PMID- 33381080
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210101
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 11
DP  - 2020
TI  - Efficacy and Safety of Rituximab in Chinese Children With Refractory Anti-NMDAR 
      Encephalitis.
PG  - 606923
LID - 10.3389/fneur.2020.606923 [doi]
LID - 606923
AB  - Purpose: To assess the efficacy and safety of rituximab treatment as second-line 
      immunotherapy in pediatric cases of anti-NMDA receptor (NMDAR) encephalitis. 
      Methods: We retrospectively recruited 8 patients with anti-NMDAR encephalitis who 
      were treated with rituximab as second-line immunotherapy. We evaluated the 
      clinical features, laboratory examination results and treatment protocols of the 
      Chinese children and defined good outcomes based on the modified Rankin scale 
      (mRS) score (0-2) at the last follow-up. Results: A total of eight pediatric 
      patients (median age 6.7 years; four female) with refractory anti-NMDAR 
      encephalitis were recruited to the study. Rituximab was given after a median 
      duration of disease of 57 days (range 50.5-113.75 days). The use of rituximab led 
      to a significant reduction in the mRS and CD19+ B-cells compared to before 
      rituximab infusion (P < 0.05). Five patients (62.5%) had a good outcome (mRS </= 2) 
      including four patients (50%) who showed complete recovery (mRS = 0) at the last 
      follow-up. Transient infusion adverse events were recorded in 2 patients (25%). 
      Two patients (25%) had severe infectious adverse events (AEs) and two patients 
      with grade 5 (death). None of the patients developed progressive multifocal 
      leukoencephalopathy (PML). Conclusion: Our study provides evidence that rituximab 
      can efficiently improve the clinical symptoms of anti-NMDAR encephalitis in 
      children. However, due to the risk of adverse infections, rituximab should be 
      restricted in pediatric patients with high rates of mortality and disability.
CI  - Copyright (c) 2020 Dou, Li, Wu, Wang, Yang, Ma, Wang and Li.
FAU - Dou, Xiangjun
AU  - Dou X
AD  - Department of Pediatric Neurology, Xi'an Children' Hospital, Xi'an, China.
FAU - Li, Dongjing
AU  - Li D
AD  - Department of Pediatric Neurology, Xi'an Children' Hospital, Xi'an, China.
FAU - Wu, Yan
AU  - Wu Y
AD  - Department of Pediatric Neurology, Xi'an Children' Hospital, Xi'an, China.
FAU - Wang, Zhijing
AU  - Wang Z
AD  - Department of Pediatric Neurology, Xi'an Children' Hospital, Xi'an, China.
FAU - Yang, Le
AU  - Yang L
AD  - Department of Pediatric Neurology, Xi'an Children' Hospital, Xi'an, China.
FAU - Ma, Nan
AU  - Ma N
AD  - Department of Pediatric Neurology, Xi'an Children' Hospital, Xi'an, China.
FAU - Wang, Dong
AU  - Wang D
AD  - Department of Pediatric Neurology, Xi'an Children' Hospital, Xi'an, China.
FAU - Li, Xia
AU  - Li X
AD  - Department of Pediatric Neurology, Xi'an Children' Hospital, Xi'an, China.
LA  - eng
PT  - Journal Article
DEP - 20201214
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC7767921
OTO - NOTNLM
OT  - adverse event
OT  - anti-NMDAR encephalitis
OT  - children
OT  - outcome
OT  - rituximab
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/01/01 06:00
MHDA- 2021/01/01 06:01
PMCR- 2020/12/14
CRDT- 2020/12/31 05:24
PHST- 2020/09/16 00:00 [received]
PHST- 2020/11/24 00:00 [accepted]
PHST- 2020/12/31 05:24 [entrez]
PHST- 2021/01/01 06:00 [pubmed]
PHST- 2021/01/01 06:01 [medline]
PHST- 2020/12/14 00:00 [pmc-release]
AID - 10.3389/fneur.2020.606923 [doi]
PST - epublish
SO  - Front Neurol. 2020 Dec 14;11:606923. doi: 10.3389/fneur.2020.606923. eCollection 
      2020.