{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T20:21:38Z","timestamp":1768076498292,"version":"3.49.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>The case of a pediatric patient with treatment refractory anti\u2013N-methyl-d-aspartate (NMDA) receptor encephalitis treated with the plasma cell\u2013depleting therapy bortezomib is reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>A 5-year-old female presented to the hospital with a 1-week history of altered mental status, agitation, and possible seizure-like activity. She was admitted to the hospital for suspected meningitis or meningoencephalitis and an extensive workup was completed, including sending blood and cerebrospinal fluid (CSF) for testing for NMDA receptor antibodies. While test results were pending, the patient was treated initially with intravenous immunoglobulin (IVIG) for 4 days followed by high-dose methylprednisolone for 5 days. The patient\u2019s serum and CSF studies were positive for NMDA receptor antibodies, confirming the diagnosis of anti\u2013NMDA receptor encephalitis. She was then treated with plasmapheresis therapy every other day for 5 treatments, without any clinical improvement. The patient then received rituximab once weekly for 6 weeks. Three weeks after completion of rituximab therapy, the patient was started on her first cycle of bortezomib therapy. She received a total of 6 cycles, with improvement in her clinical status beginning with the third cycle. Upon completion of 6 cycles, the patient\u2019s mental status and level of functioning had greatly improved. She was discharged to an inpatient rehabilitation facility and ultimately able to return home to her family.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A 5-year-old female with anti\u2013NMDA receptor encephalitis was successfully treated with bortezomib after having shown no clinical improvement during treatment with IVIG, high-dose methylprednisolone, plasmapheresis, and rituximab.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxaa415","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T15:14:53Z","timestamp":1612797293000},"page":"395-400","source":"Crossref","is-referenced-by-count":9,"title":["Bortezomib for treatment of anti\u2013NMDA receptor encephalitis in a pediatric patient refractory to conventional therapy"],"prefix":"10.1093","volume":"78","author":[{"given":"Marroyln L","family":"Simmons","sequence":"first","affiliation":[{"name":"St. Joseph\u2019s Children\u2019s Hospital, Tampa, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly A","family":"Perez","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Children\u2019s Hospital, Tampa, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,2,18]]},"reference":[{"key":"2021021913174506300_CIT0001","first-page":"811","volume-title":"J Gen Intern Med","author":"Day","year":"2011"},{"issue":"1","key":"2021021913174506300_CIT0002","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1002\/ana.21756","article-title":"Anti\u2013N-methyl-D-Aspartate receptor (NMDAR) encephalitis in children and adolescents","volume":"66","author":"Florance","year":"2009","journal-title":"Ann 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encephalitis","volume":"172","author":"Schroeder","year":"2018","journal-title":"Clin Neurol Neurosurg."},{"key":"2021021913174506300_CIT0009","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jneuroim.2017.08.011","article-title":"Successful combined targeting of B- and plasma cells in treatment refractory anti-NMDAR encephalitis","volume":"312","author":"Sveinsson","year":"2017","journal-title":"J Neuroimmunol."},{"key":"2021021913174506300_CIT0010","volume-title":"Package insert","author":"Velcade","year":"2019"},{"key":"2021021913174506300_CIT0011","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.pediatrneurol.2019.09.004","article-title":"Bortezomib-responsive refractory anti-N-methyl-D-aspartate receptor encephalitis","volume":"103","author":"Cordani","year":"2020","journal-title":"Pediatric Neurology."},{"key":"2021021913174506300_CIT0012","doi-asserted-by":"crossref","first-page":"188","DOI":"10.3389\/fneur.2020.00188","article-title":"Early bortezomib therapy for refractory anti-NMDA receptor encephalitis","volume":"11","author":"Turnbull","year":"2020","journal-title":"Front Neurol"},{"issue":"5","key":"2021021913174506300_CIT0013","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/acn3.557","article-title":"Bortezomib treatment for severe refractory anti-NMDA receptor encephalitis","volume":"5","author":"Shin","year":"2018","journal-title":"Ann Clin Transl Neurol."}],"container-title":["American Journal of Health-System 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