Affordable Access

Access to the full text

Apheresis in Autoimmune Encephalitis and Autoimmune Dementia

Authors
  • Rössling, Rosa1
  • Prüss, Harald1
  • 1 German Center for Neurodegenerative Diseases (DZNE) Berlin, 10117 Berlin, Germany
Type
Published Article
Journal
Journal of Clinical Medicine
Publisher
MDPI AG
Publication Date
Aug 19, 2020
Volume
9
Issue
9
Identifiers
DOI: 10.3390/jcm9092683
PMID: 32824982
PMCID: PMC7563270
Source
PubMed Central
Keywords
License
Green

Abstract

Autoimmune encephalitis (AE) is a rapidly progressive inflammatory neurological disease. Underlying autoantibodies can bind to neuronal surfaces and synaptic proteins resulting in psychiatric symptoms, focal neurological signs, autonomic dysfunction and cognitive decline. Early and effective treatment is mandatory to reduce clinical symptoms and to achieve remission. Therapeutic apheresis, involving both plasma exchange (PE) and immunoadsorption (IA), can rapidly remove pathogenic antibodies from the circulation, thus representing an important first-line treatment in AE patients. We here review the most relevant studies regarding therapeutic apheresis in AE, summarizing the outcome for patients and the expanding clinical spectrum of treatment-responsive clinical conditions. For example, patients with slowly progressing cognitive impairment suggesting a neurodegenerative dementia can have underlying autoantibodies and improve with therapeutic apheresis. Findings are encouraging and have led to the first ongoing clinical studies assessing the therapeutic effect of IA in patients with anti-neuronal autoantibodies and the clinical presentation of dementia. Therapeutic apheresis is an established and well tolerated option for first-line therapy in AE and, potentially, other antibody-mediated central nervous system diseases.

Report this publication

Statistics

Seen <100 times