California University of Science and Medicine, Colton, CA, USA.
Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA.
J Child Neurol. 2025 Jan;40(1):61-66. doi: 10.1177/08830738241276972. Epub 2024 Sep 5.
Epstein-Barr virus meningoencephalitis is a rare central nervous system infection that lacks standardized treatment. Immunocompetent and immunosuppressed individuals with this condition frequently have poor prognostic outcomes, making the need to identify therapeutic interventions high. Here, we report 2 pediatric cases of severe Epstein-Barr virus meningoencephalitis, both unresponsive to immunoglobulin and corticosteroid therapy, who demonstrated rapid clinical recovery following rituximab administration. Prognostic outcomes revealed marked improvements in symptoms, neurologic function, and quality of life. Rituximab may offer therapeutic potential in severe and refractory Epstein-Barr virus meningoencephalitis through the medication's target of Epstein-Barr virus harboring B cells. This report emphasizes the need for timely evaluation and consideration of rituximab therapy in immunocompetent pediatric patients with Epstein-Barr virus meningoencephalitis.
爱泼斯坦-巴尔病毒脑膜脑炎是一种罕见的中枢神经系统感染，缺乏标准化治疗方法。患有这种疾病的免疫功能正常和免疫抑制个体预后通常较差，因此需要确定治疗干预措施。在这里，我们报告了 2 例儿科重症爱泼斯坦-巴尔病毒脑膜脑炎病例，这 2 例患儿对免疫球蛋白和皮质类固醇治疗均无反应，在使用利妥昔单抗治疗后迅速临床康复。预后结果显示症状、神经功能和生活质量有明显改善。利妥昔单抗可能通过靶向携带爱泼斯坦-巴尔病毒的 B 细胞为重症和难治性爱泼斯坦-巴尔病毒脑膜脑炎提供治疗潜力。本报告强调了在免疫功能正常的儿童爱泼斯坦-巴尔病毒脑膜脑炎患者中，需要及时评估和考虑利妥昔单抗治疗。
