托珠单抗治疗1例儿童难治性抗<i>N</i>-甲基-<i>D</i>-天冬氨酸受体脑炎的病例报告及文献复习

张卫琴; 赵华伟; 王珍珍; 高峰; 袁哲锋

doi:10.13748/j.cnki.issn1007-7693.20232480

托珠单抗治疗1例儿童难治性抗N-甲基-D-天冬氨酸受体脑炎的病例报告及文献复习

A Case Report and Literature Review of A Child with Refractory Anti-N-methyl-D-aspartate Receptor Encephalitis Treated with Tocilizumab

摘要

摘要:
目的探讨托珠单抗治疗1例儿童难治性抗N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor，NMDAR)脑炎的安全性及有效性，为治疗该疾病提供参考。
方法回顾性分析浙江大学医学院附属儿童医院1例儿童难治性抗NMDAR脑炎的临床表现、诊治经过及应用托珠单抗的安全性及有效性，并结合相关文献复习加以讨论。
结果该患儿应用了2次大剂量甲泼尼龙、丙种球蛋白及6次利妥昔单抗后临床症状无好转，应用6次托珠单抗后，改良Rankin量表(mRS)评分有改善，无不良反应。
结论托珠单抗作为升级的二线免疫治疗药物对难治性抗NMDAR脑炎治疗有效，耐受性好，是一种具备潜力的治疗手段之一。

Abstract:
OBJECTIVE To explore the safety and efficacy of tocilizumab in the treatment of refractory anti-N-methyl-D-aspartate receptor encephalitis in children, and to provide reference for the treatment of this disease.
METHODS The clinical manifestations, diagnosis and treatment, safety and efficacy of tocilizumab in a case of refractory anti-NMDAR encephalitis in Children’s Hospital, Zhejiang University School of Medicine were analyzed retrospectively, and the relevant literature was reviewed.
RESULTS The clinical symptoms of the patient were not improved after 2 doses of methylprednisolone, immunoglobulin and 6 doses of rituximab. After 6 doses of tocilizumab, the modified Rankin scale(mRS) score was improved without adverse reactions.
CONCLUSION Tocilizumab, as a escalation second-line immunotherapy, is effective and well tolerated in the treatment of refractory anti-NMDAR encephalitis. It is one of the potential therapeutic means.

HTML全文

参考文献(25)

施引文献

资源附件(0)