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Case Reports
. 2020 Jul:87:155-158.
doi: 10.1016/j.bbi.2020.05.022. Epub 2020 May 7.

Plasmapheresis treatment in COVID-19-related autoimmune meningoencephalitis: Case series

Lerzan Dogan  1 , Dilaver Kaya  2 , Tugce Sarikaya  1 , Rehile Zengin  3 , Alp Dincer  4 , Ibrahim Ozkan Akinci  1 , Nazire Afsar  5
Affiliations
Case Reports

Plasmapheresis treatment in COVID-19-related autoimmune meningoencephalitis: Case series

Lerzan Dogan et al. Brain Behav Immun. 2020 Jul.

Abstract

Severe SARS-CoV-2 (COVID-19) infection has the potential for a high mortality rate. In this paper, we report the results of plasmapheresis treatment in a series of severely ill patients with COVID-19-related autoimmune meningoencephalitis in the Intensive Care Unit (ICU).

Keywords: Autoimmune; COVID-19; Encephalitis; Plasmapheresis.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Case 1: A through C. A: Axial FLAIR showing bilateral segmental frontal cortical hyperintensity together with focal effacement of right frontal sulci. T1WI images showed mild pial-subarachnoid enhancement after I.V. Gad and DWI showed frontal cortical hyperintensity without matching hypointensity on ADC mapping (data not provided). All findings were considered compatible with meningoencephalitis. Following plasmapheresis, there was prominent regression of FLAIR findings at the first (B) and second (C) week’s follow-up imaging. Similarly, DWI hyperintensities disappeared and contrast enhancement regressed following treatment (data not provided). Case 2: D through F. D: Axial FLAIR showing bilateral extensive hyperintense signal changes of the frontal and parietal white matter accompanied by focal frontal cortical hyperintensity. As in Case 1, DWI images showed matching areas of diffusion restrictions (data not provided); the findings were considered compatible with meningoencephalitis. Following plasmapheresis, there was a prominent regression on FLAIR at the first (E) and second (F) week’s follow-up imaging. These also showed linear pial-subarachnoid hyperintensity within the right frontal sulci on the second week’s follow-up FLAIR compatible with subarachnoid hemorrhage (F).
Fig. 2
Fig. 2
Ferritin levels before and after plasmapheresis. (Pf: plasmapheresis).
See this image and copyright information in PMC

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