Immunotherapy for anti-NMDAR encephalitis: A review of paraneoplastic, autoimmune encephalopathy
學年 105
學期 2
出版(發表)日期 2017-03-01
作品名稱 Immunotherapy for anti-NMDAR encephalitis: A review of paraneoplastic, autoimmune encephalopathy
作品名稱(其他語言)
著者 Ruu-Fen Tzang; Kate Hsu; Yue-Cune Chang; Tsang-Pai Liu
單位
出版者
著錄名稱、卷期、頁數 Journal of Cancer Research and Practice 4(1), p.1-4
摘要 Paraneoplastic immune-mediated encephalopathy is a recently described disease. Dalmau et al first linked the presence of Anti-N-methyl-d-aspartate receptor (anti-NMDAR) antibodies to paraneoplastic psychiatric and neurologic disease after encountering a case of anti-NMDAR encephalitis in a woman with ovarian teratoma in 2007. Nerve cells from a teratoma or previous viral infection could trigger autoantibodies, causing NMDA receptors to become dysfunctional in neurotransmission across synapses. Symptoms of anti-NMDAR encephalitis include prodromal symptoms, psychiatric symptoms, speech dysfunction, seizure, abnormal neurological movement, and autonomic dysfunction. This disease is reversible and treatable; however, early diagnosis and treatment are essential as they may prevent excess antibodies from causing severe or prolonged harm in the brain. First-line Immunotherapy includes intravenous high-dose steroids (methylprednisolone), intravenous immunoglobulin (IVIG), and/or plasmapheresis. Second-line immunotherapy includes targeted B-cell therapy with rituximab and cyclophosphamide. Taiwan is one of the countries where tests for detecting this disease, which are expensive, are not currently available. A cell-based indirect immunofluorescence test for the detection of IgG antibodies against the NMDA receptor should become more available for aiding diagnostics. Most importantly, early immune modulatory therapy including steroid, IVIG, and plasma exchange should become financially more feasible for use in treatment in Taiwan.
關鍵字 Anti-NMDAR encephalitis;Ovarian teratoma;Immunotherapy
語言 en
ISSN
期刊性質 國內
收錄於
產學合作
通訊作者
審稿制度
國別 TWN
公開徵稿
出版型式 ,電子版,紙本
相關連結

機構典藏連結 ( http://tkuir.lib.tku.edu.tw:8080/dspace/handle/987654321/112713 )