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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.
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]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Low-dose rituximab for the treatment of anti-NMDAR encephalitis in children: a case series study.
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  Data: <searchLink fieldCode="AR" term="%22Wu%2C+Haiyan%22">Wu, Haiyan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Xu%2C+Fenfen%22">Xu, Fenfen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Yuan%22">Chen, Yuan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ding%2C+Shanshan%22">Ding, Shanshan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Wei%22">Li, Wei</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Qiuyue%22">Li, Qiuyue</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Na%22">Chen, Na</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tang%2C+Lin%22">Tang, Lin</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Aug2025, Vol. 46 Issue 8, p3813-3818. 6p.
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  Data: <searchLink fieldCode="DE" term="%22Anti-NMDA+receptor+encephalitis%22">Anti-NMDA receptor encephalitis</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+sciences%22">Medical sciences</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+care+of+children%22">Hospital care of children</searchLink><br /><searchLink fieldCode="DE" term="%22B+cells%22">B cells</searchLink><br /><searchLink fieldCode="DE" term="%22CD19+antigen%22">CD19 antigen</searchLink>
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  Data: 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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  Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Aug2025
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