Unmasking a B-Cell Linkage Phenotype in Severe Acute Meningoencephalitis: A Case Report of IVIG and HydroBox-assisted Immunomodulatory Therapy.
Chang-Lung Wu, Jeng-Wei Lu, Yi-Jung Ho et al.
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Case in brief
A previously healthy 30-year-old man developed fulminant acute meningoencephalitis with coma, respiratory failure, and severe systemic inflammation. Longitudinal immune profiling showed extensive T-cell exhaustion-associated phenotypes, altered regulatory T-cell profiles, widespread inhibitory checkpoint-marker expression, excessive plasmablast expansion, and impaired antibody homeostasis. He received intensive care, intravenous immunoglobulin (IVIG), and molecular hydrogen-based adjunctive therapy using the HydroBox strategy. After treatment, systemic inflammation resolved, immune profiles progressively normalized, and neurological function recovered completely.
What made this case unusual
The case paired severe meningoencephalitis with detailed longitudinal evidence of broad immune remodeling, including both T-cell exhaustion-associated features and marked humoral activation with plasmablast expansion and impaired antibody homeostasis.
Diagnostic / clinical pearl
In severe meningoencephalitis, longitudinal immunophenotyping can reveal concurrent cellular and humoral immune abnormalities and track their evolution alongside clinical recovery.
Why it matters
The reported recovery after combined intensive care, IVIG, and molecular hydrogen-based adjunctive therapy is hypothesis-generating; the authors note that this approach warrants further investigation.