Intrathecal treatment of anti-N-Methyl-D-aspartate receptor encephalitis in children

被引：60

作者：

Tatencloux, Sarah ^{[1
,2
]}

Chretien, Pascale ^{[3
]}

Rogemond, Veronique ^{[4
,5
]}

Honnorat, Jerome ^{[4
,5
]}

Tardieu, Marc ^{[1
,2
]}

Deiva, Kumaran ^{[1
,2
]}

机构：

[1] Hop Bicetre, Hop Univ Paris Sud, AP HP, Pediat Neurol Dept, Le Kremlin Bicetre, France

[2] Univ Paris Sud, Natl Referral Ctr Neuroinflammatory Dis Children, F-94275 Le Kremlin Bicetre, France

[3] Hop Bicetre, Hop Univ Paris Sud, AP HP, Dept Immunol, Le Kremlin Bicetre, France

[4] Hop Neurol, Hosp Civils Lyon, Neurooncol Dept, French Reference Ctr Paraneoplast Neurol Syndrome, Lyon, France

[5] Univ Lyon 1, Lyon Neurosci Res Ctr, F-69365 Lyon, France

来源：

DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY | 2015年 / 57卷 / 01期

关键词：

HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS; NMDAR ENCEPHALITIS; ANTIBODIES;

D O I：

10.1111/dmcn.12545

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Anti-NDMA receptor (NMDAR) encephalitis is an auto-immune condition. There is no uniformly agreed treatment strategy for the disorder in children. We report the use of intrathecal treatment with methotrexate and methylprednisolone in three children (one male, two females, age 10y, 11y, and 14y) with anti-NMDAR encephalitis, who did not respond to steroids, plasmapheresis, or rituximab. There was significant clinical improvement and stabilization of the anti-NMDAR antibody titers in cerebrospinal fluid (CSF) and blood in two patients. In the third patient, although anti-NMDAR antibody titers in CSF decreased, clinical recovery was less satisfactory. Intrathecal treatment with methotrexate and methylprednisolone seems to be a promising alternative treatment for some paediatric cases of resistant anti-NMDAR encephalitis.

引用

页码：95 / 99

页数：5

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