{"title":"某三级医疗中心自身免疫性脑炎院内获得性感染的静脉注射免疫球蛋白与血浆交换的比较","authors":"Totsapol Surawattanawong, Akarin Hiransuthikul, Panthicha Katasrila, Thiravat Hemachudha, Abhinbhen W Saraya","doi":"10.2478/abm-2025-0018","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The prevailing approach for the acute-phase treatment of autoimmune encephalitis (AIE) is currently the administration of intravenous immunoglobulin (IVIG) or plasma exchange (PLEX), in conjunction with high-dose corticosteroids. Despite this, there is still no definitive evidence on the risks and benefits of IVIG vs. PLEX in terms of treatment-related complications.</p><p><strong>Objectives: </strong>The primary objective of this study was to determine the differences in the cumulative incidence of hospital-acquired infections (HAIs) in patients diagnosed with AIE, who received either IVIG or PLEX. The secondary objectives were to explore the differences in the duration of hospitalization and levels of disability.</p><p><strong>Methods: </strong>Patients who were hospitalized at the King Chulalongkorn Memorial Hospital, Thailand, due to AIE, were aged ≥15 years, and had received either IVIG or PLEX during their hospitalization from January 2015 to December 2020 were included in the study. The modified Rankin scale (mRS) was utilized to evaluate the degree of disability at admission and discharge.</p><p><strong>Results: </strong>Among the 44 patients included in the study, 10 (22.7%) received PLEX and 34 (77.3%) received IVIG. Those who received IVIG were significantly less likely to have HAIs (14.7% vs. 50.0%, <i>P</i> = 0.03) and had a significantly shorter duration of hospitalization (median [IQR] 12.0 [6.0 - 23.0] vs. 25.0 [21.0 - 49.0] d, <i>P</i> = 0.01) compared to those who received PLEX. Primary septicemia was the most commonly observed cause of infection in both groups. There were no significant differences in mRS at discharge, changes in mRS between admission and discharge, and the total direct cost of hospitalization between the two groups.</p><p><strong>Conclusions: </strong>The utilization of IVIG is associated with a diminished occurrence of nosocomial infections, leading to shorter hospitalization and potential cost benefits. Our findings propose that IVIG may represent a more beneficial therapeutic alternative for AIE patients compared with PLEX.</p>","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"19 3","pages":"147-153"},"PeriodicalIF":0.9000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303594/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of intravenous immunoglobulin and plasma exchange in hospital-acquired infections of autoimmune encephalitis in a tertiary care center.\",\"authors\":\"Totsapol Surawattanawong, Akarin Hiransuthikul, Panthicha Katasrila, Thiravat Hemachudha, Abhinbhen W Saraya\",\"doi\":\"10.2478/abm-2025-0018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The prevailing approach for the acute-phase treatment of autoimmune encephalitis (AIE) is currently the administration of intravenous immunoglobulin (IVIG) or plasma exchange (PLEX), in conjunction with high-dose corticosteroids. Despite this, there is still no definitive evidence on the risks and benefits of IVIG vs. PLEX in terms of treatment-related complications.</p><p><strong>Objectives: </strong>The primary objective of this study was to determine the differences in the cumulative incidence of hospital-acquired infections (HAIs) in patients diagnosed with AIE, who received either IVIG or PLEX. The secondary objectives were to explore the differences in the duration of hospitalization and levels of disability.</p><p><strong>Methods: </strong>Patients who were hospitalized at the King Chulalongkorn Memorial Hospital, Thailand, due to AIE, were aged ≥15 years, and had received either IVIG or PLEX during their hospitalization from January 2015 to December 2020 were included in the study. The modified Rankin scale (mRS) was utilized to evaluate the degree of disability at admission and discharge.</p><p><strong>Results: </strong>Among the 44 patients included in the study, 10 (22.7%) received PLEX and 34 (77.3%) received IVIG. Those who received IVIG were significantly less likely to have HAIs (14.7% vs. 50.0%, <i>P</i> = 0.03) and had a significantly shorter duration of hospitalization (median [IQR] 12.0 [6.0 - 23.0] vs. 25.0 [21.0 - 49.0] d, <i>P</i> = 0.01) compared to those who received PLEX. Primary septicemia was the most commonly observed cause of infection in both groups. There were no significant differences in mRS at discharge, changes in mRS between admission and discharge, and the total direct cost of hospitalization between the two groups.</p><p><strong>Conclusions: </strong>The utilization of IVIG is associated with a diminished occurrence of nosocomial infections, leading to shorter hospitalization and potential cost benefits. Our findings propose that IVIG may represent a more beneficial therapeutic alternative for AIE patients compared with PLEX.</p>\",\"PeriodicalId\":8501,\"journal\":{\"name\":\"Asian Biomedicine\",\"volume\":\"19 3\",\"pages\":\"147-153\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-07-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303594/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Biomedicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2478/abm-2025-0018\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Biomedicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2478/abm-2025-0018","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Comparison of intravenous immunoglobulin and plasma exchange in hospital-acquired infections of autoimmune encephalitis in a tertiary care center.
Background: The prevailing approach for the acute-phase treatment of autoimmune encephalitis (AIE) is currently the administration of intravenous immunoglobulin (IVIG) or plasma exchange (PLEX), in conjunction with high-dose corticosteroids. Despite this, there is still no definitive evidence on the risks and benefits of IVIG vs. PLEX in terms of treatment-related complications.
Objectives: The primary objective of this study was to determine the differences in the cumulative incidence of hospital-acquired infections (HAIs) in patients diagnosed with AIE, who received either IVIG or PLEX. The secondary objectives were to explore the differences in the duration of hospitalization and levels of disability.
Methods: Patients who were hospitalized at the King Chulalongkorn Memorial Hospital, Thailand, due to AIE, were aged ≥15 years, and had received either IVIG or PLEX during their hospitalization from January 2015 to December 2020 were included in the study. The modified Rankin scale (mRS) was utilized to evaluate the degree of disability at admission and discharge.
Results: Among the 44 patients included in the study, 10 (22.7%) received PLEX and 34 (77.3%) received IVIG. Those who received IVIG were significantly less likely to have HAIs (14.7% vs. 50.0%, P = 0.03) and had a significantly shorter duration of hospitalization (median [IQR] 12.0 [6.0 - 23.0] vs. 25.0 [21.0 - 49.0] d, P = 0.01) compared to those who received PLEX. Primary septicemia was the most commonly observed cause of infection in both groups. There were no significant differences in mRS at discharge, changes in mRS between admission and discharge, and the total direct cost of hospitalization between the two groups.
Conclusions: The utilization of IVIG is associated with a diminished occurrence of nosocomial infections, leading to shorter hospitalization and potential cost benefits. Our findings propose that IVIG may represent a more beneficial therapeutic alternative for AIE patients compared with PLEX.
期刊介绍：
Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries
Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
