Clinical outcomes in children with herpes simplex encephalitis receiving steroid therapy

Genç, Hülya Maraş; Yalçın, Emek Uyur; Sayan, Murat; Bayhan, Asuman; Öncel, Selim; Arısoy, Emin Sami; Kara, Bülent

doi:10.1016/j.jcv.2016.05.002

Cited by 18 publications

(6 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this respect, it is noteworthy that in our literature cohort none of the patients treated with immune therapy for HSV‐induced anti‐NMDAR encephalitis (or for HSE) was reported to have recurrence of HSE, despite only very few receiving long‐term antiviral therapy . Moreover, the beneficial effect of adjunctive steroids in HSE has been anecdotally described both in paediatric and adult age, and in an experimental study on a mouse model of HSE, the severity of long‐term MRI anti‐ N ‐methyl‐ d ‐aspartate receptor (NMDAR) abnormalities was significantly reduced with add‐on corticosteroids during acute HSE . The optimal timing for adjunctive steroid therapy has not yet been established, and while in some cases a beneficial effect has been reported after early simultaneous administration of aciclovir and steroids, in other cases steroid administration was delayed by a few days to weeks, with good results .…”

Section: Discussionmentioning

confidence: 97%

Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Nosadini

Mohammad

Corazza

et al. 2017

Develop Med Child Neuro

137

103

View full text Add to dashboard Cite

Our review suggests that movement disorder may help differentiate clinically an episode of HSV-induced anti-NMDAR encephalitis from HSE relapse. Compared with adults, children have shorter latency between HSE and anti-NMDAR encephalitis and, during anti-NMDAR encephalitis, more movement disorder, fewer psychiatric symptoms, and slightly more severe disease. According to our results, immune therapy given for HSV-induced anti-NMDAR encephalitis does not predispose patients to HSE recurrence.

show abstract

Section: Discussionmentioning

confidence: 97%

Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Nosadini

Mohammad

Corazza

et al. 2017

Develop Med Child Neuro

137

103

View full text Add to dashboard Cite

show abstract

“…In a first case series of five patients with HSE, three were successfully treated with acyclovir combined with pulse steroid therapy started 5 days after onset of the disease whereas two other patients who received pulse steroid therapy after 3 weeks did not improve and died from infection (193). In another case series of six children suffering from HSE, three patients who received adjunctive steroid therapy had improved cognition, motor function, and control of seizures compared to the three other children who were treated with acyclovir alone, but the radiologic abnormalities were similar in both groups (194). A nonrandomized retrospective study evaluated the efficacy of steroids on the outcome of HSE in 45 adult patients (195).…”

Section: Clinical and Animal Studies With Corticosteroidsmentioning

confidence: 97%

Immunomodulatory Strategies in Herpes Simplex Virus Encephalitis

Piret

Boivin

2020

Clin Microbiol Rev

View full text Add to dashboard Cite

SUMMARY Herpes simplex virus 1 (HSV-1) can be responsible for life-threatening HSV encephalitis (HSE). The mortality rate of patients with HSE who do not receive antiviral treatment is 70%, with most survivors suffering from permanent neurological sequelae. The use of intravenous acyclovir together with improved diagnostic technologies such as PCR and magnetic resonance imaging has resulted in a reduction in the mortality rate to close to 20%. However, 70% of surviving patients still do not recover complete neurological functions. Thus, there is an urgent need to develop more effective treatments for a better clinical outcome. It is well recognized that cerebral damage resulting from HSE is caused by viral replication together with an overzealous inflammatory response. Both of these processes constitute potential targets for the development of innovative therapies against HSE. In this review, we discuss recent progress in therapy that may be used to ameliorate the outcome of patients with HSE, with a particular emphasis on immunomodulatory agents. Ideally, the administration of adjunctive immunomodulatory drugs should be initiated during the rise of the inflammatory response, and its duration should be limited in time to reduce undesired effects. This critical time frame should be optimized by the identification of reliable biomarkers of inflammation.

show abstract

“…HSE is the most common sporadic viral encephalitis in the Western World but with devastating neurological consequences. It occurs in 1-2 per 500,000 people per year, while about one third of all HSE cases occurs in children and adolescents (Widener and Whitley, 2014;Maraş Genç et al, 2016). HSE represents 10-20% of all viral CNS infections (Rozenberg et al, 2011).…”

Section: Hse Occurrence and Clinical Featuresmentioning

confidence: 99%

Functional failure of TLR3 and its signaling components contribute to herpes simplex encephalitis

Mielcarska

Bossowska-Nowicka

Toka

2018

Journal of Neuroimmunology

View full text Add to dashboard Cite

Herpes simplex encephalitis (HSE) is a severe neurological disease in children and adults caused by herpes simplex virus. This review discusses recent findings on the role of Toll-like receptor 3 (TLR3) deficiencies in the HSE development. Critical checkpoints in the TLR3 signaling that contribute to innate response are discussed, including the importance of TLR3 ligand recognition site and transportation in the cell. We also indicate unresolved issues in the TLR3 functioning that might lead to thorough understanding of immunity during HSE. Such a knowledge base will lead to discovery and design of a rationale therapeutic and preventive approach against HSE.

show abstract

Clinical outcomes in children with herpes simplex encephalitis receiving steroid therapy

Cited by 18 publications

References 16 publications

Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Immunomodulatory Strategies in Herpes Simplex Virus Encephalitis

Functional failure of TLR3 and its signaling components contribute to herpes simplex encephalitis

Contact Info

Product

Resources

About