scholarly journals The Role of Intravenous Immunoglobulins in Treatment of Viral Encephalitis in Children

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Sameh A. Abd EL-Naby ◽  
Nagwan Y. saleh ◽  
Nahla M. Said ◽  
Esraa K. EL-Baz
Keyword(s):  
Viral Encephalitis ◽  
Intravenous Immunoglobulins

scholarly journals Efficacy and safety of intravenous immunoglobulins for the treatment of viral encephalitis: a systematic literature review

2021 ◽  
Author(s):  
Judith N. Wagner ◽  
Annette Leibetseder ◽  
Anna Troescher ◽  
Juergen Panholzer ◽  
Tim J. von Oertzen
Keyword(s):  
Systematic Review ◽  
Viral Encephalitis ◽  
Viral Infections ◽  
Case Reports ◽  
Ivig Therapy ◽  
Intravenous Immunoglobulins ◽  
Efficacy And Safety ◽  
Serious Adverse Events ◽  
Optimal Dosing ◽  
Cochrane Database

Abstract Background For most viral encephalitides, therapy is merely supportive. Intravenous immunoglobulins (IVIG) have been used as a prophylactic and therapeutic approach. We conduct a systematic review on the safety and efficacy of IVIG in viral encephalitis. Methods We conducted a systematic review assessing PubMed, Cochrane Database, Biosis Previews and the ClinicalTrials.gov website to identify all reports on patients with viral encephalitis treated with IVIG as of May 31, 2019. The main outcomes assessed were therapeutic efficacy and safety. For an increased homogeneity of the population, atypical viral infections were excluded, as were reports on prophylactic IVIG use, intrathecal application of immunoglobulins, or use of antibody-enriched IVIG-preparations. Data were extracted from published studies. Descriptive statistics were used. Results We included a total of 44 studies (39 case reports). The case reports cover a total of 53 patients. Our search retrieved two prospective and three retrospective studies. These show heterogeneous results as to the efficacy of IVIG therapy. Only one study reports a significant association between IVIG-use and death (odds ratio 0.032; 95% confidence interval 0.0033–0.3024; p = 0.0027). None of the studies report significant differences in the number of serious adverse events. Conclusion Data on the efficacy of IVIG-therapy is heterogeneous. While it seems generally safe, evident superiority compared to supportive treatment has not been demonstrated so far. Future trials should also investigate the optimal dosing and timing of IVIG and their benefit in the immunosuppressed.

Viral Encephalitis In Adults: A Narrative Review

2021 ◽  
Vol 16 ◽  
Author(s):  
Siciliano Valentina ◽  
Rosà Tommaso ◽  
Del Vecchio Pierluigi ◽  
D'Angelillo Anna ◽  
Brigida Mattia ◽  
...  
Keyword(s):  
Viral Encephalitis ◽  
Viral Infections ◽  
Direct Action ◽  
Ventilatory Support ◽  
Signs And Symptoms ◽  
Altered Mental Status ◽  
Poor Quality ◽  
Electrolyte Disorders ◽  
The Central Nervous System

: Viral infections of the central nervous system cause frequent hospitalization. The pathogenesis of viral encephalitis involves both the direct action of invading pathogens and the damage generated by the inflammatory reaction they trigger. The type of signs and symptoms presented by the patient depends on the severity and location of the ongoing inflammatory process. Most of the viral encephalitides are characterized by an acute development, fever, variable alterations in consciousness (confusion, lethargy, even coma), seizures (focal and generalized) and focal neurologic signs. The specific diagnosis of encephalitis is usually based on lumbar puncture. Cerebrospinal fluid examination should be performed in all patients unless absolutely contraindicated. Also, electroencephalogram and neuroimaging play a prominent role in diagnosis. Airway protection, ventilatory support, the management of raised intracranial pressure and correction of electrolyte disorders must be immediately considered in a patient with altered mental status. The only therapy strictly recommended is acyclovir in HSV encephalitis. The use of adjunctive glucocorticoids has poor-quality evidence in HSV, EBV, or VZV encephalitis. The role of antiviral therapy in other types of viral encephalitis is not well defined.

scholarly journals Alzheimers Disease: Review of Emerging Treatment Role for Intravenous Immunoglobulins

2011 ◽  
Vol 3 ◽  
pp. JCNSD.S5018 ◽  
Author(s):  
Rakez Kayed ◽  
George R. Jackson ◽  
D. Mark Estes ◽  
Alan D.T. Barrett
Keyword(s):  
Neurodegenerative Disorder ◽  
Underlying Disease ◽  
Intravenous Immunoglobulins ◽  
Phase Iii ◽  
Therapeutic Effects ◽  
Small Pilot Study ◽  
Healthy Human ◽  
Cognitive Improvement ◽  
Immune Mediated

Alzheimer's disease (AD) is the most common neurodegenerative disorder. Currently available therapies are symptomatic but do not alter underlying disease progression. Immunotherapeutic approaches such as anti Aβ peptide active vaccination trials have had limited success to date. Intravenous immunoblobulin (IVIg) is widely used in immune-mediated neurological disorders such myasthenia gravis and Guillain-Barre syndrome. These preparations have been obtained from the pooled plasma of healthy human donors and contain natural anti-amyloid antibodies and are well tolerated. A small pilot study of passive immunotherapy using IVIg has suggested cognitive improvement. A multicenter phase III trial is ongoing and will determine whether or not this treatment can ameliorate cognitive deficits in mild-to-moderate AD. Here, we briefly review the pathogenic role of amyloid and tau in AD, as well as immunotherapeutic efforts to date. We also summarize what is known about naturally occurring anti-Aβ and tau antibodies in IVIg with a view toward explaining potential mechanisms underlying their therapeutic effects.

Trend of hospital utilization for encephalitis

2011 ◽  
Vol 140 (4) ◽  
pp. 753-764 ◽  
Author(s):  
P. BARBADORO ◽  
A. MARIGLIANO ◽  
A. RICCIARDI ◽  
M. M. D'ERRICO ◽  
E. PROSPERO
Keyword(s):  
Potential Role ◽  
Viral Encephalitis ◽  
Seasonal Pattern ◽  
Hospitalization Rate ◽  
Preventive Interventions ◽  
Emerging Pathogens ◽  
Hospitalization Rates ◽  
Not Otherwise Specified ◽  
The Mean

SUMMARYEncephalitis generally results in a serious illness requiring hospitalization. The aim of this study was to describe the epidemiology of hospitalization for encephalitis in Italy, taking into account the geographical distribution, aetiology, seasonality and evolution of hospitalization rates over recent years. The mean hospitalization rate was 5·88/100 000. For most of these hospitalizations (n=13 119, 55·6%), no specific cause of encephalitis was reported. The most common aetiological category was ‘viral’, which accounted for 40·1% (n=4205) of such hospitalizations (rate 1·05/100 000). Within this category, herpes virus was the leading causative agent (n=1579, 0·39/100 000). This report highlights a significant increase of ‘viral encephalitis not otherwise specified’ (ICD-9 code 049·9) vs. a reduction of all other causes. A seasonal pattern was noted in people aged ⩾65 years in this group. Specific surveillance of encephalitis without known origin should be reinforced in order to identify the potential role of emerging pathogens and to design preventive interventions.

scholarly journals Chemokine receptors CCR2 and CX3CR1 regulate viral encephalitis-induced hippocampal damage but not seizures

2018 ◽  
Vol 115 (38) ◽  
pp. E8929-E8938 ◽  
Author(s):  
Christopher Käufer ◽  
Chintan Chhatbar ◽  
Sonja Bröer ◽  
Inken Waltl ◽  
Luca Ghita ◽  
...  
Keyword(s):  
Chemokine Receptors ◽  
Viral Encephalitis ◽  
Myeloid Cells ◽  
Cns Infection ◽  
Hippocampal Damage ◽  
Relative Role ◽  
Cd11b Expression ◽  
Brain Invasion ◽  
Reporter Mice

Viral encephalitis is a major risk factor for the development of seizures, epilepsy, and hippocampal damage with associated cognitive impairment, markedly reducing quality of life in survivors. The mechanisms underlying seizures and hippocampal neurodegeneration developing during and after viral encephalitis are only incompletely understood, hampering the development of preventive treatments. Recent findings suggest that brain invasion of blood-born monocytes may be critically involved in both seizures and brain damage in response to encephalitis, whereas the relative role of microglia, the brain’s resident immune cells, in these processes is not clear. CCR2 and CX3CR1 are two chemokine receptors that regulate the responses of myeloid cells, such as monocytes and microglia, during inflammation. We used Ccr2-KO and Cx3cr1-KO mice to understand the role of these receptors in viral encephalitis-associated seizures and neurodegeneration, using the Theiler’s virus model of encephalitis in C57BL/6 mice. Our results show that CCR2 as well as CX3CR1 plays a key role in the accumulation of myeloid cells in the CNS and activation of hippocampal myeloid cells upon infection. Furthermore, by using Cx3cr1-creER+/−tdTomatoSt/Wt reporter mice, we show that, with regard to CD45 and CD11b expression, some microglia become indistinguishable from monocytes during CNS infection. Interestingly, the lack of CCR2 or CX3CR1 receptors was associated with almost complete prevention of hippocampal damage but did not prevent seizure development after viral CNS infection. These data are compatible with the hypothesis that CNS inflammatory mechanism(s) other than the infiltrating myeloid cells trigger the development of seizures during viral encephalitis.

scholarly journals The effect of prenatal and postnatal treatment with intravenous immunoglobulin on severity of neonatal hemochromatosis: the tale of two brothers (case report)

2020 ◽  
Author(s):  
Veronica Mugarab Samedi ◽  
Michelle D Ryan ◽  
Essa Al Awad ◽  
Adel Elsharkawy
Keyword(s):  
Liver Transplantation ◽  
Intravenous Immunoglobulin ◽  
Rare Condition ◽  
Intravenous Immunoglobulins ◽  
Prenatal Treatment ◽  
Case Presentation ◽  
Neonatal Hemochromatosis ◽  
Postnatal Treatment ◽  
Antenatal Treatment

Abstract Background: Neonatal hemochromatosis (NH) is a rare condition that was the main reason for liver transplantation in infants. With the realization that NH results from the fetal complement-mediated liver injury, intravenous immunoglobulins (IVIG) were successfully introduced for the treatment. Case Presentation: We present two cases of NH from the same family to illustrate the role of antenatal treatment with IVIG in alleviation and possible prevention of this serious morbidity. Conclusion: A prenatal treatment and early postnatal administration of IVIG are effective ways to manage NH that help to reduce the severity of the symptoms, prevent liver failure and avoid the need for liver transplantation Keywords: Neonatal hemochromatosis, Intravenous immunoglobulin, prenatal treatment

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