与静脉注射多克隆免疫球蛋白治疗相关的急性无菌性脑膜炎:系统回顾。

IF 8.4 2区 医学 Q1 ALLERGY Clinical Reviews in Allergy & Immunology Pub Date : 2024-04-01 Epub Date: 2024-05-13 DOI:10.1007/s12016-024-08989-1
Elisabetta L T De Felice, Gabriel F Toti, Beatrice Gatti, Renato Gualtieri, Pietro Camozzi, Sebastiano A G Lava, Gregorio P Milani, Giorgio Treglia, Federica Vanoni, Mario G Bianchetti, Gianmaria F Bernasconi, Benedetta Terziroli Beretta Piccoli, Camilla Lavagno
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引用次数: 0

摘要

在静脉注射多克隆人免疫球蛋白治疗过程中,偶尔会出现急性无菌性脑膜炎。由于病例报告不能用来推断免疫球蛋白治疗与脑膜炎之间的关系,因此我们对文献进行了系统回顾和荟萃分析。符合条件的文献包括病例、系列病例和药物警戒研究。我们发现了 71 例单独记录的脑膜炎病例(36 人≤ 18 岁)。90%的病例在开始接受免疫球蛋白治疗后 3 天内发病,并在 7 天内痊愈(儿童病程较短:29 例(94%)病例的病程在 3 天以内)。作者注意到,有 22 例(31%)患者的脑膜炎发病与快速静脉注射免疫球蛋白有关。脑脊液分析显示主要为中性粒细胞增多(N = 46,66%)。有 8 名患者(N = 11%)在再次接触后出现复发。8 个病例系列研究了 4089 例接受免疫球蛋白治疗的患者中脑膜炎的发病率。汇总的发病率为 0.6%。最后,药物警戒数据显示,与静脉注射免疫球蛋白治疗相关的脑膜炎至少发生在五种不同的产品中。总之,静脉注射免疫球蛋白可能会引起急性无菌性脑膜炎。停药后临床症状会迅速缓解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Acute Aseptic Meningitis Temporally Associated with Intravenous Polyclonal Immunoglobulin Therapy: A Systematic Review.

An acute aseptic meningitis has been occasionally observed on intravenous polyclonal human immunoglobulin therapy. Since case reports cannot be employed to draw inferences about the relationships between immunoglobulin therapy and meningitis, we conducted a systematic review and meta-analysis of the literature. Eligible were cases, case series, and pharmacovigilance studies. We found 71 individually documented cases (36 individuals ≤ 18 years of age) of meningitis. Ninety percent of cases presented ≤ 3 days after initiating immunoglobulin therapy and recovered within ≤ 7 days (with a shorter disease duration in children: ≤ 3 days in 29 (94%) cases). In 22 (31%) instances, the authors noted a link between the onset of meningitis and a rapid intravenous infusion of immunoglobulins. Cerebrospinal fluid analysis revealed a predominantly neutrophilic (N = 46, 66%) pleocytosis. Recurrences after re-exposure were observed in eight (N = 11%) patients. Eight case series addressed the prevalence of meningitis in 4089 patients treated with immunoglobulins. A pooled prevalence of 0.6% was noted. Finally, pharmacovigilance data revealed that meningitis temporally associated with intravenous immunoglobulin therapy occurred with at least five different products. In conclusion, intravenous immunoglobulin may cause an acute aseptic meningitis. The clinical features remit rapidly after discontinuing the medication.

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来源期刊
CiteScore
22.30
自引率
1.10%
发文量
58
审稿时长
6-12 weeks
期刊介绍: Clinical Reviews in Allergy & Immunology is a scholarly journal that focuses on the advancement of clinical management in allergic and immunologic diseases. The journal publishes both scholarly reviews and experimental papers that address the current state of managing these diseases, placing new data into perspective. Each issue of the journal is dedicated to a specific theme of critical importance to allergists and immunologists, aiming to provide a comprehensive understanding of the subject matter for a wide readership. The journal is particularly helpful in explaining how novel data impacts clinical management, along with advancements such as standardized protocols for allergy skin testing and challenge procedures, as well as improved understanding of cell biology. Ultimately, the journal aims to contribute to the improvement of care and management for patients with immune-mediated diseases.
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