Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
J Neuroimmunol. 2024 Apr 15;389:578326. doi: 10.1016/j.jneuroim.2024.578326. Epub 2024 Feb 27.
Autoimmune nodopathy is a new entity of immune-mediated neuropathies associated with antibodies against nodal-paranodal epitopes. We present a detailed clinical and serological work-up of a patient with autoimmune nodopathy with anti-neurofascin-155 (anti-NF-155) IgG4 antibodies who was treated with low-dose (500 mg) rituximab, which led to a decrease of anti-NF-155 antibody titer, depletion of B cells, normalization of the levels of neurofilament light chain in serum, and significant clinical improvement. This case suggests that a low-dose rituximab could be as effective as previously reported much higher doses, and presumably with a lower risk of adverse effects and infections.
自身免疫性神经节病是一种与抗节段性-神经旁区抗原抗体相关的免疫介导性神经病变新实体。我们报告了一例自身免疫性神经节病患者的详细临床和血清学检查结果，该患者存在抗神经束蛋白-155（抗-NF-155）IgG4 抗体，接受了低剂量（500mg）利妥昔单抗治疗，导致抗-NF-155 抗体滴度下降，B 细胞耗竭，血清神经丝轻链水平正常化，且临床症状显著改善。该病例提示，低剂量利妥昔单抗可能与之前报道的更高剂量一样有效，且可能具有更低的不良反应和感染风险。
