Article ; Online: Severe Tick-Borne Encephalitis (TBE) in a Patient with X-Linked Agammaglobulinemia; Treatment with TBE Virus IgG Positive Plasma, Clinical Outcome and T Cell Responses.
Journal of clinical immunology
2024 Volume 44, Issue 5, Page(s) 116
Abstract: Purpose: A patient with X-linked agammaglobulinemia (XLA) and severe tick-borne encephalitis (TBE) was treated with TBE virus (TBEV) IgG positive plasma. The patient's clinical response, humoral and cellular immune responses were characterized pre- and ... ...
| Abstract | Purpose: A patient with X-linked agammaglobulinemia (XLA) and severe tick-borne encephalitis (TBE) was treated with TBE virus (TBEV) IgG positive plasma. The patient's clinical response, humoral and cellular immune responses were characterized pre- and post-infection. Methods: ELISA and neutralisation assays were performed on sera and TBEV PCR assay on sera and cerebrospinal fluid. T cell assays were conducted on peripheral blood the patient and five healthy vaccinated controls. Results: The patient was admitted to the hospital with headache and fever. He was not vaccinated against TBE but receiving subcutaneous IgG-replacement therapy (IGRT). TBEV IgG antibodies were low-level positive (due to scIGRT), but the TBEV IgM and TBEV neutralisation tests were negative. During hospitalisation his clinical condition deteriorated (Glasgow coma scale 3/15) and he was treated in the ICU with corticosteroids and external ventricular drainage. He was then treated with plasma containing TBEV IgG without apparent side effects. His symptoms improved within a few days and the TBEV neutralisation test converted to positive. Robust CD8 Conclusion: TBEV IgG-positive plasma given to an XLA patient with TBE without evident adverse reactions may have contributed to a positive clinical outcome. Similar approaches could offer a promising foundation for researching therapeutic options for patients with humoral immunodeficiencies. Importantly, a robust CD8 |
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| MeSH term(s) | Humans ; Encephalitis, Tick-Borne/immunology ; Encephalitis, Tick-Borne/diagnosis ; Encephalitis, Tick-Borne/therapy ; Male ; Agammaglobulinemia/immunology ; Agammaglobulinemia/therapy ; Encephalitis Viruses, Tick-Borne/immunology ; Genetic Diseases, X-Linked/immunology ; Genetic Diseases, X-Linked/therapy ; Immunoglobulin G/blood ; Immunoglobulin G/immunology ; Antibodies, Viral/blood ; T-Lymphocytes/immunology ; Treatment Outcome ; Adult ; Immunization, Passive/methods |
| Chemical Substances | Immunoglobulin G ; Antibodies, Viral |
| Language | English |
| Publishing date | 2024-04-27 |
| Publishing country | Netherlands |
| Document type | Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 779361-3 |
| ISSN | 1573-2592 ; 0271-9142 |
| ISSN (online) | 1573-2592 |
| ISSN | 0271-9142 |
| DOI | 10.1007/s10875-024-01718-5 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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