PT - JOURNAL ARTICLE AU - Kushan Karunaratne AU - Dariush Ahrabian AU - Bernadette Monaghan AU - Tom Campion AU - Tarek Yousry AU - Michael P Lunn AU - Michael S Zandi AU - Robin S Howard AU - Dimitri M Kullmann AU - Jennifer Spillane AU - Matthew Walker AU - Jeremy Chataway TI - Bortezomib for anti-NMDAR encephalitis following daclizumab treatment in a patient with multiple sclerosis AID - 10.1136/bmjno-2020-000096 DP - 2021 May 01 TA - BMJ Neurology Open PG - e000096 VI - 3 IP - 1 4099 - http://neurologyopen.bmj.com/content/3/1/e000096.short 4100 - http://neurologyopen.bmj.com/content/3/1/e000096.full SO - BMJ Neurol Open2021 May 01; 3 AB - 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is an anti-CD25 monoclonal antibody developed for the treatment of relapsing remitting multiple sclerosis, which was withdrawn worldwide in March 2018, due to emerging serious immune-mediated systemic andcentral nervous system adverse events.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.