Combined Therapy for Anti-N-methyl D-aspartate Receptor Encephalitis

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Kido Takahiro; Kobayashi Chie; Ohto Tatsuyuki; Takahashi Yukitoshi; Sumazaki Ryo; Fukushima Takashi

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Journal Paper

Paper Information

Journal: Journal of Pediatric Perspectives Year:2017 | Volume:5 | Issue:9 (45) Page(s): 5687-5691

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Title

Combined Therapy for Anti-N-methyl D-aspartate Receptor Encephalitis

Author(s)

Keywords

Anti-NMDAR encephalitis

Cyclophosphamide

Immunotherapy

Mediastinal teratoma

Rituximab

Abstract

Background Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune neurological disorder that usually occurs as a paraneoplastic syndrome and is particularly associated with ovarian teratoma. Standard therapy for severe cases is not established and the prognosis in patients who do not respond to first-line treatment is poor. Case Report An 11-year-old boy complained psychiatric symptoms and rapidly lost consciousness. CT scan revealed Mediastinal teratoma and serum/spinal fluid was positive for anti-NMDAR antibody. He kept comatose and his brain stem function was profoundly disturbed. His symptoms were refractory to first-line therapy, which involved tumor resection, methylprednisolone (mPSL) pulse, Intravenous immunoglobulin (IVIG), and plasma exchange. We administered a combination therapy of Rituximab and Cyclophosphamide as second-line therapy and achieved complete recovery without adverse effects related to treatment. Conclusion We consider early intensive treatment with a combination of Rituximab and Cyclophosphamide to be a safe and effective option for severe cases of Anti-NMDAR encephalitis.

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APA: Copy

Kido, Takahiro, Kobayashi, Chie, Ohto, Tatsuyuki, Takahashi, Yukitoshi, Sumazaki, Ryo, & Fukushima, Takashi. (2017). Combined Therapy for Anti-N-methyl D-aspartate Receptor Encephalitis. INTERNATIONAL JOURNAL OF PEDIATRICS, 5(9 (45)), 5687-5691. SID. https://sid.ir/paper/337811/en

Vancouver: Copy

Kido Takahiro, Kobayashi Chie, Ohto Tatsuyuki, Takahashi Yukitoshi, Sumazaki Ryo, Fukushima Takashi. Combined Therapy for Anti-N-methyl D-aspartate Receptor Encephalitis. INTERNATIONAL JOURNAL OF PEDIATRICS[Internet]. 2017;5(9 (45)):5687-5691. Available from: https://sid.ir/paper/337811/en

IEEE: Copy

Takahiro Kido, Chie Kobayashi, Tatsuyuki Ohto, Yukitoshi Takahashi, Ryo Sumazaki, and Takashi Fukushima, “Combined Therapy for Anti-N-methyl D-aspartate Receptor Encephalitis,” INTERNATIONAL JOURNAL OF PEDIATRICS, vol. 5, no. 9 (45), pp. 5687–5691, 2017, [Online]. Available: https://sid.ir/paper/337811/en

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