In half of the suspected autoimmune encephalitis (AIE) patients, no antibodies are identified despite extensive investigation. Therapeutic plasma exchange (TPE) is a potential first-line therapy for various subtypes of AIE. Here, we present a case of autoantibody-negative-suspected AIE, managed successfully with TPE after patient showed no response to steroids. A total of 5 sessions of TPE was done. One standard TPE procedure session was 1.2-1.5 plasma volume exchanges using 5% albumin as a replacement fluid. After five sessions, patient's clinical condition improved significantly, and a repeated magnetic resonance imaging after 5th cycle of TPE revealed a reduction in the areas of signal alteration. This was suggestive of regression of disease. Patient was discharged on 10th day of hospital admission. With early suspicion even in the absence of detectable autoantibodies, TPE plays an important role in the management of encephalitis.
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Post Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, IndiaPost Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, India
Hans, Rekha
Prakash, Satya
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Post Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, IndiaPost Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, India
Prakash, Satya
Sharma, Ratti R.
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Post Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, IndiaPost Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, India
Sharma, Ratti R.
Sankhyan, Naveen
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Post Grad Inst Med Educ & Res, Dept Paediat Med, Chandigarh, IndiaPost Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, India
Sankhyan, Naveen
Takkar, Aastha
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Post Grad Inst Med Educ & Res, Dept Neurol, Chandigarh, IndiaPost Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, India
Takkar, Aastha
Goyal, Manoj
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Post Grad Inst Med Educ & Res, Dept Neurol, Chandigarh, IndiaPost Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, India
Goyal, Manoj
Saikia, Biman
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Post Grad Inst Med Educ & Res, Dept Immunopathol, Chandigarh, IndiaPost Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, India
Saikia, Biman
La, Vivek
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Post Grad Inst Med Educ & Res, Dept Neurol, Chandigarh, IndiaPost Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, India
La, Vivek
Marwaha, Neelam
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Post Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, IndiaPost Grad Inst Med Educ & Res, Dept Transfus Med, Chandigarh 160012, India