J Korean Child Neurol Soc.  2010 Nov;18(2):300-306.

Neurological Manifestations and Experience with IV Immunoglobulin in Children with Enterovirus 71 Infections

• Lee MS
• Jung DE

Abstract

PURPOSE
The objective of the study was to report the neurological manifestations and response to high-dose immunoglobulin (IVIG) therapy in children with enterovirus 71 (EV 71) infections.
METHODS
Eleven patients who had the primary clinical marker for enteroviral infection-herpangina or hand-foot-mouth-disease (HFMD) followed by acute neurological manifestations were admitted to Ajou University Hospital from June to September, 2009. All patients were positive for enterovirus (EV) as indicated by reverse transcription polymerase chain reaction (RT-PCR). Among them, EV 71 was confirmed by semi-nested PCR in five patients. All patients received IVIG soon after admission.
RESULTS
The mean age of the patients who were EV 71 positive was 2.5 years (range, 4 months to 5.3 years). Five neurological complications associated with EV 71 infection were identified: meningoencephalitis (3 patients); acute cerebellar ataxia (1 pationt); and complex febrile seizure in another patient. Three patients (60%) had HFMD, and two(40%) had herpangina. None of the patients had neurological sequelae at follow-up.
CONCLUSION
EV 71 infection should be suspected in young children with epidemic HFMD or herpangina complicated by a variety of neurological manifestations. We have reported the response to high dose IVIG therapy in children with EV 71 infection.

Keyword

Enterovirus 71 infections; Neurologic manifestations; Immunoglobulins; Intravenous

MeSH Terms

Biomarkers
Cerebellar Ataxia
Child
Enterovirus
Herpangina
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Meningoencephalitis
Neurologic Manifestations
Polymerase Chain Reaction
Reverse Transcription
Seizures, Febrile
Immunoglobulins
Immunoglobulins, Intravenous