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Therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center

In half of the suspected autoimmune encephalitis (AIE) patients, no antibodies are identified despite extensive investigation. Therapeutic plasma exchange (TPE) is a potential first-line therapy for various subtypes of AIE. Here, we present a case of autoantibody-negative-suspected AIE, managed succ...

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Autores principales: Pandey, Prashant Kumar, Agarwal, Nitin, Gupta, Manish
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327764/
https://www.ncbi.nlm.nih.gov/pubmed/30692806
http://dx.doi.org/10.4103/ajts.AJTS_112_17
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author Pandey, Prashant Kumar
Agarwal, Nitin
Gupta, Manish
author_facet Pandey, Prashant Kumar
Agarwal, Nitin
Gupta, Manish
author_sort Pandey, Prashant Kumar
collection PubMed
description In half of the suspected autoimmune encephalitis (AIE) patients, no antibodies are identified despite extensive investigation. Therapeutic plasma exchange (TPE) is a potential first-line therapy for various subtypes of AIE. Here, we present a case of autoantibody-negative-suspected AIE, managed successfully with TPE after patient showed no response to steroids. A total of 5 sessions of TPE was done. One standard TPE procedure session was 1.2–1.5 plasma volume exchanges using 5% albumin as a replacement fluid. After five sessions, patient's clinical condition improved significantly, and a repeated magnetic resonance imaging after 5th cycle of TPE revealed a reduction in the areas of signal alteration. This was suggestive of regression of disease. Patient was discharged on 10th day of hospital admission. With early suspicion even in the absence of detectable autoantibodies, TPE plays an important role in the management of encephalitis.
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spelling pubmed-63277642019-01-28 Therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center Pandey, Prashant Kumar Agarwal, Nitin Gupta, Manish Asian J Transfus Sci Case Report In half of the suspected autoimmune encephalitis (AIE) patients, no antibodies are identified despite extensive investigation. Therapeutic plasma exchange (TPE) is a potential first-line therapy for various subtypes of AIE. Here, we present a case of autoantibody-negative-suspected AIE, managed successfully with TPE after patient showed no response to steroids. A total of 5 sessions of TPE was done. One standard TPE procedure session was 1.2–1.5 plasma volume exchanges using 5% albumin as a replacement fluid. After five sessions, patient's clinical condition improved significantly, and a repeated magnetic resonance imaging after 5th cycle of TPE revealed a reduction in the areas of signal alteration. This was suggestive of regression of disease. Patient was discharged on 10th day of hospital admission. With early suspicion even in the absence of detectable autoantibodies, TPE plays an important role in the management of encephalitis. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6327764/ /pubmed/30692806 http://dx.doi.org/10.4103/ajts.AJTS_112_17 Text en Copyright: © 2018 Asian Journal of Transfusion Science http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Pandey, Prashant Kumar
Agarwal, Nitin
Gupta, Manish
Therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center
title Therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center
title_full Therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center
title_fullStr Therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center
title_full_unstemmed Therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center
title_short Therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center
title_sort therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: a case report from a tertiary health-care center
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327764/
https://www.ncbi.nlm.nih.gov/pubmed/30692806
http://dx.doi.org/10.4103/ajts.AJTS_112_17
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