Anti-CD38 monoclonal antibody daratumumab treatment in severe anti-N-methyl-D-aspartate receptor encephalitis: one case report

doi:10.3969/j.issn.1672-6731.2023.12.015

Abstract

Key words: Encephalitis, Receptors, N-methyl-D-aspartate, Daratumumab (not in MeSH), Case reports

关键词: 脑炎, 受体，N-甲基-D-天冬氨酸, 达雷妥尤单抗（非MeSH词）, 病例报告

Chao ZHANG, Yi SHEN, Bin ZHAO, Mo-li FAN, Bing-di XIE. Anti-CD38 monoclonal antibody daratumumab treatment in severe anti-N-methyl-D-aspartate receptor encephalitis: one case report[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2023, 23(12): 1139-1144.

张超, 沈艺, 赵滨, 樊茉丽, 谢炳玓. 抗CD38单抗达雷妥尤单抗治疗重症抗N-甲基-D-天冬氨酸受体脑炎一例[J]. 中国现代神经疾病杂志, 2023, 23(12): 1139-1144.

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URL: http://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2023.12.015

http://journal11.magtechjournal.com/cjcnn/EN/Y2023/V23/I12/1139

Figures/Tables 4

Figure 1 CBA of anti-NMDAR antibody detection on admission × 200 Serum anti-NMDAR antibody was positive with antibody titer 1∶1000 (Panel 1a). Cerebrospinal fluid anti-NMDAR antibody was positive with antibody titer 1∶100 (Panel 1b).

Figure 2 LT-VEEG showed diffuse slow waves and extreme delta brush (arrow indicates).

Figure 3 CBA of anti - NMDAR antibody detection after daratumumab treatment × 200 Serum anti - NMDAR antibody was positive on day 64 of admission with antibody titer 1∶ 100 (Panel 3a). Serum anti - NMDAR antibody was positive on day 90 of admission with antibody titer 1∶ 30 (Panel 3b).

Figure 4 Head MRI findings at 4 months after discharge showed brain atrophy, dilatation of bilateral lateral ventricles, round and blunt anteroposternal corners of lateral ventricles, widening of brain sulci, flattening and shrinking of brain gyri. Axial T₁WI (Panel 4a). Axial T₂WI (Panel 4b).

References 27

1	Guan HZ , Wang JW . Expert consensus on diagnosis and treatment of autoimmune encephalitis in China. Zhonghua Shen Jing Ke Za Zhi, 2017, 50: 91- 98. doi: 10.3760/cma.j.issn.1006-7876.2017.02.004
	关鸿志, 王佳伟. 中国自身免疫性脑炎诊治专家共识. 中华神经科杂志, 2017, 50: 91- 98. doi: 10.3760/cma.j.issn.1006-7876.2017.02.004
2	Titulaer MJ , McCracken L , Gabilondo I , Armangué T , Glaser C , Iizuka T , Honig LS , Benseler SM , Kawachi I , Martinez-Hernandez E , Aguilar E , Gresa-Arribas N , Ryan-Florance N , Torrents A , Saiz A , Rosenfeld MR , Balice-Gordon R , Graus F , Dalmau J . Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol, 2013, 12: 157- 165. doi: 10.1016/S1474-4422(12)70310-1
3	Graus F , Titulaer MJ , Balu R , Benseler S , Bien CG , Cellucci T , Cortese I , Dale RC , Gelfand JM , Geschwind M , Glaser CA , Honnorat J , Höftberger R , Iizuka T , Irani SR , Lancaster E , Leypoldt F , Prüss H , Rae-Grant A , Reindl M , Rosenfeld MR , Rostásy K , Saiz A , Venkatesan A , Vincent A , Wandinger KP , Waters P , Dalmau J . A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol, 2016, 15: 391- 404. doi: 10.1016/S1474-4422(15)00401-9
4	Abboud H , Probasco JC , Irani S , Ances B , Benavides DR , Bradshaw M , Christo PP , Dale RC , Fernandez-Fournier M , Flanagan EP , Gadoth A , George P , Grebenciucova E , Jammoul A , Lee ST , Li Y , Matiello M , Morse AM , Rae-Grant A , Rojas G , Rossman I , Schmitt S , Venkatesan A , Vernino S , Pittock SJ , Titulaer MJ; Autoimmune Encephalitis Alliance Clinicians Network . Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management. J Neurol Neurosurg Psychiatry, 2021, 92: 757- 768. doi: 10.1136/jnnp-2020-325300
5	Piehl F , Eriksson-Dufva A , Budzianowska A , Feresiadou A , Hansson W , Hietala MA , Hakansson I , Johansson R , Jons D , Kmezic I , Lindberg C , Lindh J , Lundin F , Nygren I , Punga AR , Press R , Samuelsson K , Sundstrom P , Wickberg O , Brauner S , Frisell T . Efficacy and safety of rituximab for new-onset generalized myasthenia gravis: the RINOMAX randomized clinical trial. JAMA Neurol, 2022, 79: 1105- 1112. doi: 10.1001/jamaneurol.2022.2887
6	Waters MJ , Field D , Ravindran J . Refractory myasthenia gravis successfully treated with ofatumumab. Muscle Nerve, 2019, 60: E45- E47.
7	Zhang C , Zhang M , Qiu W , Ma H , Zhang X , Zhu Z , Yang CS , Jia D , Zhang TX , Yuan M , Feng Y , Yang L , Lu W , Yu C , Bennett JL , Shi FD , TANGO Study Investigators . Safety and efficacy of tocilizumab versus azathioprine in highly relapsing neuromyelitis optica spectrum disorder (TANGO): an open-label, multicentre, randomised, phase 2 trial. Lancet Neurol, 2020, 19: 391- 401. doi: 10.1016/S1474-4422(20)30070-3
8	Scheibe F , Ostendorf L , Reincke SM , Prüss H , Brünneck ACV , Köhnlein M , Alexander T , Meisel C , Meisel A . Daratumumab treatment for therapy-refractory anti-CASPR2 encephalitis. J Neurol, 2020, 267: 317- 323. doi: 10.1007/s00415-019-09585-6
9	Ratuszny D , Skripuletz T , Wegner F , Groß M , Falk C , Jacobs R , Ruschulte H , Stangel M , Sühs KW . Case report: daratumumab in a patient with severe refractory anti-NMDA receptor encephalitis. Front Neurol, 2020, 11: 602102. doi: 10.3389/fneur.2020.602102
10	Dalmau J , Gleichman AJ , Hughes EG , Rossi JE , Peng X , Lai M , Dessain SK , Rosenfeld MR , Balice-Gordon R , Lynch DR . Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol, 2008, 7: 1091- 1098. doi: 10.1016/S1474-4422(08)70224-2
11	Sabin TD , Jednacz JA , Staats PN . Case records of the Massachusetts General Hospital. Case 26-2008:a 26-year-old woman with headache and behavioral changes. N Engl J Med, 2008, 359: 842- 853. doi: 10.1056/NEJMcpc0804644
12	Seki M , Suzuki S , Iizuka T , Shimizu T , Nihei Y , Suzuki N , Dalmau J . Neurological response to early removal of ovarian teratoma in anti-NMDAR encephalitis. J Neurol Neurosurg Psychiatry, 2008, 79: 324- 326. doi: 10.1136/jnnp.2007.136473
13	Makuch M , Wilson R , Al-Diwani A , Varley J , Kienzler AK , Taylor J , Berretta A , Fowler D , Lennox B , Leite MI , Waters P , Irani SR . N-methyl-D-aspartate receptor antibody production from germinal center reactions: therapeutic implications. Ann Neurol, 2018, 83: 553- 561. doi: 10.1002/ana.25173
14	Al-Diwani A , Theorell J , Damato V , Bull J , Mcglashan N , Green E , Kienzler AK , Harrison R , Hassanali T , Campo L , Browne M , Easton A , Majd HS , Tenaka K , Iorio R , Dale RC , Harrison P , Geddes J , Quested D , Sharp D , Lee ST , Nauen DW , Makuch M , Lennox B , Fowler D , Sheerin F , Waters P , Leite MI , Handel AE , Irani SR . Cervical lymph nodes and ovarian teratomas as germinal centres in NMDA receptor-antibody encephalitis. Brain, 2022, 145: 2742- 2754. doi: 10.1093/brain/awac088
15	Lee WJ , Lee ST , Shin YW , Lee HS , Shin HR , Kim DY , Kim S , Lim JA , Moon J , Park KI , Kim HS , Chu K , Lee SK . Teratoma removal, steroid, IVIG, rituximab and tocilizumab (T-SIRT) in anti-NMDAR encephalitis. Neurotherapeutics, 2021, 18: 474- 487. doi: 10.1007/s13311-020-00921-7
16	Nosadini M , Eyre M , Molteni E , Thomas T , Irani SR , Dalmau J , Dale RC , Lim M , Anlar B , Armangue T , Benseler S , Cellucci T , Deiva K , Gallentine W , Gombolay G , Gorman MP , Hacohen Y , Jiang Y , Lim BC , Muscal E , Ndondo A , Neuteboom R , Rostásy K , Sakuma H , Sartori S , Sharma S , Tenembaum SN , Mater HAV , Wells E , Wickstrom R , Yeshokumar AK; International NMDAR Antibody Encephalitis Consensus Group . Use and safety of immunotherapeutic management of N-Methyl-D-aspartate receptor antibody encephalitis: a meta-analysis. JAMA Neurol, 2021, 78: 1333- 1344. doi: 10.1001/jamaneurol.2021.3188
17	Nosadini M , Thomas T , Eyre M , Anlar B , Armangue T , Benseler SM , Cellucci T , Deiva K , Gallentine W , Gombolay G , Gorman MP , Hacohen Y , Jiang Y , Lim BC , Muscal E , Ndondo A , Neuteboom R , Rostásy K , Sakuma H , Sharma S , Tenembaum SN , Mater HAV , Wells E , Wickstrom R , Yeshokumar AK , Irani SR , Dalmau J , Lim M , Dale RC . International consensus recommendations for the treatment of pediatric NMDAR antibody encephalitis. Neurol Neuroimmunol Neuroinflamm, 2021, 8: e1052. doi: 10.1212/NXI.0000000000001052
18	Lee WJ , Lee ST , Byun JI , Sunwoo JS , Kim TJ , Lim JA , Moon J , Lee HS , Shin YW , Lee KJ , Kim S , Jung KH , Jung KY , Chu K , Lee SK . Rituximab treatment for autoimmune limbic encephalitis in an institutional cohort. Neurology, 2016, 86: 1683- 1691. doi: 10.1212/WNL.0000000000002635
19	Damato V , Balint B , Kienzler AK , Irani SR . The clinical features, underlying immunology, and treatment of autoantibody-mediated movement disorders. Mov Disord, 2018, 33: 1376- 1389. doi: 10.1002/mds.27446
20	Scheibe F , Prüss H , Mengel AM , Kohler S , Nümann A , Köhnlein M , Ruprecht K , Alexander T , Hiepe F , Meisel A . Bortezomib for treatment of therapy-refractory anti-NMDA receptor encephalitis. Neurology, 2017, 88: 366- 370. doi: 10.1212/WNL.0000000000003536
21	Lokhorst HM , Plesner T , Laubach JP , Nahi H , Gimsing P , Hansson M , Minnema MC , Lassen U , Krejcik J , Palumbo A , van de Donk NW , Ahmadi T , Khan I , Uhlar CM , Wang J , Sasser AK , Losic N , Lisby S , Basse L , Brun N , Richardson PG . Targeting CD38 with daratumumab monotherapy in multiple myeloma. N Engl J Med, 2015, 373: 1207- 1219. doi: 10.1056/NEJMoa1506348
22	Ostendorf L , Burns M , Durek P , Heinz GA , Heinrich F , Garantziotis P , Enghard P , Richter U , Biesen R , Schneider U , Knebel F , Burmester G , Radbruch A , Mei HE , Mashreghi MF , Hiepe F , Alexander T . Targeting CD38 with daratumumab in refractory systemic lupus erythematosus. N Engl J Med, 2020, 383: 1149- 1155. doi: 10.1056/NEJMoa2023325
23	Scheibe F , Ostendorf L , Prüss H , Radbruch H , Aschman T , Hoffmann S , Blau IW , Meisel C , Alexander T , Meisel A . Daratumumab for treatment-refractory antibody-mediated diseases in neurology. Eur J Neurol, 2022, 29: 1847- 1854.
24	Drgona L , Gudiol C , Lanini S , Salzberger B , Ippolito G , Mikulska M; ESCMID Study Group for Infections in Compromised Hosts (ESGICH) . Consensus document on the safety of targeted and biological therapies: an infectious diseases perspective (agents targeting lymphoid or myeloid cells surface antigens[Ⅱ]: CD22, CD30, CD33, CD38, CD40, SLAMF-7 and CCR4). Clin Microbiol Infect, 2018, 24 Suppl 2: S83- S94.
25	Roboon J , Hattori T , Ishii H , Takarada-Iemata M , Nguyen DT , Heer CD , O'meally D , Brenner C , Yamamoto Y , Okamoto H , Higashida H , Hori O . Inhibition of CD38 and supplementation of nicotinamide riboside ameliorate lipopolysaccharide-induced microglial and astrocytic neuroinflammation by increasing NAD. J Neurochem, 2021, 158: 311- 327.
26	Meyer T , Shimon D , Youssef S , Yankovitz G , Tessler A , Chernobylsky T , Gaoni-Yogev A , Perelroizen R , Budick-Harmelin N , Steinman L , Mayo L . NAD⁺ metabolism drives astrocyte proinflammatory reprogramming in central nervous system autoimmunity. Proc Natl Acad Sci USA, 2022, 119: e2211310119.
27	Langley MR , Choi CI , Peclat TR , Guo Y , Simon WL , Yoon H , Kleppe L , Lucchinetti CF , Chini CCS , Chini EN , Scarisbrick IA . Critical role of astrocyte NAD⁺ glycohydrolase in myelin injury and regeneration. J Neurosci, 2021, 41: 8644- 8667.

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