Frontiers in Immunology (Oct 2024)

Case report: Rapid symptom relief in autoimmune encephalitis with efgartigimod: a three-patient case series

  • Qianqian Zhang,
  • Wenping Yang,
  • Yun Qian,
  • Yu Zhang,
  • Huihui Zhao,
  • Mingzhu Shu,
  • Qingyang Li,
  • Yanan Li,
  • Yu Ding,
  • Shiyu Shi,
  • Yaxi Liu,
  • Xi Cheng,
  • Qi Niu

DOI
https://doi.org/10.3389/fimmu.2024.1444288
Journal volume & issue
Vol. 15

Abstract

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IntroductionAutoimmune encephalitis (AE) comprises a group of inflammatory brain disorders mediated by autoimmune responses. Anti–N-methyl-D-aspartate receptor (NMDAR) encephalitis, anti–leucine-rich glioma-inactivated 1 (LGI1) encephalitis, and anti–γ-aminobutyric acid-B receptor (GABABR) encephalitis are the most prevalent forms, characterized by the presence of antibodies against neuronal cell-surface antigens. Efgartigimod, an antagonist of the neonatal Fc receptor, has proven efficacy in myasthenia gravis treatment. This clinical case report describes the clinical progression and functional outcomes of AE in three patients who received efgartigimod treatment.Case presentationsCase 1 was a 60-year-old man exhibiting memory impairment and psychiatric disturbances over 11 days. Case 2 was a 38-year-old man with a 1-month history of rapid cognitive decline and seizures. Case 3 was a 68-year-old woman with mental behavioral changes and seizures for 4 months. Anti-GABABR, anti-LGI1, and anti-NMDAR antibodies were confirmed in the respective patients’ cerebrospinal fluid or serum. All three patients experienced marked and swift symptomatic relief after four cycles of efgartigimod treatment, with no complication.ConclusionCurrent first-line and second-line treatments for AE have limitations, and efgartigimod has demonstrated potential in the rapid and efficacious treatment of AE, emerging as a promising option for the management of this disease.

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