New onset metabolic derangement in a pediatric patient receiving therapeutic plasma exchange for anti‐NMDA receptor encephalitis

2020 ◽  
Vol 35 (2) ◽  
pp. 125-127 ◽  
Author(s):  
Margo R. Rollins ◽  
Judith Deeter ◽  
Charlene D. Banks ◽  
Pam Langley
Keyword(s):  
Nmda Receptor ◽  
Plasma Exchange ◽  
Pediatric Patient ◽  
Therapeutic Plasma Exchange ◽  
Metabolic Derangement ◽  
Nmda Receptor Encephalitis ◽  
New Onset

scholarly journals Efficacy of Therapeutic Plasma Exchange in Patients with Severe Refractory Anti-NMDA Receptor Encephalitis

2019 ◽  
Vol 16 (3) ◽  
pp. 828-837 ◽  
Author(s):  
Yan Zhang ◽  
Gang Liu ◽  
Mengdi Jiang ◽  
Weibi Chen ◽  
Yingying Su
Keyword(s):  
Nmda Receptor ◽  
Plasma Exchange ◽  
Therapeutic Plasma Exchange ◽  
Nmda Receptor Encephalitis

Therapeutic plasma exchange for the treatment of anti-NMDA receptor encephalitis

2011 ◽  
Vol 26 (6) ◽  
pp. 320-325 ◽  
Author(s):  
Huy P. Pham ◽  
Jennifer A. Daniel-Johnson ◽  
Brie A. Stotler ◽  
Hannah Stephens ◽  
Joseph Schwartz
Keyword(s):  
Nmda Receptor ◽  
Plasma Exchange ◽  
Therapeutic Plasma Exchange ◽  
Nmda Receptor Encephalitis

scholarly journals NATURAL PRODUCTS IN TREATMENT OF ENCEPHALITIS: A REVIEW

2021 ◽  
Vol 21 (no 1) ◽  
Author(s):  
Danishpreet Kaur Takhar ◽  
Mukta Gupta
Keyword(s):  
Natural Products ◽  
Nmda Receptor ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Psychotic Disorders ◽  
Treatment Options ◽  
Therapeutic Approaches ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor

Brain on fire, an unusual phrase used for the deadliest autoimmune ailment, called anti-NMDA (N-methyl-D-aspartate) receptor encephalitis, characterizing extreme psychiatric and neurotic signs. Though being the deadliest one, still it can be treated with the help of various therapeutic approaches such as Corticosteroids, Intravenous immunoglobulin (IVIG) and plasmapheresis or plasma exchange. Although the prevalence of encephalitis can be observed in both the sexes, however the majority of ailment (95%) is seen in women with teratoma ovaries or different neoplasms. Recognition of nti-NMDA receptor encephalitis could be very essential to avoid any misconception regarding incorrect interpretation of various psychotic disorders. However, various treatment options are available still further investigation should be required to carried out to find out other clinically beneficial drugs.

scholarly journals Anti-NMDA receptor encephalitis presenting as new onset refractory status epilepticus in COVID-19

Seizure ◽  
2020 ◽  
Vol 81 ◽  
pp. 18-20 ◽  
Author(s):  
Giulia Monti ◽  
Giada Giovannini ◽  
Andrea Marudi ◽  
Roberta Bedin ◽  
Alessandra Melegari ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Nmda Receptor ◽  
Refractory Status Epilepticus ◽  
Nmda Receptor Encephalitis ◽  
Refractory Status ◽  
New Onset

scholarly journals Treatment of severe leptospirosis with therapeutic plasma exchange in a pediatric patient

2018 ◽  
Vol 60 (5) ◽  
pp. 566
Author(s):  
Faruk Ekinci ◽  
R. Dinçer Yıldızdaş ◽  
Özden Özgür Horoz ◽  
Derya Alabaz ◽  
İlknur Tolunay ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Pediatric Patient ◽  
Therapeutic Plasma Exchange ◽  
Severe Leptospirosis

scholarly journals Serious acid-base disorder or life-threatening arrhythmia in patients with ABO-incompatible liver transplantation who received therapeutic plasma exchange : A report of two cases

2021 ◽  
Author(s):  
Sangho Lee ◽  
Kyoung-Sun Kim ◽  
Bo-Hyun Sang ◽  
Gyu-Sam Hwang
Keyword(s):  
Plasma Exchange ◽  
Metabolic Alkalosis ◽  
Therapeutic Plasma Exchange ◽  
Acid Base ◽  
Metabolic Derangement ◽  
Surgical Incision ◽  
Electrolyte Disturbance ◽  
Electrolyte Disturbances ◽  
Base Disorder ◽  
Life Threatening

Background: Excessive citrate load during therapeutic plasma exchange (TPE) can cause metabolic alkalosis with compensatory hypercarbia and electrolyte disturbances. If TPE is required immediately before ABO-incompatible (ABOi) liver transplant (LT) surgery, metabolic derangement and severe electrolyte disturbance could worsen during LT anesthesia.Case: We report two ABOi LT cases who received TPE on the day of surgery because isoagglutinin titers did not be dropped below 1:8. One case had a surprisingly high metabolic alkalosis with a pH of 7.73 immediately after tracheal intubation because of hyperventilation during mask bagging. The other experienced sudden ventricular tachycardia and blood pressure drop after surgical incision accompanied with severe hypokalemia of 1.8 mmol/L despite supplementation with potassium.Conclusions: Special attention should be paid to patients who just completed TPE the operative day morning as they are vulnerable to severe acid-base disturbances and life-threatening ventricular arrhythmias in ABOi LT.

Bortezomib for treatment of anti–NMDA receptor encephalitis in a pediatric patient refractory to conventional therapy

2021 ◽  
Vol 78 (5) ◽  
pp. 395-400 ◽  
Author(s):  
Marroyln L Simmons ◽  
Kimberly A Perez
Keyword(s):  
Nmda Receptor ◽  
Clinical Improvement ◽  
Pediatric Patient ◽  
Mental Status ◽  
Clinical Status ◽  
Inpatient Rehabilitation ◽  
High Dose ◽  
Nmda Receptor Encephalitis ◽  
High Dose Methylprednisolone ◽  
Receptor Antibodies

Abstract Purpose The case of a pediatric patient with treatment refractory anti–N-methyl-d-aspartate (NMDA) receptor encephalitis treated with the plasma cell–depleting therapy bortezomib is reported. Summary A 5-year-old female presented to the hospital with a 1-week history of altered mental status, agitation, and possible seizure-like activity. She was admitted to the hospital for suspected meningitis or meningoencephalitis and an extensive workup was completed, including sending blood and cerebrospinal fluid (CSF) for testing for NMDA receptor antibodies. While test results were pending, the patient was treated initially with intravenous immunoglobulin (IVIG) for 4 days followed by high-dose methylprednisolone for 5 days. The patient’s serum and CSF studies were positive for NMDA receptor antibodies, confirming the diagnosis of anti–NMDA receptor encephalitis. She was then treated with plasmapheresis therapy every other day for 5 treatments, without any clinical improvement. The patient then received rituximab once weekly for 6 weeks. Three weeks after completion of rituximab therapy, the patient was started on her first cycle of bortezomib therapy. She received a total of 6 cycles, with improvement in her clinical status beginning with the third cycle. Upon completion of 6 cycles, the patient’s mental status and level of functioning had greatly improved. She was discharged to an inpatient rehabilitation facility and ultimately able to return home to her family. Conclusion A 5-year-old female with anti–NMDA receptor encephalitis was successfully treated with bortezomib after having shown no clinical improvement during treatment with IVIG, high-dose methylprednisolone, plasmapheresis, and rituximab.

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