Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report

Idamis Fernandez Jure; Armando Caballero Lopez; Tania Crombet Ramos; Julio Cesar Alegria Cruz

doi:doi:10.11648/j.cmr.20221104.11

| Peer-Reviewed

Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report

Idamis Fernandez Jure, Armando Caballero Lopez, Tania Crombet Ramos, Julio Cesar Alegria Cruz

Published in Clinical Medicine Research (Volume 11, Issue 4)

Received: 15 June 2022 Accepted: 6 July 2022 Published: 18 July 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Introduction: Recent-onset refractory status epilepticus (NORSE) is a neurological emergency that leads to morbidity and mortality, with rapid evolution, poor prognosis; uncommon entity in patients without active epilepsy, without clear acute or active structural, toxic or metabolic cause; and not associated with any etiology. The management of this disease is not clearly defined and has been poorly described so far in the literature. Cases of NORSE associated with COVID-19 illness have been reported. However, the frequency related to SARS-CoV-2 infection is unknown, it is a novel case in our environment. Objective: to evaluate the effectiveness of therapeutic plasmapheresis and Itolizumab as coadjuvant therapy in the treatment of this entity. Methodology: Our research reports a case of a young patient with a history of previous health, admitted to the intensive care unit of the Arnaldo Milián Castro Hospital, in February of this year, due to repetitive seizures that are difficult to control, with a precedent of respiratory manifestations. acute (runny nose) the week before; to the course of the NORSE, it was direct contact of a confirmed case to COVID-19; Due to the fact that there are pathogenic substances in the plasma that contribute to the disease process, plasmapheresis and treatment with Itolizumab are proposed to support the therapy of this entity. Conclusions: Therapeutic plasmapheresis and itolizumab constituted a correct approach in the treatment of this clinical condition associated with presumptive post-COVID-19.

Published in	Clinical Medicine Research (Volume 11, Issue 4)
DOI	10.11648/j.cmr.20221104.11
Page(s)	92-94
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Post COVID-19, Refractory Status Epilepticus (NORSE), Therapeutic Plasmapheresis, Itolizumab

References

[1]	Lattanzi S, Leitinger M, Rocchi C, Salvemini S, Matricardi S, Brigo F, et al. Unraveling the enigma of new-onset refractory status epilepticus: a systematic review of aetiologies. Eur J Neurol 2022; 29: 626-647. https://doi.org/10.1111/ene.15149.
[2]	Périn B, Szurhaj W. New onset refractory status epilepticus: State of the art. Rev Neurol (Paris) 2022; Jan 11: S0035-3787 (0021) 00791-00798. https://doi.org/10.1016/j.neurol.2021.12.005.
[3]	Steardo, L.; Steardo, L., Jr.; Zorec, R.; Verkhratsky, A. Neuroinfection may contribute to the pathophysiology and clinical manifestations of COVID-19. Acta Physiol. 2020, 229, e13473.
[4]	Gasmi, A.; Tippairote, T.; Muyawdiya, PK; Benahmed, AG; Menzel, A.; Dadar, M.; Bjørklund, G. Neurological Implications of SARS-CoV-2 Infection. mole Neurobiol. 2021, 58, 944–949.
[5]	Ipe TS, Pham HP, Williams LA 3rd. Critical updates in the 7th edition of the American Society for Apheresis guidelines. J ClinApher. 2018; 33 (1): 78-94.
[6]	Adeli SH, Asghari A, Tabarraii R, Shajari R, Afshari S, Kalhor N, et al. Using therapeutic plasma exchange as a rescue therapy in CoVID-19 patients: a case series. Pol Arch Intern Med. 2020; 130 (5): 455-458. doi: 10.20452/pamw.15340.
[7]	Cañas, CA The triggering of post-COVID-19 autoimmunity phenomena could be associated with both transient immunosuppression and an inappropriate form of immune reconstitution in susceptible individuals. Medicine. Hypothesis. 2020, 145, 110345.
[8]	Najjar, S.; Najjar, A.; Chong, DJ; Pramanik, BK; Kirsch, C.; Kuzniecky, R. I.; Pacia, SV; Azhar, S. Central nervous system complications associated with SARS-CoV-2 infection: integrative pathophysiology concepts and case reports. J. Neuroinflamm. 2020, 17, 231.
[9]	Cao, X. COVID-19: Immunopathology and its implications for therapy. Nat. Rev. Immunol. 2020, 20, 269–270.
[10]	Siow, I.; Lee, KS; Zhang, JJY; Saffari, SE; Ng, A. Encephalitis as a neurological complication of COVID-19: a systematic review and meta-analysis of incidence, outcomes, and predictors. EUR. J. Neurol. 2021, 28, 3491–3502.
[11]	Mao, L.; Jin, H.; Wang, M.; Hu, Y.; Chen, S.; He, Q.; Chang, J.; Hong, C.; Zhou, Y.; Wang, D.; et al. Neurological manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020, 77, 683–690.
[12]	Sculier C, Gaspard N. New onset refractory status epilepticus (NORSE). Seizure. 2019; 68: 72-8. https://doi.org/10.1016/j.seizure.2018.09.018
[13]	Matthews E, Alkhachroum A, Massad N, Let- chinger R, Doyle K, Claassen J, et al. New-onset super-refractory status epilepticus: A case series of 26 patients. Neurology. 2020; 95 (16): e2280-5. https://doi.org/10.1212/WNL.0000000000010787
[14]	Aladdin Y, Shirah B. New-onset refractory status epilepticus following the ChAdOx1 nCoV-19 vaccine. J Neuroimmunol. 2021; 357: 577629. https://doi.org/10.1016/j.jneuroim.2021.577629
[15]	Dono F, Carrarini C, Russo M, De Angelis MV, Anzellotti F, Onofrj M, et al. New-onset refractory status epilepticus (NORSE) in post SARS-CoV-2 autoimmune encephalitis: a case report. Neurol Sci. 2021; 42 (1): 35-8. https://doi.org/10.1007/s10072-020-04846-z

Cite This Article

Plain Text BibTeX RIS

APA Style

Idamis Fernandez Jure, Armando Caballero Lopez, Tania Crombet Ramos, Julio Cesar Alegria Cruz. (2022). Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report. Clinical Medicine Research, 11(4), 92-94. https://doi.org/10.11648/j.cmr.20221104.11

Copy | Download

ACS Style

Idamis Fernandez Jure; Armando Caballero Lopez; Tania Crombet Ramos; Julio Cesar Alegria Cruz. Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report. Clin. Med. Res. 2022, 11(4), 92-94. doi: 10.11648/j.cmr.20221104.11

Copy | Download

AMA Style

Idamis Fernandez Jure, Armando Caballero Lopez, Tania Crombet Ramos, Julio Cesar Alegria Cruz. Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report. Clin Med Res. 2022;11(4):92-94. doi: 10.11648/j.cmr.20221104.11

Copy | Download

@article{10.11648/j.cmr.20221104.11,
  author = {Idamis Fernandez Jure and Armando Caballero Lopez and Tania Crombet Ramos and Julio Cesar Alegria Cruz},
  title = {Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report},
  journal = {Clinical Medicine Research},
  volume = {11},
  number = {4},
  pages = {92-94},
  doi = {10.11648/j.cmr.20221104.11},
  url = {https://doi.org/10.11648/j.cmr.20221104.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221104.11},
  abstract = {Introduction: Recent-onset refractory status epilepticus (NORSE) is a neurological emergency that leads to morbidity and mortality, with rapid evolution, poor prognosis; uncommon entity in patients without active epilepsy, without clear acute or active structural, toxic or metabolic cause; and not associated with any etiology. The management of this disease is not clearly defined and has been poorly described so far in the literature. Cases of NORSE associated with COVID-19 illness have been reported. However, the frequency related to SARS-CoV-2 infection is unknown, it is a novel case in our environment. Objective: to evaluate the effectiveness of therapeutic plasmapheresis and Itolizumab as coadjuvant therapy in the treatment of this entity. Methodology: Our research reports a case of a young patient with a history of previous health, admitted to the intensive care unit of the Arnaldo Milián Castro Hospital, in February of this year, due to repetitive seizures that are difficult to control, with a precedent of respiratory manifestations. acute (runny nose) the week before; to the course of the NORSE, it was direct contact of a confirmed case to COVID-19; Due to the fact that there are pathogenic substances in the plasma that contribute to the disease process, plasmapheresis and treatment with Itolizumab are proposed to support the therapy of this entity. Conclusions: Therapeutic plasmapheresis and itolizumab constituted a correct approach in the treatment of this clinical condition associated with presumptive post-COVID-19.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report
AU  - Idamis Fernandez Jure
AU  - Armando Caballero Lopez
AU  - Tania Crombet Ramos
AU  - Julio Cesar Alegria Cruz
Y1  - 2022/07/18
PY  - 2022
N1  - https://doi.org/10.11648/j.cmr.20221104.11
DO  - 10.11648/j.cmr.20221104.11
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 92
EP  - 94
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20221104.11
AB  - Introduction: Recent-onset refractory status epilepticus (NORSE) is a neurological emergency that leads to morbidity and mortality, with rapid evolution, poor prognosis; uncommon entity in patients without active epilepsy, without clear acute or active structural, toxic or metabolic cause; and not associated with any etiology. The management of this disease is not clearly defined and has been poorly described so far in the literature. Cases of NORSE associated with COVID-19 illness have been reported. However, the frequency related to SARS-CoV-2 infection is unknown, it is a novel case in our environment. Objective: to evaluate the effectiveness of therapeutic plasmapheresis and Itolizumab as coadjuvant therapy in the treatment of this entity. Methodology: Our research reports a case of a young patient with a history of previous health, admitted to the intensive care unit of the Arnaldo Milián Castro Hospital, in February of this year, due to repetitive seizures that are difficult to control, with a precedent of respiratory manifestations. acute (runny nose) the week before; to the course of the NORSE, it was direct contact of a confirmed case to COVID-19; Due to the fact that there are pathogenic substances in the plasma that contribute to the disease process, plasmapheresis and treatment with Itolizumab are proposed to support the therapy of this entity. Conclusions: Therapeutic plasmapheresis and itolizumab constituted a correct approach in the treatment of this clinical condition associated with presumptive post-COVID-19.
VL  - 11
IS  - 4
ER  -

Copy | Download

Author Information

Idamis Fernandez Jure

Blood Bank, Department of Molecular Immunology, Arnaldo Milian Castro Clinical Surgical University Hospital, Villa Clara, Cuba
Armando Caballero Lopez

Blood Bank, Department of Molecular Immunology, Arnaldo Milian Castro Clinical Surgical University Hospital, Villa Clara, Cuba
Tania Crombet Ramos

Blood Bank, Department of Molecular Immunology, Arnaldo Milian Castro Clinical Surgical University Hospital, Villa Clara, Cuba
Julio Cesar Alegria Cruz

Blood Bank, Department of Molecular Immunology, Arnaldo Milian Castro Clinical Surgical University Hospital, Villa Clara, Cuba

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Idamis Fernandez Jure, Armando Caballero Lopez, Tania Crombet Ramos, Julio Cesar Alegria Cruz. (2022). Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report. Clinical Medicine Research, 11(4), 92-94. https://doi.org/10.11648/j.cmr.20221104.11

Copy | Download

ACS Style

Idamis Fernandez Jure; Armando Caballero Lopez; Tania Crombet Ramos; Julio Cesar Alegria Cruz. Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report. Clin. Med. Res. 2022, 11(4), 92-94. doi: 10.11648/j.cmr.20221104.11

Copy | Download

AMA Style

Idamis Fernandez Jure, Armando Caballero Lopez, Tania Crombet Ramos, Julio Cesar Alegria Cruz. Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report. Clin Med Res. 2022;11(4):92-94. doi: 10.11648/j.cmr.20221104.11

Copy | Download

@article{10.11648/j.cmr.20221104.11,
  author = {Idamis Fernandez Jure and Armando Caballero Lopez and Tania Crombet Ramos and Julio Cesar Alegria Cruz},
  title = {Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report},
  journal = {Clinical Medicine Research},
  volume = {11},
  number = {4},
  pages = {92-94},
  doi = {10.11648/j.cmr.20221104.11},
  url = {https://doi.org/10.11648/j.cmr.20221104.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221104.11},
  abstract = {Introduction: Recent-onset refractory status epilepticus (NORSE) is a neurological emergency that leads to morbidity and mortality, with rapid evolution, poor prognosis; uncommon entity in patients without active epilepsy, without clear acute or active structural, toxic or metabolic cause; and not associated with any etiology. The management of this disease is not clearly defined and has been poorly described so far in the literature. Cases of NORSE associated with COVID-19 illness have been reported. However, the frequency related to SARS-CoV-2 infection is unknown, it is a novel case in our environment. Objective: to evaluate the effectiveness of therapeutic plasmapheresis and Itolizumab as coadjuvant therapy in the treatment of this entity. Methodology: Our research reports a case of a young patient with a history of previous health, admitted to the intensive care unit of the Arnaldo Milián Castro Hospital, in February of this year, due to repetitive seizures that are difficult to control, with a precedent of respiratory manifestations. acute (runny nose) the week before; to the course of the NORSE, it was direct contact of a confirmed case to COVID-19; Due to the fact that there are pathogenic substances in the plasma that contribute to the disease process, plasmapheresis and treatment with Itolizumab are proposed to support the therapy of this entity. Conclusions: Therapeutic plasmapheresis and itolizumab constituted a correct approach in the treatment of this clinical condition associated with presumptive post-COVID-19.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Presumed Recent-Onset Refractory Status Epilepticus (NORSE) Post-COVID-19 Plasmapheresis and Itolizumab: Case Report
AU  - Idamis Fernandez Jure
AU  - Armando Caballero Lopez
AU  - Tania Crombet Ramos
AU  - Julio Cesar Alegria Cruz
Y1  - 2022/07/18
PY  - 2022
N1  - https://doi.org/10.11648/j.cmr.20221104.11
DO  - 10.11648/j.cmr.20221104.11
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 92
EP  - 94
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20221104.11
AB  - Introduction: Recent-onset refractory status epilepticus (NORSE) is a neurological emergency that leads to morbidity and mortality, with rapid evolution, poor prognosis; uncommon entity in patients without active epilepsy, without clear acute or active structural, toxic or metabolic cause; and not associated with any etiology. The management of this disease is not clearly defined and has been poorly described so far in the literature. Cases of NORSE associated with COVID-19 illness have been reported. However, the frequency related to SARS-CoV-2 infection is unknown, it is a novel case in our environment. Objective: to evaluate the effectiveness of therapeutic plasmapheresis and Itolizumab as coadjuvant therapy in the treatment of this entity. Methodology: Our research reports a case of a young patient with a history of previous health, admitted to the intensive care unit of the Arnaldo Milián Castro Hospital, in February of this year, due to repetitive seizures that are difficult to control, with a precedent of respiratory manifestations. acute (runny nose) the week before; to the course of the NORSE, it was direct contact of a confirmed case to COVID-19; Due to the fact that there are pathogenic substances in the plasma that contribute to the disease process, plasmapheresis and treatment with Itolizumab are proposed to support the therapy of this entity. Conclusions: Therapeutic plasmapheresis and itolizumab constituted a correct approach in the treatment of this clinical condition associated with presumptive post-COVID-19.
VL  - 11
IS  - 4
ER  -

Copy | Download