A case of anti-NMDAR encephalitis presented hypotensive shock during plasma exchange.Brain Dev. 2016 Apr; 38(4):427-30.BD
Abstract
We are reporting on a case of pediatric anti-NMDAR encephalitis with autonomic instability. The patient showed little response to first-line treatment of steroid and IVIG. We initiated plasma exchange, also a first-line treatment. This worsened his autonomic instability, resulting in hypotensive shock. He responded well to rituximab and cyclophosphamide, second-line therapies. Anti-NMDAR encephalitis is often accompanied by autonomic instability. Our and other reported cases, raise the question of plasma exchange as a first-line therapy for pediatric NMDAR encephalitis, which is frequently accompanied by autonomic instability. Plasma exchange should be performed cautiously in such patients.
Links
MeSH
Pub Type(s)
Case Reports
Journal Article
Language
eng
PubMed ID
26524986
Citation
Miyauchi, Akihiko, et al. "A Case of anti-NMDAR Encephalitis Presented Hypotensive Shock During Plasma Exchange." Brain & Development, vol. 38, no. 4, 2016, pp. 427-30.
Miyauchi A, Monden Y, Osaka H, et al. A case of anti-NMDAR encephalitis presented hypotensive shock during plasma exchange. Brain Dev. 2016;38(4):427-30.
Miyauchi, A., Monden, Y., Osaka, H., Takahashi, Y., & Yamagata, T. (2016). A case of anti-NMDAR encephalitis presented hypotensive shock during plasma exchange. Brain & Development, 38(4), 427-30. https://doi.org/10.1016/j.braindev.2015.10.009
Miyauchi A, et al. A Case of anti-NMDAR Encephalitis Presented Hypotensive Shock During Plasma Exchange. Brain Dev. 2016;38(4):427-30. PubMed PMID: 26524986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - A case of anti-NMDAR encephalitis presented hypotensive shock during plasma exchange.
AU - Miyauchi,Akihiko,
AU - Monden,Yukifumi,
AU - Osaka,Hitoshi,
AU - Takahashi,Yukitoshi,
AU - Yamagata,Takanori,
Y1 - 2015/10/31/
PY - 2015/04/15/received
PY - 2015/09/29/revised
PY - 2015/10/06/accepted
PY - 2015/11/4/entrez
PY - 2015/11/4/pubmed
PY - 2016/12/15/medline
KW - Anti-NMDAR encephalitis
KW - Autonomic instability
KW - Cyclophosphamide
KW - Plasmapheresis
KW - Rituximab
SP - 427
EP - 30
JF - Brain & development
JO - Brain Dev
VL - 38
IS - 4
N2 - We are reporting on a case of pediatric anti-NMDAR encephalitis with autonomic instability. The patient showed little response to first-line treatment of steroid and IVIG. We initiated plasma exchange, also a first-line treatment. This worsened his autonomic instability, resulting in hypotensive shock. He responded well to rituximab and cyclophosphamide, second-line therapies. Anti-NMDAR encephalitis is often accompanied by autonomic instability. Our and other reported cases, raise the question of plasma exchange as a first-line therapy for pediatric NMDAR encephalitis, which is frequently accompanied by autonomic instability. Plasma exchange should be performed cautiously in such patients.
SN - 1872-7131
UR - https://www.unboundmedicine.com/medline/citation/26524986/A_case_of_anti_NMDAR_encephalitis_presented_hypotensive_shock_during_plasma_exchange_
L2 - https://linkinghub.elsevier.com/retrieve/pii/S0387-7604(15)00221-1
DB - PRIME
DP - Unbound Medicine
ER -