Effect of Specific Antibodies on Chronic Echovirus Type 5 Encephalitis in a Patient with Hypogammaglobulinemia

• Published in: The Journal of infectious diseases 1979-12, Vol.140 (6), p.858-863
• Main Authors: Weiner, L. S., Howell, J. T., Langford, M. P., Stanton, G. J., Baron, S., Goldblum, R. M., Lord, R. A., Goldman, A. S.
• Format: Article
• Language: English
• Subjects: Agammaglobulinemia; Agammaglobulinemia - complications; Antibodies; Antibodies, Viral - administration & dosage; Antibody Specificity; Blood plasma; Blood Transfusion; Cerebrospinal fluid; Child, Preschool; Chronic Disease; Echovirus infections; Encephalitis; Encephalitis - complications; Encephalitis - immunology; Enterovirus B, Human - immunology; Enterovirus B, Human - isolation & purification; gamma-Globulins - therapeutic use; Human enterovirus B; Humans; Infections; Interferons - cerebrospinal fluid; Major Articles; Male; Plasma - transplantation; Polio; Viruses
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/140.6.858

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 × 104 units per injection). Virus disappeared from blood and CSF when plasma containing high concentrations of antibodies (total dose, 1–4 × 104 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 ⩾16 units/ml. Although the patient died, hyperimmune plasma improved the neurologic status and eliminated detectable virus from the blood and CSF.