Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3036520 | Brain and Development | 2016 | 4 Pages |
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.
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Authors
Akihiko Miyauchi, Yukifumi Monden, Hitoshi Osaka, Yukitoshi Takahashi, Takanori Yamagata,