Therapeutic Plasma Exchange (TPE) in autoimmune encephalitis: a case report
Main Article Content
Keywords
autoimmune, encephalitis, NMDA, TPE
Abstract
Introduction: Encephalitis is an inflammatory process of the brain parenchyma caused by viruses, bacteria, fungi, or autoimmunity. These rare cases result from antibody reactions to extracellular membrane antigens in the nervous system. The anti-n-methyl D-Aspartate Receptor (NMDA) test confirms autoimmune encephalitis diagnosis. The American Society for Apheresis (ASFA) recommends immunotherapy and Therapeutic Plasma Exchange (TPE) in autoimmune encephalitis, a medical procedure to remove pathogenic antibodies and replace them with substitute fluid. This study aimed to describe TPE in an autoimmune encephalitis patient.
Case description: An 18-year-old female with decreased consciousness GCS E2M4Vx. History of body seizures, frequency 4 times, duration 5-20 minutes, accompanied by fever. The patient had memory deficits and psychiatric disorders like hallucinations. A neurological physical examination revealed stiffness and weakness in all of the extremities. Radiology showed mesial temporal sclerosis, and abnormal electroencephalogram (EEG) results in a suspected structural lesion. Laboratory results showed leukocytosis, elevated inflammatory markers, and staphylococcus haemolyticus, which were detected from liquor cerebrospinal analysis. The patient met the criteria for the diagnosis of autoimmune encephalitis. TPE was performed 5 times as curative therapy. Neurological physical monitoring and routine blood tests, electrolytes (sodium, potassium, and chloride), and albumin as monitoring of TPE and therapeutic response.
Conclusion: The results of TPE were significant for the improvement of consciousness and improvement of motoric extremities in autoimmune encephalitis.
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