Effect of Erythropoietin in Refractory Autoimmune Encephalitis Patients

Effect of Erythropoietin in Refractory Autoimmune Encephalitis Patients

This study evaluates the efficacy of erythropoietin in refractory autoimmune encephalitis. Ten patients will receive 100 IU/kg of erythropoietin 3 times a week for 12 weeks.

Erythropoietin can improve the refractory autoimmune encephalitis. Erythropoietin has tissue-protective effect via activation of Janus kinase (JAK)-2, signal transducer and activator of transcription (STAT)-5 pathway and NF-kappa B pathway. The activation of JAK-2 and STAT-5 promote hemoglobin synthesis and facilitate cell cycle progression. Also, NF-kappa B pathway inhibition regulates pro-inflammatory cytokine production.

We expect that erythropoietin may lead to improve the symptoms and outcome of autoimmune encephalitis.

Inclusion Criteria:

• Clinically diagnosed autoimmune encephalitis
• Ineffective 1st line treatment (e.g. steroid IV, IVIg) and 2nd line treatment (e.g. Rituximab or cyclophosphamide)

Exclusion Criteria:

• Hemoglobin > 12g/dL
• Hematochrit >36%
• Thrombocytosis > 750K
• AST or ALT > 120
• HIV (+)
• Allergic reaction upon erythropoietin
• Uncontrolled hypertension
• mRS before the autoimmune encephalitis > 3
• Breast feeding or pregnancy
• History of ischemic stroke or pulmonary thrombosis
• Refuse to be enrolled