Ikeguchi Ryotaro, Shibuya Koichi, Akiyama Shigeo, Hino Shuji, Kubo Hiromasa, Takeda Takahiro, Shibata Noriyuki, Yamamoto Kenji
Department of Neurology, Saitama Red Cross Hospital, Japan.
Intern Med. 2012;51(12):1585-9. doi: 10.2169/internalmedicine.51.6874. Epub 2012 Jun 15.
We report the case of a young woman with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, without tumor, who was successfully treated with rituximab. Because conventional immunotherapy, including corticosteroids, immunoglobulin (IVIg), and plasma exchange showed little improvement in our patient, we introduced another treatment using rituximab. A week after the first administration of rituximab, her symptoms improved gradually and significantly. This case provides in vivo evidence that rituximab is an effective agent for treating anti-NMDAR encephalitis, even in those cases where conventional immunotherapies have been ineffective. Rituximab should be regarded as a beneficial therapeutic agent for this disease.
我们报告了一例年轻女性抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎患者的病例，该患者无肿瘤，接受利妥昔单抗治疗成功。由于包括皮质类固醇、免疫球蛋白（IVIg）和血浆置换在内的传统免疫疗法在我们的患者中几乎没有改善，我们引入了使用利妥昔单抗的另一种治疗方法。首次给予利妥昔单抗一周后，她的症状逐渐且显著改善。该病例提供了体内证据，表明利妥昔单抗是治疗抗NMDAR脑炎的有效药物，即使在传统免疫疗法无效的情况下也是如此。利妥昔单抗应被视为治疗这种疾病的有益治疗药物。
