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methotrexate nmdar

Xun-Zhe Yang, Hua-Dong Zhu, Hai-Tao Ren, Yi-Cheng Zhu, Bin Peng, Li-Ying Cui, Hong-Zhi Guan
BACKGROUND: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a treatable autoimmune neurologic syndrome that occurs with or without tumor association. However, some severe cases are refractory to systemic immunotherapy. This pilot study aimed to evaluate the utility and safety of intrathecal methotrexate injection for severe patients with anti-NMDAR encephalitis who did not respond to first-line immunotherapy. METHODS: Intrathecal injections with methotrexate and dexamethasone were performed weekly in four legible patients within consecutive 4 weeks...
January 20, 2018: Chinese Medical Journal
Lisbeth Samsø Schmidt, Troels W Kjær, Kjeld Schmiegelow, Alfred Peter Born
Sub-acute neurotoxicity is a well-known complication to high-dose and intrathecal methotrexate (MTX) treatment of children with leukemia. Symptoms can be treated safely by dextromethorphan, a non-competitive antagonist to N-methyl-D-aspartic acid receptor (NMDAR). In a female with subacute MTX neurotoxicity, we observed an electroencephalographic (EEG) with extreme delta brush. Extreme delta brush is an EEG pattern previously described in patients with NMDAR autoimmune encephalitis. The observations suggest that the mechanism of this neurotoxicity may be mediated by the NMDAR...
September 2017: European Journal of Paediatric Neurology: EJPN
Sarah Tatencloux, Pascale Chretien, Veronique Rogemond, Jerome Honnorat, Marc Tardieu, Kumaran Deiva
Anti-NDMA receptor (NMDAR) encephalitis is an auto-immune condition. There is no uniformly agreed treatment strategy for the disorder in children. We report the use of intrathecal treatment with methotrexate and methylprednisolone in three children (one male, two females, age 10y, 11y, and 14y) with anti-NMDAR encephalitis, who did not respond to steroids, plasmapheresis, or rituximab. There was significant clinical improvement and stabilization of the anti-NMDAR antibody titers in cerebrospinal fluid (CSF) and blood in two patients...
January 2015: Developmental Medicine and Child Neurology
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