Breakthrough in Treating COVID-19-Related Autoimmune Encephalitis with Ofatumumab
Nikhil Prasad Fact checked by:Thailand Medical News Team Mar 20, 2025 13 hours, 9 minutes ago
Medical News: Autoimmune encephalitis, a rare but severe complication arising from COVID-19 infections, has traditionally been managed using immunomodulatory therapies such as steroids, intravenous immunoglobulin (IVIG), or plasma exchange. However, these treatments are not universally effective. A recent case study from the First Hospital of Shanxi Medical University-China highlights the potential of Ofatumumab, a fully human anti-CD20 monoclonal antibody, in treating COVID-19-associated autoimmune encephalitis.
Breakthrough in Treating COVID-19-Related Autoimmune Encephalitis with Ofatumumab
Case Presentation
The case involves a 33-year-old male who was admitted to the hospital on April 29, 2024, after experiencing six days of fever and one day of sudden limb convulsions. Prior to admission, he had persistent high fever (38–39.5 °C), headaches, and excessive sweating, but no respiratory symptoms like cough or runny nose. The convulsions were characterized by loss of consciousness and lip cyanosis.
Upon examination, the patient exhibited cognitive impairment, epileptic seizures, rapid heart rate (tachycardia), and excessive sweating (diaphoresis). Cranial MRI scans showed abnormalities similar to those seen in limbic encephalitis. Initial treatments, including antiviral therapy, high-dose steroids, and IVIG, yielded limited improvement.
Introduction of Ofatumumab
Given the suboptimal response to standard treatments, the medical team administered Ofatumumab. Following this intervention, the patient's clinical symptoms and cranial MRI findings showed significant improvement. This
Medical News report underscores the potential of Ofatumumab as a viable treatment option for similar cases.
Understanding COVID-19-Associated Encephalitis
Neurological complications are increasingly recognized in COVID-19 patients, with studies indicating that 30–85% of hospitalized individuals exhibit central or peripheral nervous system involvement. Encephalitis, although affecting less than 1% of patients, poses significant risks, including higher rates of intensive care admissions, ventilator use, and mortality.
The exact mechanisms behind COVID-19-associated encephalitis are not fully understood. While SARS-CoV-2 can invade neural tissue, autopsy studies often reveal low viral loads in the brain, suggesting that direct viral invasion may not be the primary cause. Instead, immune-mediated inflammatory responses, including autoimmune reactions, are believed to play a central role.
Traditional Treatment Approaches
Standard treatments for COVID-19-associated encephalitis include immunotherapies like steroids, IVIG, and plasma exchange, combined with antiviral medications. Many patients respond positively to these therapies, experiencing symptom relief and reduced neurological complications. Additionally, immunologic agents such as Tocilizumab (an IL-6 receptor antagonist) and Rituximab (another anti-CD20 monocl
onal antibody) have shown promise in individual cases.
Ofatumumab: A Promising Alternative
Ofatumumab is a fully human anti-CD20 monoclonal antibody that targets B-cells, which are implicated in autoimmune responses. In this case, the patient's notable improvement following Ofatumumab administration suggests its potential effectiveness in treating COVID-19-related autoimmune encephalitis, especially when standard therapies are insufficient.
Conclusions
This case highlights the potential of Ofatumumab as an effective treatment for COVID-19-associated autoimmune encephalitis, particularly in patients who do not respond adequately to conventional therapies. The patient's significant clinical and radiological improvements following Ofatumumab administration underscore its promise as a therapeutic option. However, further research and larger clinical studies are necessary to validate these findings and establish comprehensive treatment guidelines.
The case study was published in the peer-reviewed Journal of Neuroimmunology.
https://www.sciencedirect.com/science/article/abs/pii/S0165572825000700
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