{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:50:24Z","timestamp":1790369424955,"version":"4.1.0"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,9]]},"abstract":"\n Introduction:<\/jats:title>\n Narcolepsy type 1 is an organic sleep disorder caused by the destruction of hypocretin producing neurons in hypothalamus. In addition to daytime sleepiness, the spectrum and severity of symptoms are very variable. Psychiatric comorbidity and phenomena resembling psychotic symptoms are also common. Current treatment options for narcolepsy are symptomatic but there are few case reports of positive effect of immunotherapy. We report a very severely affected young boy treated with rituximab (RXB).<\/jats:p>\n <\/jats:sec>\n \n Case Report:<\/jats:title>\n A 12-year-old boy developed narcolepsy after Pandemrix H1N1 vaccination in 2010. He started to express severe psychiatric symptoms shortly after the onset. Cataplexy and sleepiness were devastatingly disabling. Conventional treatments did not have any effect on symptoms so we decided to try RXB, chimeric human monoclonal antibody against CD20+<\/jats:sup> expressed in B lymphocytes. After the first treatment his condition ameliorated dramatically. Unfortunately, the effect lasted only for 2 months. Following attempts did not show any effect.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Effect of RXB on narcolepsy has not been reported before. Remarkable but short-lasting effect of RXB in narcolepsy is intriguing as it could imply that there is still ongoing B cell\u2013mediated autoimmune response possible contributing to symptoms in narcolepsy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/nrl.0000000000000099","type":"journal-article","created":{"date-parts":[[2016,8,25]],"date-time":"2016-08-25T15:52:23Z","timestamp":1472140343000},"page":"85-86","source":"Crossref","is-referenced-by-count":19,"title":["Transient Impact of Rituximab in H1N1 Vaccination\u2013associated Narcolepsy With Severe Psychiatric Symptoms"],"prefix":"10.1097","volume":"21","author":[{"given":"Tomi","family":"Sarkanen","sequence":"first","affiliation":[{"name":"Neurology"},{"name":"Helsinki Sleep Clinic, Vitalmed Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reija","family":"Al\u00e9n","sequence":"additional","affiliation":[{"name":"Child Neurology, Central Finland Central Hospital, Jyv\u00e4skyl\u00e4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"Partinen","sequence":"additional","affiliation":[{"name":"Helsinki Sleep Clinic, Vitalmed Research Centre"},{"name":"Department of Neurological Sciences, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230929","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/S1474-4422(14)70075-4","article-title":"Narcolepsy as an autoimmune disease: the role of H1N1 infection and vaccination","volume":"13","author":"Partinen","year":"2014","journal-title":"Lancet Neurol"},{"key":"R2-20230929","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s11920-013-0433-9","article-title":"The hypocretin system and psychiatric disorders","volume":"16","author":"Pizza","year":"2014","journal-title":"Curr Psychiatry Rep"},{"key":"R3-20230929","doi-asserted-by":"crossref","first-page":"615","DOI":"10.5665\/sleep.4582","article-title":"Psychiatric comorbidity and cognitive profile in children with narcolepsy with or without association to the H1N1 influenza vaccination","volume":"38","author":"Szak\u00e1cs","year":"2015","journal-title":"Sleep"},{"key":"R4-20230929","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1212\/WNL.0b013e3181bd1344","article-title":"Normalization of hypocretin-1 in narcolepsy after intravenous immunoglobulin treatment","volume":"73","author":"Dauvilliers","year":"2009","journal-title":"Neurology"},{"key":"R5-20230929","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/j.1365-2869.2011.00985.x","article-title":"A remarkable effect of alemtuzumab in a patient suffering from narcolepsy with cataplexy","volume":"21","author":"Donjacour","year":"2012","journal-title":"J Sleep Res"},{"key":"R6-20230929","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1053\/j.seminhematol.2010.01.011","article-title":"Rituximab: mechanism of action","volume":"47","author":"Weiner","year":"2010","journal-title":"Semin Hematol"},{"key":"R7-20230929","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1212\/WNL.0000000000000570","article-title":"Utility and safety of rituximab in pediatric autoimmune and inflammatory CNS disease","volume":"83","author":"Dale","year":"2014","journal-title":"Neurology"},{"key":"R8-20230929","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1093\/sleep\/26.7.809","article-title":"Report of a case of immunosuppression with prednisone in an 8-year-old boy with an acute onset of hypocretin-deficiency narcolepsy","volume":"26","author":"Hecht","year":"2003","journal-title":"Sleep"}],"container-title":["The Neurologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00127893-201609000-00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T09:28:22Z","timestamp":1695979702000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00127893-201609000-00004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9]]},"references-count":8,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.1097\/nrl.0000000000000099","relation":{},"ISSN":["1074-7931"],"issn-type":[{"value":"1074-7931","type":"print"}],"subject":[],"published":{"date-parts":[[2016,9]]}}}