Document Detail

Clinical application of reverse-transcription polymerase chain reaction and intravenous immunoglobulin for enterovirus encephalitis.
MedLine Citation:
PMID:  18219129     Owner:  NLM     Status:  MEDLINE    
Although polymerase chain reaction (PCR) is a highly sensitive procedure for the diagnosis of enteroviruses, it has never been systemically applied to the treatment of enteroviral encephalitis using intravenous immunoglobulin (IVIg). We conducted a 2-year randomized, controlled comparison of reverse transcription (RT)-PCR of cerebrospinal fluid (CSF) with traditional viral isolation to guide IVIg treatment. Seventy-five patients were enrolled and classified into three groups: one group with clinical manifestations of enteroviral infections and two without. The latter two groups were separated on the basis of whether IVIg treatment was guided by RT-PCR or virus culture assay. CSF specimens from the 18 confirmed cases of enteroviral encephalitis were RT-PCR positive for enterovirus in all but one case. Of the remaining 57 cases of nonenteroviral encephalitis, only 4 were positive for enterovirus RT-PCR. One patient in the group of IVIg treatment guided by viral isolation subsequently displayed a sequel of epilepsy. No patients in the IVIg treatment groups guided by RT-PCR had any neurological sequelae. In conclusion, the use of RT-PCR allowed rapid, sensitive, and specific detection of enteroviral RNA in CSF. When used to guide IVIg treatment, RT-PCR may shorten hospitalization and improve outcomes of patients with enteroviral encephalitis.
Ming-Fang Cheng; Bao-Chen Chen; Tsi-Shu Huang; Kai-Sheng Hsieh; Shu-Nuan Chen; Yung-Ching Liu
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Japanese journal of infectious diseases     Volume:  61     ISSN:  1344-6304     ISO Abbreviation:  Jpn. J. Infect. Dis.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-25     Completed Date:  2008-03-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100893704     Medline TA:  Jpn J Infect Dis     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  18-24     Citation Subset:  IM    
Department of Pediatrics, Veterans General Hospital-Kaohsiung, Kaohsiung, Taiwan.
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MeSH Terms
Child, Preschool
Cytokines / blood
Encephalitis, Viral / cerebrospinal fluid,  therapy*,  virology
Enterovirus / isolation & purification*
Enterovirus Infections / cerebrospinal fluid,  therapy*,  virology
Immunoglobulins, Intravenous / therapeutic use*
RNA, Viral / blood
Reverse Transcriptase Polymerase Chain Reaction / methods*
Sensitivity and Specificity
Reg. No./Substance:
0/Cytokines; 0/Immunoglobulins, Intravenous; 0/RNA, Viral

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