Why the study?
Does hyperimmune plasma containing high concentrations of specific antibodies eliminate virus and improve neurologic status in a patient with x-linked hypogammaglobulinemia and chronic echovirus type 5 encephalitis?
Does hyperimmune plasma containing high concentrations of specific antibodies eliminate virus and improve neurologic status in a patient with x-linked hypogammaglobulinemia and chronic echovirus type 5 encephalitis?
High-titer specific antibodies administered intravenously can clear echovirus from the blood and CSF in patients with hypogammaglobulinemia, though it may not prevent mortality in advanced chronic encephalitis.
Hypothesis-generating for hyperimmune plasma in hypogammaglobulinemia-associated echovirus encephalitis; prospective studies needed before clinical adoption.
The effects of specific antibodies in chronic echovirus type 5 (echo 5) encephalitis were investigated in a patient with x-linked hypogammaglobulinemia. Virus was detected in cerebrospinal fluid (CSF) and blood despite treatment with commercial human gammaglobulin that contained low titers of antibodies to echo 5 (0.6 x 10(4) units per injection). Virus disappeared from blood and CSF when plasma containing high concentrations of antibodies (total dose, 1--4 x 10(4) units/kg) was administered intravenously. Maximal inhibition of virus was achieved in culture and in the patient's CSF when the titer of antibody to echo 5 in CSF was greater than or equal to 16 units/ml. Although the patient died, hyperimmune plasma improved the neurologic status and eliminated detectable virus from the blood and CSF.
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Weiner et al. (1979) studied this question.
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