评价利妥昔单抗治疗儿童无肿瘤抗 NMDAR 脑炎的有效性和安全性。 18 例静脉注射免疫球蛋白（IVIG）和甲泼尼龙治疗失败后接受利妥昔单抗治疗的 NMDAR 脑炎儿童患者进行了研究。回顾性分析其病史、临床特征、实验室检查结果和治疗情况。采用改良Rankin量表（mRS）评分、外周血CD19 B细胞、复发和不良事件来评估利妥昔单抗的疗效和安全性。患者在IVIG和甲泼尼龙治疗结束后3.2±1.0天接受利妥昔单抗治疗。初始利妥昔单抗治疗4周后，所有患者的mRS评分和CD19 B细胞数量均显着低于治疗前（P < 0.05）。末次随访时（44.1 个月，17.7 S.D.），所有患者均恢复良好（mRS ≤ 2），14 名患者（77.8%）完全康复（mRS = 0），3 名患者出现反复癫痫发作，1 名患者出现精神障碍。和语言障碍。两名患者在输注期间出现短暂的轻度不良事件，其他患者在住院或随访期间均未出现严重不良事件。利妥昔单抗似乎安全，并且可能有效治疗首次难治性儿童的抗 NMDAR 脑炎，无肿瘤。线路代理。版权所有 © 2024 Elsevier Inc. 保留所有权利。

To evaluate the efficacy and safety of rituximab treatment for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis without tumor in children.Eighteen pediatric patients with NMDAR encephalitis treated with rituximab after failure of intravenous immunoglobulin (IVIG) and methylprednisolone treatment were analyzed retrospectively in terms of their medical history, clinical features, laboratory examination results, and treatments. The modified Rankin scale (mRS) score, peripheral blood CD19+ B cells, recurrence, and adverse events were used to evaluate the efficacy and safety of rituximab.The patients were treated with rituximab 3.2 ± 1.0 days after the end of IVIG and methylprednisolone treatment. After initial rituximab treatment for four weeks, the mRS score and number of CD19+ B cells in all patients were significantly lower than those before treatment (P < 0.05). At the last follow-up (44.1 months, 17.7 S.D.), all patients had recovered well (mRS ≤2), 14 patients (77.8%) recovered completely (mRS = 0), three patients had recurrent seizures, and one patient had mental and language impairment. Two patients had transient mild adverse events during infusion, and none of the other patients experienced severe adverse events during hospitalization or follow-up.Rituximab appears safe and may be effective for the treatment of anti-NMDAR encephalitis without tumor in children refractory to first-line agents.Copyright © 2024 Elsevier Inc. All rights reserved.