The Role of Intravenous Immunoglobulins in Treatment of Viral Encephalitis in Children

Pediatrics Department, Faculty of Medicine, Menoufia University, Egypt

Corresponding author

*Esraa Kamal EL-Baz, Ashmoun City, Menoufia Governorate, Egypt, Tel: 010-095-700-71; Fax: 048-342-0726; Email: [email protected]. #Sameh Abd Allah Abd EL-Naby, Department of pediatrics, Menoufia University, Shebin El-kom, Egypt, Tel: 010-680-679-64; E-mail: [email protected].    
Received : August 25, 2020
Published : September 22, 2020

ABSTRACT

Objectives: To determine the efficacy and safety of intravenous immunoglobulin (IVIG) as add on therapy in treatment of viral encephalitis in children.

Background: Encephalitis is a syndrome of neurological dysfunction that results from inflammation of brain parenchyma, caused by an infection or an exaggerated host immune response, or both. Attenuation of brain inflammation through modulation of the immune response could improve patient outcomes. Biological agents such as immunoglobulin have anti-inflammatory and immunomodulatory properties therefore may be useful as add on therapy in treatment of children with encephalitis.

Material and Methods: 60 children with encephalitis were enrolled through a randomized controlled trial, 30 children received intravenous immunoglobulins (IVIG) as add on standard therapy of encephalitis and 30 children received standard therapy only. Duration of hospital admission and post encephalitic sequelae were assessed and followed.

Results: Children with viral encephalitis who received IVIG as add on standard therapy (group1) and who received standard therapy only (group2) showed no significant difference regarding mortality (P0.67). No significant difference regarding post encephalitic sequelae (P0.461).No significant difference regarding duration of hospital admission (P0.093).

Conclusion: The study suggests no clinical benefit of using IVIG as add on therapy in treatment of pediatric viral encephalitis regarding mortality, duration of hospital admission, and post-encephalitic sequelae. Despite these findings, the risk of bias in the included studies and quality of the evidence make it impossible to reach any firm conclusions on the efficacy and safety of IVIG as add on therapy in treatment of pediatric encephalitis. Consideration should be given to a large sample size with statistical power to detect clinically significant differences in theses outcomes and longer term follow up.

KEYWORDS: Encephalitis; Intravenous immunoglobulin; Pediatric