic-disorder as memory decline, disorientation or hallucination; 3. Tonic seizure as FBDS; 4.Hyponatremia related symptoms.
The LGI1 gene was discovered in the 1980s, which encodes a protein LRR (leucine-rich repeats) with conserved flanking sequences. In the LRR domain, LGI1 shares the highest homology with many transmembrane and extracellular proteins, and these proteins act as receptors and adhesion proteins[13]. LGI1 primarily expresses in neural tissues, particularly in the brain, which reduced in low-grade brain tumors as malignant gliomas[14, 15]. LGI1 modulates ADAM22 (a disintegrin and metalloproteinase domain-containing protein 22) or ADAM23 as a secretion protein[1]. LGI1 micro-rearrangements were observed in a collection of ADLTE (autosomal dominant lateral temporal epilepsy) families and sporadic LTE (lateral temporal epilepsy) patients and investigated novel ADLTE and LTE patients[16]. Anti-LGI1 limbic encephalitis was distinguished from VGKC antibody group encephalitis (anti-LGI1, Caspr2, or VGKC positive groups) with hyponatremia and typical FBDS[17-19]. In this report, the patient failed to show obvious abnormalities in MRI scans, including T1, T2, DWI scans(Figure 1), thus lacked the characteristic imaging presentations in the hippocampus[20], striatum[21] and mesial temporal lobes[22]. However, EEG based studies showed hippocampal functional dynamics changes beyond structural abnormalities[19, 23]. In this report, the sLORETA based source analysis showed frontal lobe sourced epileptic foci (Figure 1 C, D), which could shed light on the positioning diagnosis. There is no congruous treatment strategy for autoimmune encephalitis; the indicated and accepted therapies are immuno-therapies as steroids and sequenced immunoglobulins [24, 25]]. . In our report, the patient presented with typical features of anti-LGI1 limbic encephalitis, including cognitive defects, FBDS, hyponatremia, and had an excellent response to steroids and IVIG therapy [26, 27].
Hyponatremia, another characteristic symptom of LGI1 encephalitis patients, defined as serum sodium<135mmol> 30mmol/L, increased FEurate with normal renal, adrenal and thyroid function [29, 30]. There is accumulating evidence to utilize a new algorithm where FEurate is central to our evaluation of hyponatremia. In this algorithm, FEurate increases to >11% during hyponatremia in both SIADH and RSW. However, after the correction of hyponatremia, FEurate returns to normal in SIADH but remains increased in RSW(Supplementary Table 1). Our patient with paraneoplastic LGI1 encephalitis had increased FEurate after correction of hyponatremia when serum sodium was 141 mmol/L to meet the criteria for RSW where treatment with saline is most appropriate[30]. The etiology of RSW is most likely due to the presence of a circulating natriuretic peptide that is somehow up-regulated in diverse clinical conditions, and is not confined to those with cerebral disease. The natriuretic factor and increased FEurite has its major effect in the proximal tubule where uric acid is exclusively transported[31-33]. In this patient, we traced the LGI1 origin in renal tissues for the clues of this phenomenon. Even there was no reported LGI1 expressions in the literature research, it is in accordance with previously reported mice LGI1 expressions in renal tubule in mice[34] It would be interesting to speculate that LGI1 may play a role in the development of the urology carcinoma, as it has been shown for the development of prostate cancer[35]. According to IHC staining studies of the kidney, LGI1 appears to exist more abundantly in the proximal tubule as compared to the distal tubule (Figure 2). The intensity of the staining is reduced when there are circulating antibodies in serum(Figure 2, A, C) as compared to the absence of circulating antibodies to LGI1(Figure 2, B, D). It is interesting that there was absence of staining in renal carcinoma cells with or without the presence of circulating antibodies (Figure 2 E, F). These data indicate that circulating antibodies in sera might be binding to extracellular LGI1 predominantly in the proximal tubule where the major defect in solute transport exists in RSW.
Anti-LGI1 encephalitis with FBDS should be assessed not only structural but also functional measures as EEG based analysis. The sLORETA analysis could provide insight into the Anti-LGI1 encephalitis. Also, LGI1 encephalitis is a multisystem disorder that includes the renal tubule, which is manifested as a renal salt wasting syndrome due to a circulating natriuretic peptide and must be differentiated from SIADH because of opposed therapeutic goals. Anti-LGI1 encephalitis should be a syndrome that is not only confined to patients with encephalitis. However, this case report did not obtain FEurate before hyponatremia correction, the etiology of hyponatremia as RSW could be evaluated in a large sample of anti-LGI1 encephalitis with or without renal carcinoma, thus lead to the conclusion besides rare circumstances.
LGI1 leucine-richanti-glioma1protein; FBDS faciobrachial dystonic seizure; RSW renal Salt Wasting; CRSW cerebral/renal salt wasting; FEurate fractional excretion of uric acid; SIADH syndrome of inappropriate secretion of antidiuretic hormone; IHC Immunohistochemistry; MMSE minimental state examination; CSF cerebral spinal fluid; MRI magnetic resonance imaging; VGKC voltage-gated potassium channels; AMPA1 glutamate receptor, ionotropic, alpha 1; AMPA2 glutamate receptor, ionotropic, alpha 2; GABAR gamma aminobutyric acid receptors; NMDAR N-methyl-D-aspartate receptors; IVMP intravenous methylprednisolone; IVIG intravenous immunoglobulin; VPA valproic acid sodium; OXC oxcarbazepine; CRMPs amphiphysin, collapsin response mediator proteins; LRR leucine-rich repeats; ADAM22 a disintegrin and metalloproteinase domain-containing protein 22; ADLTE autosomal dominant lateral temporal epilepsy; LTE lateral temporal epilepsy; HLA human leukocyte antigen; SAH subarachnoid hemorrhage.
Ethics approval and consent to participate
Written Informed consent and ethical approval were obtained from the subject in accordance with the Helsinki Declaration.
Written Informed consent to participate and publication including clinical data, images and videos were obtained from the patient at 6-month follow up, when she had no orientation defections and estimated by 2 attending physicians in neurology department and her family to for the acceptable capacity to make decisions.
Availability of data and material
All data generated or analyzed during this study are included in this published article [and its supplementary information files]. The raw datasets used and/or analyzed during the current study are also available from the corresponding author on reasonable request.
Competing interests
All of the authors declare no conflict of competing interests.
Funding
This work was supported in part by grants from the Key Science and Technology Project of Hainan Province (ZDXM2015070) and (ZDYF2018141). The funding supported the collection, analysis, and interpretation of data.
Authors' contributions
All authors listed have contributed sufficiently to the project to be included as authors, and all those who are qualified to be authors are listed in the author byline. Dr. YL M.D.& P.H.D. -acquisition of data, analysis and interpretation, critical revision of the manuscript for important intellectual content. Dr. ZCL M.D.-study concept and design, analysis and interpretation of data analysis and interpretation of data analysis and interpretation of data. Pro. JM. -conceptual guidance, anaylysis and interpretation, critical revision of the manuscript for important intellectual content. Dr. YLH M.D.- analysis and interpretation. Dr. XLX M.D.& M.S-acquisition of data. Pro. GQW M.D.- analysis and interpretation. Dr. QQ M.D.& P.H.D. -study concept, analysis and interpretation, critical revision of the manuscript for important intellectual content. Dr. TL M.D.& P.H.D.-study concept and design, analysis and interpretation of data. analysis and interpretation of data analysis and interpretation of data, critical revision of the manuscript and supervision of the study. Dr. SXH M.D.& P.H.D. -study concept, acquisition of data, analysis and interpretation, critical revision of the manuscript for important intellectual content, study supervision.
This study was supported by mutli-department cooperation. Including Dr. HB Quan, Dr. DH Cai, Dr. DJ Chen for their clinical care of the patient; Dr. Hongwen Zhu; Prof. Wei Qiu; Dr. Yun Zhong for the manuscript preparation.
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Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
