N-Methyl-D-Aspartate Receptor Antibody Encephalitis is an autoimmune disorder that affects the central nervous system. Total plasma exchange can provide clinical improvement by removing the autoantibodies.
Total plasma exchange is used to remove autoantibodies. This may be performed in conjunction with rituximab with or without cyclophosphamide, which reduces production of the autoantibody.
Other therapies:
(1) high-dose intravenous methylprednisolone
(2) intravenous immune globulin (IVIG)
(3) search for an underlying teratoma
Target volume: 1.5 times total plasma volume
Replacement fluid: albumin
Frequency: every other day
Response may be slow since the autoantibodies need to be removed from the central nervous system.
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