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A Simple Cell-based Immunofluorescence Assay to Detect Autoantibody Against the N-Methyl-D-Aspartate (NMDA) Receptor in Blood
07:20

A Simple Cell-based Immunofluorescence Assay to Detect Autoantibody Against the N-Methyl-D-Aspartate (NMDA) Receptor in Blood

Published on: January 9, 2018

[An 8-year-old boy with anti-NMDA receptor encephalitis, successfully treated with cyclophosphamide]

Tadahiro Mitani1, Yoshimitsu Ohtsuka, Kei Yamamoto

  • 1Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Kanagawa.

No to Hattatsu = Brain and Development
|April 19, 2013
PubMed

Insights

Cyclophosphamide therapy offers a promising treatment for pediatric anti-NMDA receptor (NMDAR) encephalitis. This approach, following initial immunotherapy, led to significant clinical improvement in an 8-year-old boy with NMDAR encephalitis.

Area of Science:

  • Neurology
  • Immunology
  • Pediatrics

Background:

  • Anti-NMDA receptor (NMDAR) encephalitis is a severe autoimmune neurological disorder.
  • Pediatric cases often present with complex symptoms including seizures, psychosis, and movement disorders.

Observation:

  • An 8-year-old boy with non-paraneoplastic anti-NMDAR encephalitis showed no improvement with standard therapies like methylprednisolone pulse (mPSL) and intravenous immunoglobulin (IVIg).
  • The patient experienced psychotic symptoms and involuntary movements secondary to intractable seizures.

Findings:

  • Following three cycles of monthly cyclophosphamide pulse therapy, the patient exhibited gradual clinical improvement.
  • Neurological function normalized six months post-treatment, with no reported side effects.

Implications:

  • Cyclophosphamide pulse therapy is a viable and effective treatment option for pediatric anti-NMDAR encephalitis.
  • This suggests cyclophosphamide should be considered alongside mPSL and IVIg in the management of pediatric anti-NMDAR encephalitis.

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