|
KMID : 1151120200280040145
|
|
Annals of Child Neurology
2020 Volume.28 No. 4 p.145 ~ p.155
|
|
|
Effectiveness of Intravenous Immunoglobulin Therapy for Pediatric Viral Encephalitis
|
|
Byun Ji-Eun
Lee Kyung-Yeon
|
|
|
Abstract
|
|
|
Purpose: Intravenous immunoglobulin (IVIg) is considered as a first-line therapy for autoimmune encephalitis. However, its effectiveness in viral encephalitis has yet to be evaluated. Therefore, we investigated the effectiveness of IVIg therapy for pediatric viral encephalitis.
Methods: We retrospectively reviewed the records of 35 pediatric patients who were hospitalized with confirmed or suspected viral encephalitis. Twenty patients (57.1%) were treated with IVIg in conjunction with conventional therapy (IVIg-treated group), and 15 patients (42.9%) were treated with conventional therapy (non-IVIg-treated group). We compared the clinical characteristics of the groups at admission and their clinical outcomes.
Results: Compared to the non-IVIg-treated group, the IVIg-treated group had more critical clinical features at admission, with a lower score on the pediatric Glasgow Coma Scale (mean±standard deviation, 9.1±2.3 vs. 10.8±2.7, P=0.025), longer fever duration (3.5±2.2 days vs. 1.8±1.1 days, P=0.022), and higher incidence of magnetic resonance imaging abnormalities (14/19 [73.7%] vs. 3/15 [20.0%], P=0.002). Nevertheless, the clinical outcomes of the IVIg-treated group were comparable to those of the non-IVIg-treated group in terms of mortality rate (1/20 [5.0%] vs. 0/15 [0%]), neurological deficits at discharge (2/20 [10.0%] vs. 1/15 [6.7%]), and occurrence of epilepsy (5/20 [25.0%] vs. 2/15 [13.3%]). Fourteen (70.0%) and 13 (85.7%) patients in the IVIg-treated and the non-IVIg-treated groups, respectively, achieved complete recovery without any neurological complications.
Conclusion: IVIg may be considered as a potential immunomodulating agent when treating critical pediatric viral encephalitis to improve neuropsychological outcomes.
|
|
|
KEYWORD
|
|
|
Encephalitis, viral, Immunoglobulins, intravenous, Treatment outcome, Immunomodulation
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|
|