Infection-induced autoimmune encephalopathy: Treatment with intravenous immune globulin therapy. A report of six patients

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Denis A Bouboulis

Advanced Allergy Immunology and Asthma, USA

: J Immunol Tech Infect Dis

Abstract

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Objective: To present illustrative patients Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) and are successfully treated with an anti-infective and immune modulatory protocol. Methods: Six children age 5 to 17 years with the diagnosis of IIAE associated with various infections and comorbid conditions including humoral immunodeficiency and Autism Spectrum Disorder (ASD) are described. Pertinent literature from 1958 to the present is reviewed. Antimicrobial and high dose (1 gram per kilogram total body weight) intravenous immune globulin (IVIg) therapy was administered every 8 weeks according to an established anti-infective and immune modulatory protocol. Informed consent by the parents and legal authorization was obtained in all cases. Neuro-radiological testing was not performed in any of the cases. Results: The combination of antimicrobial medication followed by IVIg in this cohort was well-tolerated leading to improvement in symptoms and signs of IIAE allowing tapering or discontinuation of maintenance medications. Conclusion: IVIg is a safe and beneficial therapy in IIAE, PANDAS and ASD impacting favorably on underlying humoral immune deficiency and infectious-induced CNS autoimmunity in this small and highly selected cohort. The present findings are awaiting further replication by other investigators and should be further explored relative to the optimal dose and duration of therapy.

Biography

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Denis A Bouboulis is a board-certified physician licensed in Connecticut, New York and Pennsylvania in the area of Allergy & Immunology and Internal Medicine. He has experience in private practice and hospital settings and in the development of treatment and testing devices. He has treated over 17,000 patients nationally and internationally through this practice. He provides care for children suffering with PANDAS (Pediatric Autoimmune Neuro-Psychiatric Disorder Associated with Streptococcus).

E-mail: advancedallergy@yahoo.com