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Therapeutic apheresis for autoimmune encephalitis : A nationwide data collection.
MedLine Citation:
PMID:  23325312     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The correlation between detection of autoantibodies and the pattern and severity of symptoms in patients with encephalitis was the crucial factor for the initiation of immune therapy. The elimination of autoantibodies using therapeutic apheresis by plasma exchange (PE) and immunoadsorption (IA) is a pathophysiologically guided therapeutic approach. The aim was to evaluate the current use of PE and for the first time also of IA for patients with autoimmune encephalitis. METHODS: A nationwide data collection was performed and the modified Rankin score (mRS) was used to evaluate the severity of neurological symptoms. RESULTS: Data of 31 treatment courses (30 patients and 1 relapse) were documented and 22 patients were positive for autoantibodies (NMDA-R, GABA, VGKC, Hu). In 23 cases PA was performed, tryptophan IA in 7 cases and in 1 patient both methods were applied. In 67 % of the treatment courses the mRS improved and the mean mRS of all patients was 3.2 before apheresis and 2.2 after apheresis (p < 0.05). All patients who were treated with IA improved clinically from a mean mRS of 3.9 before IA to 1.9 after IA (p < 0.01). CONCLUSIONS: For immune-mediated forms of encephalitis rapid elimination of autoantibodies with PA and IA seems to be an effective therapeutic option as part of a multimodal immune therapy and is already established in many clinics in Germany.
Authors:
S Ehrlich; C M Fassbender; C Blaes; C Finke; A Günther; L Harms; F Hoffmann; K Jahner; R Klingel; A Kraft; T Lempert; M Tesch; J Thomsen; H Topka; J Jochim; C Veauthier; W Köhler
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-18
Journal Detail:
Title:  Der Nervenarzt     Volume:  -     ISSN:  1433-0407     ISO Abbreviation:  Nervenarzt     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400773     Medline TA:  Nervenarzt     Country:  -    
Other Details:
Languages:  GER     Pagination:  -     Citation Subset:  -    
Affiliation:
Klinik für Neurologie und neurologische Intensivmedizin, Fachkrankenhaus Hubertusburg, An der Hubertusburg 85, 04779, Wermsdorf, Deutschland.
Vernacular Title:
Therapeutische Apherese bei autoimmuner Enzephalitis : Eine bundesweite Datenerhebung.
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