دورية أكاديمية

Efficacy of Therapeutic Plasma Exchange in Patients with Severe Refractory Anti-NMDA Receptor Encephalitis.

التفاصيل البيبلوغرافية
العنوان: Efficacy of Therapeutic Plasma Exchange in Patients with Severe Refractory Anti-NMDA Receptor Encephalitis.
المؤلفون: Zhang, Yan, Liu, Gang, Jiang, Mengdi, Chen, Weibi, Su, Yingying
المصدر: Neurotherapeutics; Jul2019, Vol. 16 Issue 3, p828-837, 10p
مستخلص: The objective of the present study was to assess the efficacy of therapeutic plasma exchange (TPE) in patients with severe refractory anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis. Patients with severe anti-NMDA receptor encephalitis who showed no improvement after steroids and/or intravenous immunoglobulin treatment for at least 10 days were enrolled. All patients received immunotherapy and were divided into a TPE group and a non-TPE group according to treatment received. Each patient in the TPE group received at least 1 TPE course. NMDA receptor antibody titers in the cerebrospinal fluid (CSF) and plasma were evaluated within 1 week after the last TPE procedure. The clinical efficacy of treatment was evaluated after 1 month, 2 months, 3 months, 6 months, and 12 months. Forty patients were enrolled: 19 in the TPE group and 21 in the non-TPE group. Nineteen patients received TPE for a total of 118 procedures. NMDA receptor antibody titers in the CSF and/or plasma decreased or were negative after the last TPE procedure in 18 patients (94.7%). Compared with the non-TPE group, the TPE group exhibited greater clinical improvement after 1 month and 2 months following treatment (P < 0.05). After 3 months, 6 months, and 12 months, there were no significant differences in the outcomes between the TPE group and non-TPE group. The results suggest that TPE might rapidly improve the clinical manifestations in patients with severe refractory anti-NMDA receptor encephalitis, and we believe that TPE should be considered as a first-line treatment. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:19337213
DOI:10.1007/s13311-019-00725-4