Open AccessTherapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center
Author(s) -
Prashant Pandey,
Nitin Agarwal,
Manish Gupta
Publication year - 2018
Publication title -
asian journal of transfusion science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.262
H-Index - 22
eISSN - 1998-3565
pISSN - 0973-6247
DOI - 10.4103/ajts.ajts_112_17
Subject(s) - medicine , autoantibody , autoimmune encephalitis , therapeutic plasma exchange , plasmapheresis , encephalitis , magnetic resonance imaging , antibody , pediatrics , immunology , radiology , virus
In half of the suspected autoimmune encephalitis (AIE) patients, no antibodies are identified despite extensive investigation. Therapeutic plasma exchange (TPE) is a potential first-line therapy for various subtypes of AIE. Here, we present a case of autoantibody-negative-suspected AIE, managed successfully with TPE after patient showed no response to steroids. A total of 5 sessions of TPE was done. One standard TPE procedure session was 1.2-1.5 plasma volume exchanges using 5% albumin as a replacement fluid. After five sessions, patient's clinical condition improved significantly, and a repeated magnetic resonance imaging after 5th cycle of TPE revealed a reduction in the areas of signal alteration. This was suggestive of regression of disease. Patient was discharged on 10th day of hospital admission. With early suspicion even in the absence of detectable autoantibodies, TPE plays an important role in the management of encephalitis.