关键词: 　抗-NMDA受体脑炎；　临床表现；　利妥昔单抗；　儿童

Abstract: Objective　To explore the clinical features and prognostic factors of anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis in children. Method　The clinical data of anti-NMDA receptor encephalitis in 51 children from January 2015 to December 2017 were collected and analyzed, and the short-term prognostic results at 6 months after discharge were evaluated. Results　In 51 children (21 males and 30 females) with an average age of (7.36±3.24) years, the most common clinical symptoms were motor disorder (45 cases), personality change (43 cases), epilepsy (42 cases) and cognitive impairment (16 cases). Two cases were transferred to other hospital by themselves. In 49 children treated, 45 received intravenous immunoglobulin and 41 received methylprednisolone at the same time. Eight children received plasma exchange. The second-line treatment with rituximab were given to eight patients, among whom 6 patients had previously received ineffective intravenous immunoglobulin and methylprednisolone therapy and 2 patients had previously received ineffective plasma exchange therapy. Seven children were lost to follow-up. Forty-two children completed the assessment at 6-month follow-up after discharge, and 23 children had good short-term prognosis. Multiple logistic regression analysis showed that cognitive impairment (OR=23.97, 95%CI：1.12~513.30, P=0.042) and abnormal brain MRI (OR=14.29, 95%CI: 1.36~150.10, P=0.027) were independent risk factors for poor short-term prognosis. Conclusion　Anti-NMDA receptor encephalitis is commonly manifested as motor disorder, personality change, epilepsy and cognitive impairment. Abnormal MRI and cognitive impairment are important predictors of short-term poor prognosis.

Key words: 　anti-NMDA receptor encephalitis;　clinical manifestation;　rituximab;　child