Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 25, Number 11—November 2019
CME ACTIVITY - Research

Lack of Efficacy of High-Titered Immunoglobulin in Patients with West Nile Virus Central Nervous System Disease

John W. GnannComments to Author , Amy Agrawal, John Hart, Martha Buitrago, Paul Carson, Diane Hanfelt-Goade, Ken Tyler, Jared Spotkov, Alison Freifeld, Thomas Moore, Jorge Reyno, Henry Masur, Penelope Jester, Ilet Dale, Yufeng Li, Inmaculada Aban, Fred D. Lakeman, Richard J. WhitleyComments to Author , and for the National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group
Author affiliations: University of Alabama at Birmingham, Birmingham, Alabama, USA (J.W. Gnann, Jr., P. Jester, I. Dale, Y. Li, I. Aban, F.D. Lakeman, R.J. Whitley); National Institutes of Health Clinical Center, Bethesda, Maryland, USA (A. Agrawal, H. Masur); University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA (J. Hart); Idaho Falls Infectious Diseases PLLC, Idaho Falls, Idaho, USA (M. Buitrago); North Dakota State University, Fargo, North Dakota, USA (P. Carson); University of New Mexico, Albuquerque, New Mexico, USA (D. Hanfelt-Goade); University of Colorado at Denver Anschutz Medical Campus, Aurora, Colorado, USA (K. Tyler); Kaiser Permanente South Bay Medical Center, Harbor City, California, USA (J. Spotkov); University of Nebraska Medical Center, Omaha, Nebraska, USA (D. Freifeld); Via Christi Hospital St. Francis, Wichita, Kansas, USA (T. Moore); Infectious Diseases Consultations, Rapid City, South Dakota, USA (J. Reyno)

Main Article

Table 1

Demographics and clinical characteristics of patients in study of treatments for West Nile virus central nervous system disease, by treatment arm*

Characteristic Omr-IgG-am, n = 37 Polygam, n = 12 Normal saline, n = 13 Total, n = 62
Race
Caucasian/not Hispanic 24 (64.9) 10 (83.3) 11 (84.6) 45 (72.6)
Black/not Hispanic 2 (5.4) 0 1 (7.7) 3 (4.8)
Hispanic 8 (21.6) 1 (8.3) 1 (7.7) 10 (16.1)
Other
 3 (8.1)
 1 (8.3)
 0 (0)
 4 (6.5)
Sex
M 25 (67.6) 7 (58.3) 9 (69.2) 41 (66.1)
F
 12 (32.4)
 5 (41.7)
 4 (30.8)
 21 (33.9)
Age, y, mean ± SE
 56.2 ± 2.2
 54.0 ± 4.1
 58.4 ± 4.8
 56.2 ± 1.8
Cerebrospinal fluid
Leukocytes, cells/µL, mean ± SE (median) 207.7 ± 40.3 (124) 187.4 ± 105.5 (58) 146.6 ± 85.8 (37) 192.3 ± 35.3 (95.5)
% Lymphocytes, mean ± SE (median)
 53.9 ± 5.0 (52.5)
 39.3 ± 10.0 (36.5)
 50.2 ± 11.6 (34)
 50.1 ± 4.3 (43)
Time from admission to drug infusion, d, 
mean ± SE (median)
 2.9 ± 0.5 (2)
 2.8 ± 0.5 (2.5)
 2.0 ± 0.4 (2)
 2.7 ± 0.3 (2)
Disease group and risk factors
With encephalitis/myelitis 25 (64.7) 9 (75.0) 11 (84.6) 44 (71.0)
Without encephalitis/myelitis 12 (32.4) 3 (25.0) 2 (15.4) 17 (27.4)
Hematologic malignancy 1 (8.3) 0 0 1 (5.9)
Diabetes mellitus 2 (16.7) 0 0 2 (11.8)
Bone marrow transplant
 1 (8.3)
 0
 0
 1 (5.9)
Immunosuppressive medications 1 (8.3) 0 0 1 (5.9)

*Values are no. (%) patients except as indicated. In comparing Omr-IgG-am with Polygam and Omr-IgG-am with normal saline, no significant differences were identified for characteristics listed in this table (all p values >0.05). Denominators vary according to the number of evaluable patients or assessments.

Main Article

Page created: October 15, 2019
Page updated: October 15, 2019
Page reviewed: October 15, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external