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Efficacy and safety of intravenous high-dose immunoglobulin in treatment of the severe form of Japanese encephalitis

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Abstract

Purpose

To explore the efficacy and safety of intravenous immunoglobulin (IVIG) in the treatment of severe Japanese encephalitis (JE).

Methods

A retrospective study of 124 children diagnosed with the severe or very severe form of JE was undertaken. There were 62 cases in the IVIG group and control group. The efficacy, safety, and tolerability of IVIG were evaluated 3 days, as well as 1, 2, and 3 weeks after IVIG, respectively, and the prognosis was assessed at 6 months.

Results

Cox regression survival analysis suggested that the IVIG group reached the criteria for efficacious treatment faster than that in the control group. The duration of unconsciousness and the number of days of seizures, a dull response to light, the pyramidal sign, and meningeal-irritation sign in the IVIG group were shorter than those in the control group (p < 0.05). The number of complications occurring in the IVIG group (including gastrointestinal bleeding and pneumonia) was less than that in the control group (p < 0.05). Cox regression survival analysis suggested that age (p = 0.003) and imaging abnormalities (p = 0.042) had an effect on the efficacy of IVIG treatment. The Liverpool Outcome Score at 6 months showed that the prognosis of the IVIG group was better than that of the control group (p < 0.05). IVIG treatment was safe and tolerable.

Conclusion

IVIG showed good efficacy, safety, and tolerance for treatment of the severe form of JE. The age and imaging abnormalities of patients affect the efficacy of IVIG treatment.

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Data availability

The dataset generated during and/or analyzed during the study is available from the corresponding author upon reasonable request.

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Acknowledgements

We sincerely thank all the children and their parents for their cooperation during this study.

Author information

Authors and Affiliations

  1. Department of Neurology, Children’s Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yu Zhong District, Chongqing, 400014, China

    Dan Chen, Peng Wu, Li Jiang & Yue Hu

  2. Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China

    Dan Chen, Peng Wu, Li Jiang & Yue Hu

  3. National Clinical Research Center for Child Health and Disorders, Chongqing, China

    Dan Chen, Peng Wu, Li Jiang & Yue Hu

  4. China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China

    Dan Chen, Peng Wu, Li Jiang & Yue Hu

  5. Chongqing Key Laboratory of Pediatrics, Chongqing, China

    Dan Chen, Peng Wu, Li Jiang & Yue Hu

  6. Guangzhou Women and Children’s Medical Center, Guangzhou, China

    Dan Chen

  7. Division of Science and Technology, Beijing Normal University-Hongkong Baptist University United International College, Beijing, China

    Xiaoling Peng

  8. Department of Pediatrics, Sichuan Provincial People’s Hospital, Chengdu, China

    Yu Zhan

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  1. Dan Chen
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  4. Peng Wu
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  5. Li Jiang
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  6. Yue Hu
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Contributions

D.C. contributed to the acquisition and interpretation of data, and was involved in drafting the manuscript. Y.H. conceived of the study, participated in its design, and helped to draft the manuscript. X.L.P., Y.Z., and P.W. participated in the design of the study and undertook statistical analyses. L.J. revised the manuscript critically for important intellectual content. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Yue Hu.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

The study protocol was approved by the Scientific and Ethical Committee of the Children’s Hospital of Chongqing Medical University (Chongqing, China).

Informed consent

Written informed consent was obtained from the accompanying relative/guardian of the child.

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Cite this article

Chen, D., Peng, X., Zhan, Y. et al. Efficacy and safety of intravenous high-dose immunoglobulin in treatment of the severe form of Japanese encephalitis. Neurol Sci 43, 3911–3918 (2022). https://doi.org/10.1007/s10072-022-05891-6

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  • DOI: https://doi.org/10.1007/s10072-022-05891-6

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