engleski

Aggressive anti-LGI1 encephalitis defeated by one cycle of intravenous rituximab-a case report

Background Anti LGI-1 encephalitis is a form of VGKC encephalitis which typically evolves acutely or subacutely and predominately affects elderly males. In a majority of patients, anti LGI-1 encephalitis has been successfully treated with diverse first-line treatments including intravenous and oral corticosteroids, therapeutic plasma exchange and intravenous immunoglobulins. Despite the lack of strong evidence from randomized controlled trials, in resistant cases of autoimmune encephalitides a suggested second-line therapy such as rituximab, cyclophosphamide, azathioprine, mycophenolate mofetil, toclizumab have showed a substantial efficacy. Case presentation We report a case of aggressive form of anti LGI-1 encephalitis in a 64-years-old woman which presented predominately with psychiatric features and short-term memory impairment. The first-line treatments showed only partial efficacy resulting in a relapse of the disease in a two-month period. Further therapy included application of IV rituximab in total 2g IV, divided in two doses in two weeks apart. Clinical recovery was observed immediately and no signs of the disease as well as no neurological and psychiatric seqela was observed during the nine-month follow-up. Conclusions This case report highlights the necessity of early recognition and consideration of more specific immunotherapy at the very beginning of the treatment of the anti LGI1 encephalitis.

anti LGI1 ; encephalitis ; rituximab

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