Effect of Corticosteroids on RVNA production of a patient with acute disseminated encephalomyelitis following rabies vaccination as well as administration of HRIG.

糖皮质激素对狂犬病疫苗接种和 HRIG 给药后急性播散性脑脊髓炎患者 RVNA 产生的影响。

• 影响指数: 4.526
• 发表时间: 2014
• 来源期刊: Hum Vaccin Immunother
• DOI: 10.4161/21645515.2014.979621
• PMID: 25668669
• 文章类型: Case Reports
• 中科院分区: Q2
• 方向: 医学
• 作者列表: Peng J,Chen L,Zhu ZG,Zhu ZR,Hu Q,Fang Y

关键词: ADEM; ADEM, acute disseminated encephalomyelitis; ANCA, Antineutrophil cytoplasmic antibodies; ASO, Anti-streptolycin O; CRP, C-reactive protein; CSF, Cerebrospinal fluid; CT, Computed tomography; EEG, electroencephalography; ESR, Erythrocyte sedimentation rate; FLAIR, fluid-attenuated inversion recovery; HDCV, human diploid cell vaccine; HRIG; HRIG, Human Rabies Immunoglobulin; MRI, magnetic resonance image; MS, multiple sclerosis; PCECV, purified Chick embryo cell vaccines; PEP, post-exposure prophylaxis; PPRC, Pharmacopoeia of the People's Republic of China; PVRV; PVRV, purified Vero cell rabies vaccine; RABV, rabies virus; RFFIT, rapid fluorescent focus inhibition test; RVNA; RVNA, rabies virus neutralizing antibodies; T2W, T2-weighted; glucocorticoids

Mesh: Adrenal Cortex Hormones / pharmacology; Aged; Antibodies, Neutralizing / biosynthesis; Antibodies, Viral / biosynthesis immunology; Encephalomyelitis, Acute Disseminated / immunology; Humans; Immunoglobulins / therapeutic use; Male; Rabies Vaccines / immunology; Rabies virus / immunology; Vaccination

Abstract

It has not been reported that administration of combining rabies vaccines and immunoglobulin resulted in acute disseminated encephalomyelitis (ADEM) yet. This report described that an old man acquired ADEM after being administrated with purified Vero cell rabies vaccine (PVRV) and Human Rabies Immunoglobulin (HRIG). Then he was given intravenous and oral glucocorticoids. Simultaneously, rabies vaccination was continued with purified Chick embryo cell vaccines (PCECV) instead of PVRV. Furthermore, we analyzed the rabies virus neutralizing antibodies (RVNA) levels in the patient\'s blood at different time points after rabies vaccination. Collectively, we observed that PCECV vaccination did not affect the prognosis of ADEM, and glucocorticoid was crucial and effective, which had no significant influence on efficacy of PCECV.

摘要

目前尚无狂犬病疫苗和免疫球蛋白联合使用导致急性播散性脑脊髓炎（ADEM）的报道。该报告描述了一名老人在服用纯化的Vero细胞狂犬病疫苗（PVRV）和人狂犬病免疫球蛋白（HRIG）后获得了ADEM。然后给他静脉注射和口服糖皮质激素。同时,用纯化的鸡胚细胞疫苗（PCECV）代替PVRV继续狂犬病疫苗接种。此外，我们分析了狂犬病疫苗接种后不同时间点患者血液中的狂犬病病毒中和抗体（RVNA）水平。总的来说，我们观察到PCECV疫苗接种不影响ADEM的预后，糖皮质激素是关键和有效的，对PCECV的疗效无明显影响。