Gofshteyn Jacqueline, Cárdenas Ana María, Bearden David
Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Division of Pathology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Pediatr Neurol. 2016 Nov;64:94-98. doi: 10.1016/j.pediatrneurol.2016.06.014. Epub 2016 Jun 25.
Enterovirus may result in a devastating chronic encephalitis in immunocompromised patients, particularly in patients with X-linked agammaglobulinemia. Prognosis for patients with chronic enterovirus encephalitis is poor, almost invariably resulting in mortality without specific treatment. There are currently no approved antiviral agents for enterovirus, but the antidepressant drug fluoxetine has been identified through library-based compound screening as a potential anti-enteroviral agent in vitro. However, use of fluoxetine has not previously been studied in humans with enteroviral disease.
A five year old boy with X-linked agammaglobulinemia presented with progressive neurological deterioration and was found to have chronic enterovirus encephalitis by brain biopsy. He failed to respond to standard treatment with high dose intravenous immunoglobulin, but showed stabilization and improvement following treatment with fluoxetine.
This is the first report to describe the use of fluoxetine as a potential therapy for chronic enterovirus infection. Further investigation of fluoxetine as a treatment option for chronic enterovirus encephalitis is necessary.
肠道病毒可导致免疫功能低下患者，尤其是X连锁无丙种球蛋白血症患者发生严重的慢性脑炎。慢性肠道病毒脑炎患者的预后很差，若无特异性治疗，几乎总会导致死亡。目前尚无获批用于治疗肠道病毒的抗病毒药物，但通过基于文库的化合物筛选，已确定抗抑郁药氟西汀在体外是一种潜在的抗肠道病毒药物。然而，此前尚未在患有肠道病毒疾病的人类中研究过氟西汀的使用情况。
一名患有X连锁无丙种球蛋白血症的5岁男孩出现进行性神经功能恶化，经脑活检发现患有慢性肠道病毒脑炎。他对大剂量静脉注射免疫球蛋白的标准治疗无反应，但在接受氟西汀治疗后病情稳定并有所改善。
这是第一份描述使用氟西汀作为慢性肠道病毒感染潜在治疗方法的报告。有必要进一步研究氟西汀作为慢性肠道病毒脑炎治疗选择的可能性。
