Immunoadsorption Therapy in Managing NMDAR Antibodies Encephalitis

Summary

The purpose of the study is to assess the efficacy of immunoadsorption therapy (IA) on improving the neurological status of severe pediatric anti-NMDAR encephalitis patients.

Eligibility

Inclusion Criteria:

* Age: 0-18 years inclusive
* Autoimmune encephalitis with positive anti-NMDAR antibodies in CSF (definite anti-NMDAR encephalitis according to Graus's criteria (Graus et al., 2016).
* PCPCS and mRS at 4 or over at the inclusion after first line therapy (steroids and/or IgIV) when Rituximab therapy is warranted
* Parents or legal guardians signed the Informed consent form
* Social insurance affiliation

Exclusion Criteria:

* Autoimmune encephalitis without NMDAR antibodies
* PCPCS and mRS scores under 4 after first-line therapy
* Contraindication to perform central vascular access
* Pregnancy, breastfeeding or absence of effective contraception (including abstinence) in a pubertal patient.
* Contraindication to perform IA therapy :

  * Clinical conditions that prohibit transitory volume changes
  * Indications that prohibit anticoagulation using Heparin and/or ACD-A solutions
  * History of hypercoagulability
  * Generalized viral, bacterial and/or mycotic infections
  * Severe immune deficiencies (e.g. AIDS)
  * Suspected allergies against sheep antibodies or agarose

Conditions2

Interventions2

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