Background Daclizumab is an anti-CD25 monoclonal antibody developed for the treatment of relapsing remitting multiple sclerosis, which was withdrawn worldwide in March 2018, due to emerging serious immune-mediated systemic andcentral nervous system adverse events. We report a case of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis occurring 14 weeks after stopping daclizumab, which responded to the proteasome inhibitor bortezomib. Methods Following lack of effective clinical response to first line (corticosteroid, plasma exchange, intravenous immunoglobulin) and second line (rituximab) treatments, bortezomib therapy was commenced. The patient received six cycles of bortezomib treatment. Results Clinical improvement was noted 4 weeks after the first of six cycles of bortezomib and the patient experienced sustained clinical improvement. Conclusion Our case provides further class IV evidence of the use of bortezomib therapy for treatment refractory anti-NMDAR encephalitis. All data relevant to the study are included in the article.

中文翻译：

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硼替佐米治疗多发性硬化症患者达珠单抗治疗后的抗 NMDAR 脑炎

背景 Daclizumab 是一种抗 CD25 单克隆抗体，开发用于治疗复发缓解型多发性硬化症，由于出现严重的免疫介导的全身和中枢神经系统不良事件，该药物于 2018 年 3 月在全球范围内撤回。我们报告了一例在停止达珠单抗后 14 周发生的抗 N-甲基-D-天冬氨酸受体 (NMDAR) 脑炎病例，达珠单抗对蛋白酶体抑制剂硼替佐米有反应。方法 在对一线（皮质类固醇、血浆置换、静脉注射免疫球蛋白）和二线（利妥昔单抗）治疗缺乏有效临床反应后，开始使用硼替佐米治疗。患者接受了六个周期的硼替佐米治疗。结果 在硼替佐米的六个周期中的第一个周期后 4 周注意到临床改善，并且患者经历了持续的临床改善。结论 我们的病例为使用硼替佐米治疗难治性抗 NMDAR 脑炎提供了进一步的 IV 级证据。与研究相关的所有数据都包含在文章中。