Analysis of efficacy and safety of intravenous immunoglobulin for treatment of anti-N-methyl-D-aspartate receptor encephalitis
10.3760/cma.j.issn.1008-5734.2015.05.001
- VernacularTitle:人免疫球蛋白治疗抗N-甲基-D-门冬氨酸受体脑炎的疗效和安全性分析
- Author:
Yan ZHANG
1
;
Yingying SU
1
;
Hong YE
1
;
Daiquan GAO
1
Author Information
1. 首都医科大学宣武医院神经内科,北京,100053
- Publication Type:Journal Article
- Keywords:
Anti-N-methyl-D-aspartate receptor encephalitis;
Immunoglobulins;
Treatment outcome;
Patient safety
- From:
Adverse Drug Reactions Journal
2015;17(5):321-324
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of intravenous immunoglobulin (IVIG) for treatment of anti-N-methyl-D-aspartatc (NMDA) receptor encephalitis.Methods Data of patients with anti-NMDA receptor encephalitis seen in Xuanwu Hospital, Capital Medical University from January 2012 to December 2014 were collected and a retrospective study was conducted.All patients received the first course of treatment with IVIG 0.4 g/(kg · d) , once daily for 5 consecutive days.The adverse reactions of IVIG during the observational period of IVIG administration and one week thereafter were recorded.The therapeutic effect of IVIG was assessed by using modified Rankin Scale one month post IVIG.According to the therapeutic effect of IVIG, patients were divided into effective group and ineffective group.Results Twenty-six patients were enrolled, including 11 male and 15 female with an average age of (25 ± 10) years (16 to 57 years).The duration from symptom onset to starting treatment of IVIG was 8-68 days (median 26 days).Treatment effects were assessed after one month post IVIG.Fourteen patients (53.8％) had improvement (effective group, including 6 patients who were improved significantly and 8 patients improved).The mean duration between the treatment of IVIG and clinical improvements was 17 (range 7-30) days.Percentage of male in the effective group was higher than that in the ineffective group [64.3％ (9/14) vs.16.7％ (2/12), P ＜ 0.05].The efficacy rate in males patients was higher than that in female patients[81.8％ (9/11) vs.33.3％ (5/15), P ＜0.05].During the observational period, 3 patients had fever, 2 patients had abnormality of liver function, and 1 patient had rash.The symptoms and abnormality of laboratory tests disappeared after reducing the speed of IVIG infusion, liver-protective and antianaphylactic treatment.Conclusion The treatment with IVIG for anti-NMDA receptor encephalitis was effective and relatively safe, therefore IVIG could be used as the first-line immunotherapy.
