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immunoglobulin intravenous in encephalitis

Alice Lejeune, Luise Martin, Sabine Santibanez, Stephanie Thee, Alexander Gratopp, Peter Späth, Annette Mankertz, Tilmann Kallinich, Horst von Bernuth
Most non-immune individuals exposed to the highly contagious measles virus will develop measles. Complications, such as encephalitis and bacterial infections due to measles virus-induced immunomodulation, account for an acute mortality rate of approximately 0.1% (1). It has been calculated that measles-related immunomodulation may last for several years and may contribute to child mortality on a larger scale than acute measles-related mortality (2). Since humans provide the only host for the virus, and an efficient vaccine is available, it is possible to eliminate measles...
October 17, 2016: Acta Paediatrica
Massimiliano Godani, Marco Zoccarato, Alessandro Beronio, Luigi Zuliani, Luana Benedetti, Bruno Giometto, Massimo Del Sette, Elisa Raggio, Roberta Baldi, Angela Vincent
BACKGROUND: The spectrum of autoimmune neurological diseases associated with voltage-gated potassium channel (VGKC)-complex antibodies (Abs) ranges from peripheral nerve disorders to limbic encephalitis. Recently, low titers of VGKC-complex Abs have also been reported in neurodegenerative disorders, but their clinical relevance is unknown. OBJECTIVE: The aim of the study was to explore the prevalence of VGKC-complex Abs in slow-progression motor neuron disease (MND)...
October 7, 2016: Neuro-degenerative Diseases
Jae-Bum Jun, Yunsuk Choi, Hawk Kim, Sun Ho Lee, Joseph Jeong, Jiwon Jung
To date, only 1 case of BK polyomavirus (BKPyV) encephalitis combined with transplant-associated thrombotic microangiopathy has been reported in a hematopoietic stem cell transplantation (HCT) recipient. We report the case of a HCT recipient who developed thrombotic microangiopathy and subsequent BKPyV encephalitis. She died despite treatment with cidofovir, ciprofloxacin, and intravenous immunoglobulin without improvement in mental status. Early suspicion of BKPyV encephalitis in a HCT recipient presenting with altered mentality and hemorrhagic cystitis is important...
October 1, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Chikako Kaneko, Norshalena Shakespear, Mario Tuchiya, Jin Kubo, Teiji Yamamoto, Soichi Katayama, Yukitoshi Takahashi
Five consecutive cases of anti-NMDA-receptor encephalitis that we encountered were marked by a rapidly fluctuating level of consciousness associated with psychotic and delirious mental states. Opisthotonus, catatonia, and rhythmic and non-rhythmic involuntary movements of the mouth and jaw were also characteristic features of these particular cases. Serious and potentially fatal problems included epilepsia partialis continua, partial and generalized seizures, and respiratory depression, resembling the symptoms of encephalitis lethargica...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
Jacqueline Gofshteyn, Ana María Cárdenas, David Bearden
INTRODUCTION: Enterovirus may result in a devastating chronic encephalitis in immunocompromised patients, particularly in patients with X-linked agammaglobulinemia. Prognosis for patients with chronic enterovirus encephalitis is poor, almost invariably resulting in mortality without specific treatment. There are currently no approved antiviral agents for enterovirus, but the antidepressant drug fluoxetine has been identified through library-based compound screening as a potential anti-enteroviral agent in vitro...
June 25, 2016: Pediatric Neurology
Qi Huang, Yuan Wu, Rongfa Qin, Xing Wei, Meigang Ma
Anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an acute neurological disorder affecting children and adults. We aimed to compare the clinical characteristics, treatments, and outcomes between children and adults with anti-NMDAR encephalitis and to assess the probable risk factors. In this observational study, patients who tested positive for anti-NMDAR antibody in the cerebrospinal fluid were enrolled. The patients were divided into children and adults group on the basis of age (whether <16 or not)...
September 15, 2016: Journal of Neurology
Étienne de Montmollin, Sophie Demeret, Noëlle Brulé, Marie Conrad, Frédéric Dailler, Nicolas Lerolle, Jean-Christophe Navellou, Carole Schwebel, Mikaël Alves, Martin Cour, Nicolas Engrand, Jean-Marie Tonnelier, Eric Maury, Stéphane Ruckly, Géraldine Picard, Véronique Rogemond, Éric Magalhaes, Tarek Sharshar, Jean-François Timsit, Jérôme Honnorat, Romain Sonneville
RATIONALE: Encephalitis due to anti-N-methyl-D-aspartate receptor (NMDAR) antibodies is the leading cause of immune-mediated encephalitis. There is limited data on intensive care unit (ICU) management of these patients. OBJECTIVES: To identify prognostic factors of good neurologic outcome in patients admitted to an ICU with anti-NMDAR encephalitis. METHODS: Observational multicenter study of all consecutive adult patients diagnosed with anti-NMDAR encephalitis, admitted to an ICU between 2008 and 2014...
August 23, 2016: American Journal of Respiratory and Critical Care Medicine
Charuwan Tantipalakorn, Atiwat Soontornpun, Tip Pongsuvareeyakul, Theera Tongsong
This report is aimed to describe a life-threatening case of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis secondary to ovarian teratoma with rapid recovery in 1 day after the removal of the tumour. A 23-year-old woman presented with sudden headache, personality changes and seizure. After neurological assessment, limbic or herpes encephalitis was provisionally diagnosed and treated with intravenous immunoglobulin, acyclovir and steroids. The patient had progressive severe neurological symptoms, requiring prolonged intubation and mechanical ventilation...
2016: BMJ Case Reports
Jun-Liang Yuan, Shuang-Kun Wang, Xiao-Juan Guo, Wen-Li Hu
Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system, which has been associated with several vaccines such as rabies, diphtheria-tetanus-polio, smallpox, measles, mumps, rubella, Japanese B encephalitis, pertussis, influenza, and the Hog vaccine. Here, we presented a case of 12-year-old child who suffered from ADEM three weeks after hepatitis B vaccination. He was admitted to our hospital with symptoms of weakness of limbs, high fever, and alteration of consciousness...
2016: Case Reports in Neurological Medicine
Mikihiro Yunoki, Takeshi Kurosu, Ritsuko Kubota Koketsu, Kazuo Takahashi, Yoshinobu Okuno, Kazuyoshi Ikuta
Japanese encephalitis virus (JEV), West Nile virus (WNV), and dengue virus (DenV) are causal agents of Japanese encephalitis, West Nile fever, and dengue fever, respectively. JEV is considered to be indigenized and widespread in Japan, whereas WNV and DenV are not indigenized in Japan. Globulin products seem to reflect the status of the donor population according to antivirus neutralization activity. However, the anti-JEV, -WNV, and -DenV neutralization activities of globulin products derived from donors in Japan have not been clarified...
2016: Biologics: Targets & Therapy
Dayanand Bagdure, Jason W Custer, Suchitra Rao, Kevin Messacar, Samuel Dominguez, Brandon W Beam, Adnan Bhutta
OBJECTIVES: Given the paucity of data on resource utilization among children with encephalitis, the objective of this study was to describe the epidemiology and evaluate resource utilization and discharge data of children with encephalitis admitted to US hospitals from 2004 to 2013. METHODS: We conducted a retrospective cohort study utilizing the Pediatric Health Information System database of children aged 0 to 18 years with the International Classification of Diseases, Ninth Revision codes for encephalitis from 2004 to 2013...
August 2016: Pediatric Neurology
Fahad A Bashiri, Abdulrahman A Al-Rasheed, Saeed M Hassan, Muddathir H A Hamad, Heba Y El Khashab, Amal Y Kentab, Fahad B AlBadr, Mustafa A Salih
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a recently identified auto-immune disorder characterised by severe memory deficit, a decreased level of consciousness, seizures, autonomic dysfunction and movement disorders. Three girls with the disorder are reported; they were aged 4 years, 5 years and 10 months. The 10-month-old infant who is one of the youngest patients reported with anti-NMDAR encephalitis worldwide, had MRI features suggestive of herpes simplex encephalitis (known to trigger anti-NMDAR encephalitis), but CSF PCR for herpes simplex was negative...
June 22, 2016: Paediatrics and International Child Health
Tanya J Williams, David R Benavides, Kelly-Ann Patrice, Josep O Dalmau, Alexandre Leon Ribeiro de Ávila, Dung T Le, Evan J Lipson, John C Probasco, Ellen M Mowry
IMPORTANCE: Paraneoplastic encephalitides usually precede a diagnosis of cancer and are often refractory to immunosuppressive therapy. Conversely, autoimmune encephalitides are reversible conditions that can occur in the presence or absence of cancer. OBJECTIVE: To report the induction of autoimmune encephalitis in 2 patients after treatment of metastatic cancer with a combination of the immune checkpoint inhibitors nivolumab and ipilimumab. DESIGN, SETTING, AND PARTICIPANTS: A retrospective case study was conducted of the clinical and management course of 2 patients with progressive, treatment-refractory metastatic cancer who were treated with a single dose each (concomitantly) of the immune checkpoint inhibitors nivolumab, 1 mg/kg, and ipilimumab, 3 mg/kg...
August 1, 2016: JAMA Neurology
Margherita Nosadini, Shekeeb S Mohammad, Agnese Suppiej, Stefano Sartori, Russell C Dale
AIM: Intravenous immunoglobulin (IVIG) is an expensive therapy used in immunodeficiency and autoimmune disorders. Increasing demands and consequent shortages result in a need for usage to conform to guidelines. METHOD: We retrospectively evaluated IVIG use for neuroimmunological indications and adherence to existing guidelines in a major Australian paediatric hospital between 2000 and 2014. RESULTS: One-hundred and ninety-six children (96 male, 100 female; mean age at disease onset 6y 5mo [range 3mo-15y 10mo], mean age at first IVIG dose 7y 2mo [range 3mo-16y 5mo]) received IVIG for neuroimmunological indications during the study period (28...
May 31, 2016: Developmental Medicine and Child Neurology
Lale Ozisik, Mine Durusu Tanriover, Esen Saka
Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe drug hypersensitivity reaction characterized by rash, fever and multi-organ failure. Limbic encephalitis (LE) is a rare disorder characterized by cognitive dysfunction with memory disturbance, seizures and psychiatric symptoms. We herein present an unusual case of DRESS syndrome due to lamotrigine with reactivation of Epstein-Barr virus, which developed autoimmune LE and syndrome of inappropriate antidiuretic hormone secretion. Discontinuation of lamotrigine, administration of methylprednisolone and intravenous immunoglobulin led to improvement...
2016: Internal Medicine
Tamer Celik, Umit Celik, Mustafa Kömür, Orkun Tolunay, Riza Dincer Yildizdas, Begul Yagci-Kupeli, Fulya Kücük, İsmail Eroglu
OBJECTIVES: Lyme disease is a vector-associated infectious disease, caused by the agent, spirochete Borrelia burgdorferi. Neurologic findings are observed in approximately 12% of the cases and termed Lyme neuroborreliosis (LNB). Lyme neuroborreliosis may manifest with different clinical neurologic manifestations. METHODS: The study was conducted at tertiary training and research hospital. From January 2014 to September 2015, a total of 75 patients diagnosed with encephalitis, ataxia, Guillain Barre Syndrome (GBS), facial paralysis, acute disseminated encephalomyelitis (ADEM), pseudotumorcerebri were evaluated for inclusion to the study...
2016: Neuro Endocrinology Letters
Takahiro Iizuka, Juntaro Kaneko, Naomi Tominaga, Hidehiro Someko, Masaaki Nakamura, Daisuke Ishima, Eiji Kitamura, Ray Masuda, Eiichi Oguni, Toshiyuki Yanagisawa, Naomi Kanazawa, Josep Dalmau, Kazutoshi Nishiyama
IMPORTANCE: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an immune-mediated disorder that occurs with IgG antibodies against the GluN1 subunit of NMDAR. Some patients develop reversible diffuse cerebral atrophy (DCA), but the long-term clinical significance of progressive brain and cerebellar atrophy is unknown. OBJECTIVE: To report the long-term clinical implications of DCA and cerebellar atrophy in anti-NMDAR encephalitis. DESIGN, SETTING, AND PARTICIPANTS: A retrospective observational study and long-term imaging investigation was conducted in the Department of Neurology at Kitasato University...
June 1, 2016: JAMA Neurology
J Yuan, B Peng, H Z Guan, Y Huang, Q Lu, H T Ren, X Z Yang, N Jiang, Y C Zhu, L Y Cui
OBJECTIVE: To provide evidence for establishing standardized treatment strategy of severe anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in China, by demonstrating the clinical characteristics and comparing the treatment strategy with that adopted in foreign countries. METHODS: A total of 35 hospitalized cases who met the diagnostic criteria for severe anti-NMDAR encephalitis were retrospectively analyzed. Demographic data, clinical history, past medical history, laboratory tests, imaging studies, treatment and the follow-up information were recorded using unified forms...
April 5, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Kam-Lun Ellis Hon, Yin Ching K Tsang, Lawrence C N Chan, Hing Wing Tsang, Kit Ying Kitty Wong, Yuet Hong Gordon Wu, Paul K S Chan, Kam Lau Cheung, Eric Y K Ng, Balagangadhar R Totapally
OBJECTIVE: To review pathogens, morbidity and mortality in pediatric intensive care unit (PICU) patients with viral and infectious encephalitis. METHODS: Retrospective chart review of all patients with encephalitis admitted to the PICU between 2002 and 2014 was done. RESULTS: Encephalitis (n = 46) accounted for 2.7 % of PICU admissions, but 11.8 % PICU mortality over a 12-y period. A microorganism (primarily virus) was identified in 59 % of encephalitis patients in the PICU...
October 2016: Indian Journal of Pediatrics
Li Zhang, Qiang Lu, Hong-Zhi Guan, Jun-Hua Mei, Hai-Tao Ren, Ming-Sheng Liu, Bin Peng, Li-Ying Cui
BACKGROUND: Morvan syndrome is a rare disorder characterized by the combination of peripheral nerve hyperexcitability, encephalopathy and dysautonomia with marked insomnia. It was reported to have association to antibodies to voltage-gated potassium channels including contactin associated protein-like 2 antibodies (CASPR2-Ab) and leucine-rich glioma inactivated protein 1 antibodies (LGI1-Ab). LGI1-Ab was reported to associate with seizures, amnesia, confusion, hyponatraemia and a good prognosis, while CASPR2-Ab with peripheral presentations, probable risk for tumor and a poor prognosis...
2016: BMC Neurology
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