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Qingqing C, Dongliang L, Qingqing S, Daoqian S. The effect of a large dose of intravenous immunoglobulin on general paresis of the insane. EUR J INFLAMM 2021. [DOI: 10.1177/20587392211040899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
General paresis of the insane (GPI) remains the form of neurosyphilis most closely associated with dementia, even after the advent of penicillin. Penicillin remains the top treatment choice for syphilis, but treatment failure is not rare. Although the neurological symptoms of GPI can be alleviated by antibiotic treatment, mental symptoms may continue. A 60-year-old man was admitted to hospital due to rapidly progressive dementia. He was diagnosed as GPI. With the patient’s informed consent, we treated him with a large dose of intravenous immunoglobulin (IVIG) (0.4 g/kg/day) for 5 days, as well as penicillin (24 million units daily divided into six doses) for 14 days. A near-immediate improvement in his emotions and orientation occurred on the 17th day in hospital. The patient made an excellent recovery 6 weeks after treatment, his psychotic and mood symptoms improved significantly. Therefore, we hypothesize that patients with GPI treated with IVIG and penicillin G would have better outcomes than those treated with penicillin G alone. IVIG may be introduced as a necessary treatment for GPI.
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Affiliation(s)
- Chen Qingqing
- Department of Neurology, Taihe County People’s Hospital, Fuyang, China
| | - Liu Dongliang
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Sang Qingqing
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Sang Daoqian
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
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Cavaliere FM, Prezzo A, Conti V, Bilotta C, Pulvirenti F, Iacobini M, Quinti I. Intravenous immunoglobulin replacement induces an in vivo reduction of inflammatory monocytes and retains the monocyte ability to respond to bacterial stimulation in patients with common variable immunodeficiencies. Int Immunopharmacol 2015; 28:596-603. [DOI: 10.1016/j.intimp.2015.07.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 07/13/2015] [Accepted: 07/14/2015] [Indexed: 12/17/2022]
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High-dose intravenous immunoglobulin does not reduce the numbers of circulating CD14+CD16++ monocytes in patients with inflammatory disorders. Clin Immunol 2012; 145:11-2. [DOI: 10.1016/j.clim.2012.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 07/15/2012] [Indexed: 11/21/2022]
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