VIÊM NÃO TỰ MIỄN DO KHÁNG THỂ KHÁNG THỤ THỂ NMDA TÁI PHÁT NHIỀU LẦN Ở TRẺ EM: MỘT BÁO CÁO CA BỆNH

Abstract

Objective: To describe the clinical, paraclinical characteristics and disease course of a pediatric case of anti-NMDA receptor autoimmune encephalitis with multiple relapses over a two-year period despite maintenance immunosuppressive therapy at the Neurology Department, Children’s Hospital 2. Methods: Case report. Results: A 14-year-old girl initially presented with behavioral changes, seizures, and movement disorder. Cerebrospinal fluid was positive for anti-NMDA receptor antibodies. She was treated with intravenous methylprednisolone and plasma exchange, recovered, and then relapsed three more times over the following two years. Each relapse presented similarly but with milder severity, and remained positive for anti-NMDA receptor antibodies. After the fourth relapse, the patient was switched to Rituximab with a good clinical response. Conclusion: This case highlights the challenge in managing relapsing anti-NMDA receptor encephalitis in children. Early consideration of Rituximab may help reduce relapse and limit corticosteroid-related adverse effects.