文本框: IMMUNOLOGICAL CHANGES AND THERAPEUTIC EFFECTS OF HIGH DOSE INTRAVENOUS IMMUNOGLOBULIN (IVIG) THERAPY IN CHILDREN WITH SEVERE VIRAL ENCEPHALITIS (SVE)
Li ZP, Cao JM.
Affiliated Hospital of Qingdao University Medical College, Qingdao, China

Objective:To investigate the immunological changes and the therapeutic effects of IVIG therapy in children with SVE.
Methods:Forty-five children with SVE were randomly divided into two groups of routine and IVIG (n=25) treatment. The disappearing time of various severe clinical manifestation, the hospitalization time, the incidence rate of multiple organ function failure (MOF) and sequelae, the fatality rate were studied; the plasma and cerebral spinal fluid (CSF) interlukin-6 (IL-6) and tumor necrosis factor -alpha (TNF-a) levels were measured before and after treatment.
Results:After IVIG treatment, the disappearing time of various severe clinical manifestation, the hospitalization time, the fatality rate, the incidence rate of MOF and worse sequelae reduced significantly in IVIG group compared with those in routine group. The plasma and CSF IL-6 (8.3ng/L, 4.5ng/L) and TNF-a (65.9ng/L, 42.4ng/L) levels in IVIG group reduced significantly after IVIG treatment compared with those before treatment (61.1ng/L, 135.6ng/L and 2618.1ng/L, 2279.6ng/L), but were still higher than those in control group. No obvious changes of the plasma and CSF IL-6 and TNF-a levels have been found before and after treatment in routine group. 
Conclusion: IVIG therapy could block the occurrence of the abnormal immunoreaction in brain and the formation of systemic cytokine storm, alleviate the symptom of increased intracranial pressure and cerebral parenchyma impairment, lower the incidence rate of MOF and worse sequelae, and shorten the SVE course.

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