Long-term selective IgG immuno-adsorption improves Rasmussen's encephalitis.
We report that long-term selective immunoglobulin G immunoadsorption by protein A (PAI) improved seizure frequency and neuropsychological deficits in a 16-year-old patient with severe treatment-resistant Rasmussen's encephalitis (RE). Clinical improvement correlated with reduction of antiglutamate receptor 3 antibodies. The efficacy of PAI in our patient supports the autoimmune hypothesis of RE and suggests its application to avoid, or at least delay, functional hemispherectomy in selected cases.
Neuromuscular Research Department, Istituto Nazionale Neurologico Carlo Besta, Milan, Italy.
C
C
Antozzi
T
T
Granata
N
N
Aurisano
G
G
Zardini
P
P
Confalonieri
G
G
Airaghi
R
R
Mantegazza
R
R
Spreafico
D000293:Adolescent; D001323:Autoantibodies / Q000302:isolation & purification*; D004660:Encephalitis / Q000276:immunology / Q000628:therapy*; D017036:Epilepsia Partialis Continua / Q000276:immunology / Q000628:therapy*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000302:isolation & purification*; D007164:Immunosorbents; D007802:Language; D009483:Neuropsychological Tests; D018094:Receptors, Metabotropic Glutamate / Q000276:immunology; D013205:Staphylococcal Protein A / Q000276:immunology
D001323:Autoantibodies; D007074:Immunoglobulin G; D007164:Immunosorbents; D018094:Receptors, Metabotropic Glutamate; D013205:Staphylococcal Protein A; C102718:metabotropic glutamate receptor 3