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Asian J Transfus Sci. 2018 Jul-Dec;12(2):173-175. doi: 10.4103/ajts.AJTS_112_17.

Therapeutic plasma exchange as a life-saving therapy in a suspected case of autoimmune encephalitis: A case report from a tertiary health-care center.

Author information

1
Department of Transfusion Medicine, Jaypee Hospital, Noida, Uttar Pradesh, India.
2
Department of Neurology, Jaypee Hospital, Noida, Uttar Pradesh, India.

Abstract

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.

KEYWORDS:

Autoimmune encephalitis; corticosteroid; intravenous immunoglobulins; therapeutic plasma exchange

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