Anti-NMDA receptor encephalitis is an acute disease occurring when antibodies produced by the body's own immune system attack N-methyl-D-aspartate (NMDA) receptors in the brain. Recovery from this disease occurs as a multistage process, which can take from several months to several years after disease onset. Some Anti-NMDA receptor encephalitis patients have detectable tumors, and they had significant improvement after tumor resection. It reveals that this tumor is the cause of this disorder. For other patients, the cause is often unknown. There are several reports indicating that it is related to vaccination.
The treatments for this disorder include first-line immunotherapies: steroids, intravenous immunoglobulin (IVIG) or plasmapheresis (or plasma exchange); and second-line immunotherapy such as rituximab or cyclophosphamide. In addition, it is suggested that tumors be resected from these patients. The choice of treatments may be a potential factor that facilitates an early recovery from anti-NMDA receptor encephalitis. Studies on the efficacies of treatments for anti-NMDA receptor encephalitis have revealed that patients receiving at least two different forms of therapy may have higher efficacy rates than patients receiving a single form of therapy
Since this disorder occurs more often in females than in males, we are interested in whether the efficacy of treatment depends on the gender of the patient. The efficacy of the treatments including intravenous immunoglobulin, plasma exchange, plasmapheresis, rituximab or cyclophosphamide for male anti-NMDA receptor encephalitis patients without tumor is compared. The results reveal that we it is possible to find the effective treatment strategy for a specific group of patients although this treatment strategy may not always be effective for the patients that are not in this specific group. Most studies for the anti-NMDA receptor encephalitis provided an overview statistical result for this disease but did not focus on any patient-specific treatment discussion. This study can provide a patient-specific treatment strategy since the efficacy rate of plasmapheresis (or plasma exchange) is not inferior to those of intravenous immunoglobulin and rituximab (or cyclophosphamide) for male patients without tumor.
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Wang H. (2018). Anti-NMDA Receptor Encephalitis: Efficacy of Treatment for Male Patients and miRNA Biomarker, Curr Med Chem., Vol. 25, DOI: 10.2174/0929867325666180221142623