Tocilizumab combined with hyperbaric oxygen therapy in treatment of children with antibody-negative autoimmune encephalitis： A case report and literature review
10.19845/j.cnki.zfysjjbzz.2026.0062
- VernacularTitle:托珠单抗联合高压氧治疗儿童抗体阴性自身免疫性脑炎1例报告并文献复习
- Author:
Yanfei ZHAO
1
;
Huiyi JIANG
1
Author Information
1. Department of Pediatrics， Lequn Branch of The First Hospital of Jilin University， Changchun 130021， China
- Publication Type:Journal Article
- Keywords:
Tocilizumab;
Autoimmune encephalitis;
Hyperbaric oxygen therapy;
Children
- From:
Journal of Apoplexy and Nervous Diseases
2026;43(4):363-368
- CountryChina
- Language:Chinese
-
Abstract:
Antibody-negative autoimmune encephalitis （AE） in children poses certain challenges for clinical diagnosis and treatment due to the lack of characteristic autoantibodies. This study conducts a retrospective analysis of the clinical data of a boy， aged 7 years， who had the main manifestations of “irritability， vomiting， pyrexia， and lethargy”. Video electroencephalography showed diffuse slow waves， with the presence of type 2 cerebrospinal fluid oligoclonal bands， and the boy was tested negative for related autoantibodies in blood and cerebrospinal fluid. Finally the boy was diagnosed with antibody-negative AE. After admission， the boy received first-line immunotherapy with methylprednisolone and intravenous immunoglobulin， combined with tocilizumab for intensive treatment， and the symptoms were rapidly relieved. At 1 week after discharge， the boy experienced memory loss， and head MRI suggested cerebral atrophy. After 1 month of adjuvant hyperbaric oxygen therapy， the boy’s memory recovered to the level before disease onset， and reexaminations of MRI and video electroencephalography obtained normal results.No recurrence was observed during follow-up for 6 months， and the boy achieved satisfactory academic performance.This case suggests that for children with antibody-negative AE， first-line immunotherapy combined with tocilizumab can rapidly control inflammation， and the addition of hyperbaric oxygen therapy can effectively improve subsequent cerebral structural and cognitive abnormalities， with few adverse reactions， which provides a new clinical approach for the treatment of this type of disease.
