title: [Therapeutic apheresis for autoimmune encephalitis: a nationwide data collection].
abstract: BACKGROUND
  The correlation between detection of autoantibodies and the pattern and severity of symptoms in patients with encephalitis was the crucial factor for the initiation of immune therapy. The elimination of autoantibodies using therapeutic apheresis by plasma exchange (PE) and immunoadsorption (IA) is a pathophysiologically guided therapeutic approach. The aim was to evaluate the current use of PE and for the first time also of IA for patients with autoimmune encephalitis.
  
  
  METHODS
  A nationwide data collection was performed and the modified Rankin score (mRS) was used to evaluate the severity of neurological symptoms.
  
  
  RESULTS
  Data of 31 treatment courses (30 patients and 1 relapse) were documented and 22 patients were positive for autoantibodies (NMDA-R, GABA, VGKC, Hu). In 23 cases PA was performed, tryptophan IA in 7 cases and in 1 patient both methods were applied. In 67 % of the treatment courses the mRS improved and the mean mRS of all patients was 3.2 before apheresis and 2.2 after apheresis (p < 0.05). All patients who were treated with IA improved clinically from a mean mRS of 3.9 before IA to 1.9 after IA (p < 0.01).
  
  
  CONCLUSIONS
  For immune-mediated forms of encephalitis rapid elimination of autoantibodies with PA and IA seems to be an effective therapeutic option as part of a multimodal immune therapy and is already established in many clinics in Germany.
authors: Klinik für Neurologie und neurologische Intensivmedizin, Fachkrankenhaus Hubertusburg, An der Hubertusburg 85, 04779 Wermsdorf, Deutschland.
authors: S
authors: S
authors: Ehrlich
authors: C M
authors: CM
authors: Fassbender
authors: C
authors: C
authors: Blaes
authors: C
authors: C
authors: Finke
authors: A
authors: A
authors: Günther
authors: L
authors: L
authors: Harms
authors: F
authors: F
authors: Hoffmann
authors: K
authors: K
authors: Jahner
authors: R
authors: R
authors: Klingel
authors: A
authors: A
authors: Kraft
authors: T
authors: T
authors: Lempert
authors: M
authors: M
authors: Tesch
authors: J
authors: J
authors: Thomsen
authors: H
authors: H
authors: Topka
authors: J
authors: J
authors: Jochim
authors: C
authors: C
authors: Veauthier
authors: W
authors: W
authors: Köhler
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001323:Autoantibodies / Q000276:immunology / Q000302:isolation & purification*; D001781:Blood Component Removal / Q000379:methods*; D001927:Brain Diseases / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy*; D004660:Encephalitis; D005260:Female; D005858:Germany / Q000453:epidemiology; D050031:Hashimoto Disease / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001323:Autoantibodies