Nishikawa M, Ichiyama T, Hayashi T, Ouchi K, Furukawa S
Department of Pediatrics, Yamaguchi University School of Medicine, Ube, Japan.
Pediatr Neurol. 1999 Aug;21(2):583-6. doi: 10.1016/s0887-8994(99)00042-9.
Three children ranging in age from 2 to 5 years with acute disseminated encephalomyelitis (ADEM) were successfully treated with high-dose intravenous immunoglobulin (IVIG). Their symptoms were somnolence, fever, headache, vomiting, and resting tremor. In all of these patients, it was difficult to distinguish the condition from viral encephalitis before analyzing the myelin basic protein. ADEM was diagnosed because of increased levels of myelin basic protein in their cerebrospinal fluid and abnormal high-signal intensity on T2-weighted magnetic resonance imaging. All patients were given IVIG at a dose of 400 mg/kg/day for 5 consecutive days. The patients rapidly regained consciousness in 14 hours, 2 days, and 4 days and demonstrated a complete clinical improvement within 18 days, 10 days, and 7 days of the initiation of the treatment, respectively. IVIG may prove useful as an alternative treatment to corticosteroids for ADEM.
三名年龄在2至5岁之间的急性播散性脑脊髓炎（ADEM）患儿通过大剂量静脉注射免疫球蛋白（IVIG）成功治愈。他们的症状包括嗜睡、发热、头痛、呕吐和静止性震颤。在分析髓鞘碱性蛋白之前，所有这些患者的病情都很难与病毒性脑炎区分开来。由于他们脑脊液中髓鞘碱性蛋白水平升高以及T2加权磁共振成像上出现异常高信号强度，因此诊断为ADEM。所有患者均接受IVIG治疗，剂量为400 mg/kg/天，连续5天。患者分别在14小时、2天和4天迅速恢复意识，并在治疗开始后的18天、10天和7天内临床症状完全改善。IVIG可能被证明是一种替代皮质类固醇治疗ADEM的有效方法。
