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Comparison of Clinical, Laboratory and Immune Characteristics of the Monophasic and Biphasic Course of Tick-Borne Encephalitis

The biphasic course of tick-borne encephalitis (TBE) is well described, but information on the monophasic course is limited. We assessed and compared the clinical presentation, laboratory findings, and immune responses in 705 adult TBE patients: 283 with monophasic and 422 with biphasic course. Pati...

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Autores principales: Bogovič, Petra, Lotrič-Furlan, Stanka, Avšič-Županc, Tatjana, Korva, Miša, Kastrin, Andrej, Lusa, Lara, Strle, Klemen, Strle, Franc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070281/
https://www.ncbi.nlm.nih.gov/pubmed/33920166
http://dx.doi.org/10.3390/microorganisms9040796
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author Bogovič, Petra
Lotrič-Furlan, Stanka
Avšič-Županc, Tatjana
Korva, Miša
Kastrin, Andrej
Lusa, Lara
Strle, Klemen
Strle, Franc
author_facet Bogovič, Petra
Lotrič-Furlan, Stanka
Avšič-Županc, Tatjana
Korva, Miša
Kastrin, Andrej
Lusa, Lara
Strle, Klemen
Strle, Franc
author_sort Bogovič, Petra
collection PubMed
description The biphasic course of tick-borne encephalitis (TBE) is well described, but information on the monophasic course is limited. We assessed and compared the clinical presentation, laboratory findings, and immune responses in 705 adult TBE patients: 283 with monophasic and 422 with biphasic course. Patients with the monophasic course were significantly (p ≤ 0.002) older (57 vs. 50 years), more often vaccinated against TBE (7.4% vs. 0.9%), more often had comorbidities (52% vs. 37%), and were more often treated in the intensive care unit (12.4% vs. 5.2%). Multivariate logistic regression found strong association between the monophasic TBE course and previous TBE vaccination (OR = 18.45), presence of underlying illness (OR = 1.85), duration of neurologic involvement before cerebrospinal fluid (CSF) examination (OR = 1.39), and patients’ age (OR = 1.02). Furthermore, patients with monophasic TBE had higher CSF levels of immune mediators associated with innate and adaptive (Th1 and B-cell) immune responses, and they had more pronounced disruption of the blood–brain barrier. However, the long-term outcome 2–7 years after TBE was comparable. In summary, the monophasic course is a frequent and distinct presentation of TBE that is associated with more difficult disease course and higher levels of inflammatory mediators in CSF than the biphasic course; however, the long-term outcome is similar.
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spelling pubmed-80702812021-04-26 Comparison of Clinical, Laboratory and Immune Characteristics of the Monophasic and Biphasic Course of Tick-Borne Encephalitis Bogovič, Petra Lotrič-Furlan, Stanka Avšič-Županc, Tatjana Korva, Miša Kastrin, Andrej Lusa, Lara Strle, Klemen Strle, Franc Microorganisms Article The biphasic course of tick-borne encephalitis (TBE) is well described, but information on the monophasic course is limited. We assessed and compared the clinical presentation, laboratory findings, and immune responses in 705 adult TBE patients: 283 with monophasic and 422 with biphasic course. Patients with the monophasic course were significantly (p ≤ 0.002) older (57 vs. 50 years), more often vaccinated against TBE (7.4% vs. 0.9%), more often had comorbidities (52% vs. 37%), and were more often treated in the intensive care unit (12.4% vs. 5.2%). Multivariate logistic regression found strong association between the monophasic TBE course and previous TBE vaccination (OR = 18.45), presence of underlying illness (OR = 1.85), duration of neurologic involvement before cerebrospinal fluid (CSF) examination (OR = 1.39), and patients’ age (OR = 1.02). Furthermore, patients with monophasic TBE had higher CSF levels of immune mediators associated with innate and adaptive (Th1 and B-cell) immune responses, and they had more pronounced disruption of the blood–brain barrier. However, the long-term outcome 2–7 years after TBE was comparable. In summary, the monophasic course is a frequent and distinct presentation of TBE that is associated with more difficult disease course and higher levels of inflammatory mediators in CSF than the biphasic course; however, the long-term outcome is similar. MDPI 2021-04-10 /pmc/articles/PMC8070281/ /pubmed/33920166 http://dx.doi.org/10.3390/microorganisms9040796 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bogovič, Petra
Lotrič-Furlan, Stanka
Avšič-Županc, Tatjana
Korva, Miša
Kastrin, Andrej
Lusa, Lara
Strle, Klemen
Strle, Franc
Comparison of Clinical, Laboratory and Immune Characteristics of the Monophasic and Biphasic Course of Tick-Borne Encephalitis
title Comparison of Clinical, Laboratory and Immune Characteristics of the Monophasic and Biphasic Course of Tick-Borne Encephalitis
title_full Comparison of Clinical, Laboratory and Immune Characteristics of the Monophasic and Biphasic Course of Tick-Borne Encephalitis
title_fullStr Comparison of Clinical, Laboratory and Immune Characteristics of the Monophasic and Biphasic Course of Tick-Borne Encephalitis
title_full_unstemmed Comparison of Clinical, Laboratory and Immune Characteristics of the Monophasic and Biphasic Course of Tick-Borne Encephalitis
title_short Comparison of Clinical, Laboratory and Immune Characteristics of the Monophasic and Biphasic Course of Tick-Borne Encephalitis
title_sort comparison of clinical, laboratory and immune characteristics of the monophasic and biphasic course of tick-borne encephalitis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070281/
https://www.ncbi.nlm.nih.gov/pubmed/33920166
http://dx.doi.org/10.3390/microorganisms9040796
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