Halliday E, Winkelstein J, Webster A D B
Department of Immunology, Royal Free Hospital, Pond Street, London, NW3 2QG, UK.
J Infect. 2003 Jan;46(1):1-8. doi: 10.1053/jinf.2002.1066.
We have explored the natural history of enteroviral infection in patients with primary antibody deficiency by surveying both published and unpublished case reports before the new anti-enteroviral drug, pleconaril, was available. Many different enteroviruses were involved, Echovirus 11 being the most common. The central nervous system was nearly always involved, with evidence of systemic involvement of muscle and/or liver and/or joints in about 40% of patients. Neurological symptoms and signs varied with minor or no changes in the cerebro-spinal fluid. There was high morbidity and mortality; a third of polio cases (usually vaccine related), and nearly half of non-polio infected patients died; about 40% of survivors of the initial illness had long-term neurological symptoms. Prophylactic immunoglobulin therapy did not prevent infection but these patients were on lower doses as compared to current recommendations. Our data provides a useful background for assessing the efficacy of new anti-viral treatment in this condition.
在新型抗肠道病毒药物普来可那立上市之前，我们通过查阅已发表和未发表的病例报告，探究了原发性抗体缺陷患者肠道病毒感染的自然史。涉及多种不同的肠道病毒，其中埃可病毒11型最为常见。几乎所有患者的中枢神经系统都会受累，约40%的患者有肌肉和/或肝脏和/或关节的全身受累迹象。神经症状和体征各不相同，脑脊液仅有轻微变化或无变化。发病率和死亡率都很高；三分之一的脊髓灰质炎病例（通常与疫苗有关）以及近一半的非脊髓灰质炎感染患者死亡；约40%的初始疾病幸存者有长期神经症状。预防性免疫球蛋白治疗不能预防感染，但与当前建议相比，这些患者使用的剂量较低。我们的数据为评估这种情况下新型抗病毒治疗的疗效提供了有用的背景。
