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immunoglobulin intravenous in encephalitis

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https://www.readbyqxmd.com/read/29096847/immunoadsorption-for-autoimmune-encephalitis
#1
Cordula Fassbender, Reinhard Klingel, Wolfgang Köhler
Autoimmune encephalitis is a severe inflammatory disorder of the brain. The discovery that several non-infectious forms of encephalitis are associated with autoantibodies was a breakthrough in the care of this previously untreatable group of patients. The correlation of antibody type and titer with pattern and severity of symptoms was essential for the initiation of immunotherapies. First line therapy consists of steroids, intravenous immunoglobulins, plasma exchange or immunoadsorption. Rapid elimination of autoantibodies using selective immunoadsorption and avoiding the disadvantage of plasma substitution is a pathophysiologically guided therapeutic approach, and has been proven to be an effective therapeutic option as part of multimodal immunotherapy...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29058581/opsoclonus-myoclonus-syndrome-in-a-patient-with-japanese-encephalitis-a-case-report
#2
Subatharshini Sountharalingam, H M M T B Herath, Dharshana Wijegunasinghe, Sunethra Senanayke
BACKGROUND: Opsoclonus myoclonus syndrome is a rare neurological disorder that usually manifests as a paraneoplastic phenomenon. Although some viruses are reported to cause this condition, opsoclonus myoclonus syndrome by Japanese encephalitis has not been reported previously. CASE PRESENTATION: Here we present the case of a 31-year-old Sri Lankan woman who presented with fever, altered level of consciousness, opsoclonus, and facial myoclonus. She was diagnosed as having Japanese encephalitis based on cerebrospinal fluid and serum Japanese encephalitis-specific immunoglobulin M antibody and characteristic magnetic resonance imaging abnormalities...
October 23, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29049232/case-report-central-nervous-system-involvement-of-human-graft-versus-host-disease-report-of-7-cases-and-a-review-of-literature
#3
Mathilde Ruggiu, Wendy Cuccuini, Karima Mokhtari, Véronique Meignin, Régis Peffault de Latour, Marie Robin, Flore Sicre de Fontbrune, Aliénor Xhaard, Gérard Socié, David Michonneau
RATIONALE: Central nervous system (CNS) involvement of graft versus host disease (GvHD) is a rare cause of CNS disorders after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Chronic CNS GvHD symptoms are heterogeneous and include cerebrovascular manifestations, demyelinating disease and immune-mediated encephalitis. CNS-Acute GvHD is not formally defined in literature. PATIENTS CONCERNS AND DIAGNOSES: We report 7 cases of CNS-GvHD among which two had histological-proven disease...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28982346/mog-antibody-seropositivity-in-a-patient-with-encephalitis-beyond-the-classical-syndrome
#4
Sara Mariotto, Salvatore Monaco, Patrick Peschl, Ilaria Coledan, Romualdo Mazzi, Romana Höftberger, Markus Reindl, Sergio Ferrari
BACKGROUND: The presence of circulating anti-myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) has been described in sera of patients with different inflammatory conditions of the central nervous system. In adults the core clinical feature is usually characterised by acute myelitis and/or optic neuritis. We here report an atypical case with serum and cerebrospinal fluid MOG-Abs and a clinical picture suggestive for acute encephalitis. CASE PRESENTATION: A 31-year-old Indian man presented with altered mental status, slight fever, and ataxia...
October 5, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28974594/an-unusual-case-of-refractory-status-epilepticus-in-a-young-lady-anti-nmda-receptor-encephalitis
#5
Ching Soong Khoo, Nurul Husna Zulkifli, Siti Soraya Ab Rahman
We describe a case of a young lady with anti-NMDA (N-methyl-D-aspartate) receptor encephalitis, who initially presented with status epilepticus. Her seizures and orofacial dyskinesia were refractory to four anticonvulsants. She received intravenous immunoglobulin and a left ovarian tumour (an associated feature) was resected. However, her outcome was poor because of delayed treatment, autonomic dysfunction and complications of prolonged hospitalisation. This case highlights the importance of an early recognition of this rare but increasingly recognised disease...
October 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28967695/intravenous-immunoglobulin-for-the-treatment-of-childhood-encephalitis
#6
REVIEW
Mildred A Iro, Natalie G Martin, Michael Absoud, Andrew J Pollard
BACKGROUND: Encephalitis is a syndrome of neurological dysfunction due to inflammation of the brain parenchyma, caused by an infection or an exaggerated host immune response, or both. Attenuation of brain inflammation through modulation of the immune response could improve patient outcomes. Biological agents such as immunoglobulin that have both anti-inflammatory and immunomodulatory properties may therefore be useful as adjunctive therapies for people with encephalitis. OBJECTIVES: To assess the efficacy and safety of intravenous immunoglobulin (IVIG) as add-on treatment for children with encephalitis...
October 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28938341/neurological-toxicities-associated-with-immune-checkpoint-inhibitors
#7
Mehdi Touat, Daniel Talmasov, Damien Ricard, Dimitri Psimaras
PURPOSE OF REVIEW: Immune-checkpoint inhibitors (ICIs) constitute a novel class of agents recently approved to treat a number of human malignancies. Due to their immunomodulatory mechanism of action, ICIs can generate a wide range of immune-related adverse events (irAEs) of which neurological toxicities are of special interest because of their potential severity. The objective of this review is to examine the recent literature describing neurological irAEs and discuss their optimal management...
December 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28914199/clinical-applications-of-intravenous-immunoglobulins-in-child-neurology
#8
Maria Gogou, Efimia Papadopoulou-Alataki, Martha Spilioti, Sofia Alataki, Athanasios Evangeliou
BACKGROUND: While there are guidelines for the use of intravenous immunoglobulins in children with Guillain-Barre syndrome and myasthenia gravis based on high-level evidence studies, data is fewer for the majority of neurologic disorders in this age group. Neuronal antibodies are detected in children with seizures of autoimmune etiology. Intravenous immunoglobulins with their broad immunomodulatory mechanism of action could be ideally effective in different forms of immune-dysregulated intractable epilepsies such as autoimmune epilepsy and autoimmune Rasmussen encephalitis...
September 15, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28884051/anti-n-methyl-d-aspartate-receptor-nmdar-encephalitis-in-association-with-ovarian-teratoma
#9
Javaad Ahmad, Muhammad Saad Sohail, Amina Khan, Ahmed H Qavi, Pramod Gaudel, Mehr Zahid, Salman Assad
Anti-N-methyl-D-aspartate-Receptor (NMDAR) encephalitis is an autoimmune disorder with a multifaceted presentation that involves memory deficits, psychiatric symptoms, and autonomic instability. This case report describes the classic presentation of Anti-NMDAR encephalitis and highlights its association with ovarian teratomas. We present a 26 -year-old female who came in with new onset seizures and altered mentation who subsequently developed automatism. Electroencephalograms (EEG) showed left frontal spikes and right temporal delta activity...
July 5, 2017: Curēus
https://www.readbyqxmd.com/read/28881516/-effectiveness-and-safety-of-rituximab-for-children-with-autoimmune-diseases-of-the-nervous-system
#10
Z Fu, X H Bao, Y Wu, J Zhou, Y H Zhang, Y Zhang, T Y Ji, Y Chen
Objective: To assess the effectiveness and safety of rituximab in Chinese children with autoimmune diseases of the nervous system. Method: An ambispective cohort study enrolled patients with refractory and(or) relapse autoimmune diseases of nervous system from June 2010 to June 2016 in Peking University First Hospital.These patients failed to respond to steroids and(or)intravenous immunoglobulin (IVIG) were treated with rituximab and seen for follow-up visits once every 3 months.The effectiveness was assessed by modified Rankin scale (mRs) and the annualized relapse rate...
September 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28831691/parvovirus-b19-infection-associated-with-hemolytic-anemia-and-cranial-polyneuropathy
#11
João Sequeira, Ana Calado, Margarida Dias, Manuel Manita
Parvovirus B19 (PB19) is a common, widespread, small, single-stranded DNA virus which has been linked with a broad spectrum of clinical illnesses, including a variety of neurological complications such as encephalitis, meningitis, myelitis, stroke, cerebellar ataxia, and neuropathy. The authors describe a case of PB19 infection associated with hemolytic anemia and cranial polyneuropathy involving the second and third cranial nerves in a 23-year-old immunocompetent woman. The diagnosis of acute PB19 infection was established with detection of positive DNA and anti-PB19 IgM antibodies in blood samples...
August 22, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28816832/reversible-splenial-lesion-syndrome-after-intravenous-immunoglobulin-treatment-for-guillain-barre-syndrome
#12
Elif Uygur Kucukseymen, Burcu Yuksel, Fatma Genc, Eylem Ozaydin Goksu, Sevim Yildiz, Yasemin Bicer Gomceli
Reversible corpus callosum splenial (CCS) lesions have been described in patients with varied etiologies. The most common causes of previously reported reversible focal lesions of the CCS are viral encephalitis, antiepileptic drug toxicity/withdrawal, and metabolic disorders. Intravenous immunoglobulin (IVIG) therapy is used for different immune-mediated diseases. It is generally safe, and serious adverse reactions are uncommon. We presented a rare case of disturbed consciousness with reversible CCS lesions after IVIG therapy for Guillain-Barre syndrome in an adult woman...
September 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28810906/atypical-presentation-of-anti-n-methyl-d-aspartate-receptor-encephalitis-two-case-reports
#13
Maria Cristina Maggio, Greta Mastrangelo, Aldo Skabar, Alessandro Ventura, Marco Carrozzi, Giuseppe Santangelo, Francesca Vanadia, Giovanni Corsello, Rolando Cimaz
BACKGROUND: Anti-N-methyl-D-aspartate receptor encephalitis is a rare autoimmune disease characterized by severe neurological and psychiatric symptoms and a difficult diagnosis. The disease is often secondary to a neoplastic lesion, seldom diagnosed years later. Psychiatric symptoms are prevalent in adults; neurologic symptoms are more evident in children, who typically present primarily with neurological symptoms. To the best of our knowledge, the association with juvenile idiopathic arthritis has not been described...
August 16, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28720215/autoimmune-meningitis-and-encephalitis-in-adult-onset-still-disease-case-report
#14
Milena Bożek, Magdalena Konopko, Teresa Wierzba-Bobrowicz, Grzegorz Witkowski, Grzegorz Makowicz, Halina Sienkiewicz-Jarosz
INTRODUCTION: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown cause. Its symptoms usually include persistent fever, fugitive salmon-colored rash, arthritis, sore throat (not specific), but it may also lead to internal organs' involvement, which presents with enlargement of the liver and spleen, swollen lymph nodes, carditis or pleuritis - potentially life-threatening complications. In rare cases, AOSD can cause aseptic meningitis or/and encephalitis...
July 8, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28717094/limbic-encephalitis-associated-with-human-herpesvirus-7-hhv-7-in-an-immunocompetent-adult-the-first-reported-case-in-japan
#15
Yoko Aburakawa, Takayuki Katayama, Tsukasa Saito, Jun Sawada, Tatsuo Suzutani, Hitoshi Aizawa, Naoyuki Hasebe
A 35-year-old male who had not previously suffered any major illnesses was admitted to our hospital because of general fatigue, fever, headache, vomiting, consciousness disturbance, and seizures. A neurological examination showed that he was in a semi-comatose state and exhibited neck stiffness. Brain magnetic resonance imaging detected high-intensity areas in the bilateral hippocampi and periventricular white matter. A cerebrospinal fluid examination revealed mononuclear pleocytosis, an elevated protein level, and positivity for human herpesvirus-7 (HHV-7) DNA...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28637936/a-case-of-bickerstaff-brainstem-encephalitis-with-transient-reflex-myoclonus
#16
Ryusuke Takaki, Takamura Nagasaka, Yumi Suwa, Mai Tsuchiya, Kishin Kho, Yoshihisa Takiyama
A 33-year-old woman was admitted due to disturbance of consciousness, dysarthria, dysphagia, sensory disturbances and weakness of the left upper limb after mycoplasma infection. She was treated with intravenous immunoglobulin and intravenous high-dose methylprednisolone as Bickerstaff brainstem encephalitis (BBE). On the 15th hospital day, reflex myoclonus appeared on her face, neck, body and limbs induced by techniques of jaw jerk reflex and patellar tendon reflex. The myoclonus was disappeared after two weeks in accordance with improvement of BBE...
July 29, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28606234/-efficacy-and-safety-of-cyclophosphamide-as-a-sequential-immunotherapy-drug-for-anti-n-methyl-d-aspartate-receptor-encephalitis-in-children
#17
Wei-Wen Zhu, Wei-Ping Liao, Yong-Hong Yi, Xing-Wang Song
OBJECTIVE: To evaluate the efficacy and safety of cyclophosphamide as a second-line drug in the treatment of children with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. METHODS: Six children with anti-NMDAR encephalitis, who showed poor response to steroids and intravenous immunoglobulin, were given cyclophosphamide as a second-line immunotherapy. Follow-up was performed to evaluate the efficacy and safety of cyclophosphamide. RESULTS: After first-line immunotherapy for 1-4 weeks, the six patients had reduced psychiatric symptoms, seizures, and involuntary movements; three patients had an improved level of consciousness and were able to make simple conversations...
June 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28514704/guillain-barr%C3%A3-syndrome-variants-forms-fruste-reclassification-with-new-criteria
#18
Fu Liong Hiew, Rahmansah Ramlan, Shanthi Viswanathan, Santhi Puvanarajah
OBJECTIVES: This study aimed to evaluate the clinical and electrophysiological characteristics of various distinctive classical and localised Guillain-Barré syndrome (GBS) subtypes. PATIENTS AND METHODS: Clinical characteristics and electrophysiological data of sixty-one consecutive patients admitted between 2012 and 2015 were systematically analysed and reclassified according to the new GBS clinical classification. Neurophysiology was evaluated with Hadden et al...
July 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28513810/epstein-barr-virus-encephalitis-in-solid-organ-transplantation
#19
Jillian S Y Lau, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Arthur Richard Kitching, Tony M Korman
Epstein-Barr virus (EBV) is typically associated with post transplant lymphoproliferative disease (PTLD) after solid organ and stem cell transplantation. However, it is rarely associated with neurological complications. We report a case of severe encephalitis complicating primary EBV infection six months post renal transplantation, and review the literature on EBV encephalitis in solid organ transplantation in adults. A 55-year-old male presented 6 months post cadaveric renal transplant with headache, fever and confusion...
July 2017: New Microbiologica
https://www.readbyqxmd.com/read/28506503/extended-clinical-spectrum-of-anti-n-methyl-d-aspartate-receptor-encephalitis-in-children-a-case-series
#20
Ajay Goenka, Vivek Jain, Hiroki Nariai, Alfred Spiro, Mitchell Steinschneider
OBJECTIVE: There is a wide spectrum of clinical manifestations in children with anti-N-methyl-d-aspartate (NMDA) receptor antibody encephalitis from two different health care settings. METHODS: We describe our experience with 13 patients (median age, 7 years; range, 5 months to 19 years) presenting to tertiary referral centers in India and the United States. RESULTS: Initial manifestations were neurological (seizures or movement disorders) in eight patients, and psychiatric (e...
July 2017: Pediatric Neurology
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