Low-dose rituximab for the treatment of anti-NMDAR encephalitis in children: a case series study.
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| Title: | Low-dose rituximab for the treatment of anti-NMDAR encephalitis in children: a case series study. |
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| Authors: | Wu, Haiyan (AUTHOR), Xu, Fenfen (AUTHOR), Chen, Yuan (AUTHOR), Ding, Shanshan (AUTHOR), Li, Wei (AUTHOR), Li, Qiuyue (AUTHOR), Chen, Na (AUTHOR), Tang, Lin (AUTHOR) |
| Source: | Neurological Sciences. Aug2025, Vol. 46 Issue 8, p3813-3818. 6p. |
| Subjects: | Anti-NMDA receptor encephalitis, Medical sciences, Hospital care of children, B cells, CD19 antigen |
| Abstract: | Background and purpose: Rituximab is a widely used second-line immune drug for the treatment of anti-NMDAR encephalitis in patients who fail to improve approximately 2 weeks after the initiation of first-line therapies (corticosteroids, intravenous immunoglobulin, plasma exchange). The aim of this study was to investigate the efficacy and safety of low-dose rituximab in the treatment of autoimmune encephalitis in children. Methods: This case series included 6 hospitalized children without tumors with anti-NMDAR encephalitis from January 2018 to December 2020. These children were treated with low-dose rituximab (100 mg, once weekly, according to peripheral blood CD19 + B-cell levels, 3–4 cycles, until CD19 + B cells in peripheral blood were cleared) approximately 2 weeks after the initiation of 2 or more first-line immunotherapies. Results: After 3–4 cycles of low-dose rituximab (100 mg) treatment, the mRS score and CD19 + B-cell count decreased significantly, and the patients maintained stable neurological function (mRS ≤ 2). No adverse events resulting from infusion or other adverse reactions occurred in any patient. Conclusion: In children with autoimmune encephalitis without tumors for whom first-line immunotherapy is ineffective, low-dose rituximab effectively reduces peripheral blood CD19 + B-cell counts, improves the clinical symptoms of patients and reduces hospitalization expenses. RCTs with sufficient sample sizes are needed to firmly establish the value of low-dose rituximab therapy for treating anti-NMDAR encephalitis in children. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Background and purpose: Rituximab is a widely used second-line immune drug for the treatment of anti-NMDAR encephalitis in patients who fail to improve approximately 2 weeks after the initiation of first-line therapies (corticosteroids, intravenous immunoglobulin, plasma exchange). The aim of this study was to investigate the efficacy and safety of low-dose rituximab in the treatment of autoimmune encephalitis in children. Methods: This case series included 6 hospitalized children without tumors with anti-NMDAR encephalitis from January 2018 to December 2020. These children were treated with low-dose rituximab (100 mg, once weekly, according to peripheral blood CD19 + B-cell levels, 3–4 cycles, until CD19 + B cells in peripheral blood were cleared) approximately 2 weeks after the initiation of 2 or more first-line immunotherapies. Results: After 3–4 cycles of low-dose rituximab (100 mg) treatment, the mRS score and CD19 + B-cell count decreased significantly, and the patients maintained stable neurological function (mRS ≤ 2). No adverse events resulting from infusion or other adverse reactions occurred in any patient. Conclusion: In children with autoimmune encephalitis without tumors for whom first-line immunotherapy is ineffective, low-dose rituximab effectively reduces peripheral blood CD19 + B-cell counts, improves the clinical symptoms of patients and reduces hospitalization expenses. RCTs with sufficient sample sizes are needed to firmly establish the value of low-dose rituximab therapy for treating anti-NMDAR encephalitis in children. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 15901874 |
| DOI: | 10.1007/s10072-025-08228-1 |
