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首页> 外文期刊>Emerging Infectious Diseases >Treatment of West Nile Virus Encephalitis with Intravenous Immunoglobulin
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Treatment of West Nile Virus Encephalitis with Intravenous Immunoglobulin

机译：静脉注射免疫球蛋白治疗西尼罗河病毒性脑炎

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To the Editor: West Nile virus is endemic in Israel. The overwhelming majority of infections are mild and asymptomatic, but there have been periodic symptomatic outbreaks (1). In August 2000, an epidemic of West Nile virus broke out in Israel, with >260 confirmed cases and 20 deaths by the end of September 2000. Hitherto, the only treatment for this condition has been supportive with no proven in vivo specific therapy, although ribavirin has shown promise in in vitro studies (2). We report an apparent dramatic response to intravenous immunoglobulin in an immunosuppressed patient and suggest that this was the result of specific antibodies in the Israeli immunoglobulin used. A 70-year-old woman was admitted to the hospital because of fever and vomiting of 24 hours’ duration. She had a 12-year history of chronic lymphatic leukemia (Rai stage II) but was not on treatment. A routine outpatient assessment 1 week earlier had shown no unexpected findings. On physical examination the patient appeared generally well, with temperature 39.0°C, regular pulse 100/ minute, and blood pressure 130/70. Apart from splenomegaly 2-3 cm below the costal margin, there were no abnormal physical signs, including lymphadenopathy. Chest X ray results were normal. Hb was 12 g/dL, HCt 32%, mean corpuscular volume 84, leukocyte count 280x109/L (90% lymphocytes, 13% neutrophils, and 10% monocytes), platelets 280x109/L, Coombs negative. Her biochemical profile was entirely within the normal range. Blood and urine cultures were negative. Immunoglobulin G (IgG) was 14.5 g/L, IgM 2.6 g/L, and IgA 2.6 g/L.
机译：致编辑：西尼罗河病毒在以色列流行。绝大多数感染是轻度和无症状的，但有周期性的症状爆发（1）。在2000年8月，以色列爆发了西尼罗河病毒的流行病，到2000年9月底，确诊病例超过260例，死亡20例。迄今为止，该病的唯一治疗方法是支持性的，尽管没有经过体内验证的特异性疗法利巴韦林在体外研究中显示出希望（2）。我们报告了在免疫抑制的患者中对静脉内免疫球蛋白的明显反应，并表明这是所用以色列免疫球蛋白中特定抗体的结果。一名70岁的妇女因发烧和持续24小时呕吐而入院。她有12年的慢性淋巴白血病病史（Rai II期），但未接受治疗。 1周前进行的常规门诊评估未发现任何意外发现。体格检查患者表现良好，体温39.0°C，规律脉搏100 /分钟，血压130/70。除了在肋缘下方2-3 cm的脾肿大以外，没有异常的体征，包括淋巴结肿大。胸部X线检查结果正常。 Hb为12 g / dL，HCt 32％，平均红细胞体积84，白细胞计数280x109 / L（90％淋巴细胞，13％中性粒细胞和10％单核细胞），血小板280x109 / L，Coombs阴性。她的生化特征完全在正常范围内。血液和尿液培养均为阴性。免疫球蛋白G（IgG）为14.5 g / L，IgM 2.6 g / L和IgA 2.6 g / L。

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