May early intervention with high dose intravenous immunoglobulin pose a potentially successful treatment for severe cases of tick-borne encephalitis?

Ruzek, Daniel and Dobler, Gerhard and Niller, Hans Helmut (2013) May early intervention with high dose intravenous immunoglobulin pose a potentially successful treatment for severe cases of tick-borne encephalitis? BMC INFECTIOUS DISEASES, 13: 306. ISSN 1471-2334,

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Abstract

Background: Arthropod-borne viral encephalitis of diverse origins shows similar clinical symptoms, histopathology and magnetic resonance imaging, indicating that the patho mechanisms may be similar. There is no specific therapy to date. However, vaccination remains the best prophylaxis against a selected few. Regardless of these shortcomings, there are an increasing number of case reports that successfully treat arboviral encephalitis with high doses of intravenous immunoglobulins. Discussion: To our knowledge, high dose intravenous immunoglobulin has not been tested systematically for treating severe cases of tick-borne encephalitis. Antibody-dependent enhancement has been suspected, but not proven, in several juvenile cases of tick-borne encephalitis. Although antibody-dependent enhancement during secondary infection with dengue virus has been documented, no adverse effects were noticed in a controlled study of high dose intravenous immunoglobulin therapy for dengue-associated thrombocytopenia. The inflammation-dampening therapeutic effects of generic high dose intravenous immunoglobulins may override the antibody-dependent enhancement effects that are potentially induced by cross-reactive antibodies or by virus-specific antibodies at sub-neutralizing levels. Summary: Analogous to the increasing number of case reports on the successful treatment of other arboviral encephalitides with high dose intravenous immunoglobulins, we postulate whether it may be possible to also treat severe cases of tick-borne encephalitis with high dose intravenous immunoglobulins as early in the course of the disease as possible.

Item Type: Article
Uncontrolled Keywords: WEST-NILE-VIRUS; JAPANESE ENCEPHALITIS; FOLLOW-UP; T-CELLS; INFECTION; FLAVIVIRUS; MRI; IMMUNOTHERAPY; ENHANCEMENT; VACCINATION; Arboviruses; T-cell; Inflammation; MRI; Macrophage; Neopterin; TBE; Tick-borne encephalitis; T2-weighted hyper intensity
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene
Depositing User: Dr. Gernot Deinzer
Date Deposited: 06 Apr 2020 11:46
Last Modified: 06 Apr 2020 11:46
URI: https://pred.uni-regensburg.de/id/eprint/16378

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