---
title: "IVIG Plus HydroBox Molecular Hydrogen in Severe Acute Meningoencephalitis: Case Report and Immune"
id: "pubmed-42665411"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42665411"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42665411/"
doi: "10.21873/invivo.14471"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# IVIG Plus HydroBox Molecular Hydrogen in Severe Acute Meningoencephalitis: Case Report and Immune
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42665411
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42665411/)
- **DOI:** [10.21873/invivo.14471](https://doi.org/10.21873%2Finvivo.14471)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Severe acute meningoencephalitis can drive life-threatening neuroinflammation, systemic immune dysregulation, and secondary immune dysfunction characterized by immune exhaustion and abnormal immune remodeling. - A previously healthy 30-year-old man developed fulminant acute meningoencephalitis with coma, respiratory failure, and marked systemic inflammation. - Longitudinal deep immunophenotyping revealed profound immune dysregulation: extensive **T-cell exhaustion** phenotypes, abnormal regulatory T-cell remodeling, widespread inhibitory checkpoint expression, and prominent humoral activation with excessive **plasmablast** expansion and disrupted antibody homeostasis. - The treating team used standard critical care plus adjunctive immunomodulation consisting of intravenous immunoglobulin (**IVIG**) and a molecular hydrogen–based strategy (referred to as **HydroBox**). - After initiating IVIG and HydroBox adjunctive therapy, systemic inflammation resolved rapidly, immune profiles trended toward normalization, and the patient achieved full neurological recovery. - The case illustrates a dynamic interplay between acute neuroinflammation and systemic immune remodeling and supports the value of longitudinal immunophenotyping to monitor disease-associated immune dysfunction and response to therapy. - Authors propose that combined **IVIG** and **molecular hydrogen** adjunctive therapy may help restore immune homeostasis in critical neuroinflammatory states, but they note that further study is needed to validate this strategy. - Keywords emphasized in the report include T-cell dysfunction, acute meningoencephalitis, deep immunophenotyping, and neuroinflammation.
## Clinical Analysis & Structured Key Points
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more resources ](https://pubmed.ncbi.nlm.nih.gov/42665411/#linkout) Title & authors Abstract Similar articles Publication types MeSH terms Substances LinkOut - more resources Case Reports In Vivo Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22In+Vivo%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22In+Vivo%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665411/) . 2026 Sep-Oct;40(5):3242-3251. doi: 10.21873/invivo.14471. # Unmasking a B-Cell Linkage Phenotype in Severe Acute Meningoencephalitis: A Case Report of IVIG and HydroBox-assisted Immunomodulatory Therapy [Chang-Lung Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+CL&cauthor_id=42665411)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-1 "School of Medicine, National Taiwan University, Taipei, Taiwan, R.O.C."), [Jeng-Wei Lu](https://pubmed.ncbi.nlm.nih.gov/?term=Lu+JW&cauthor_id=42665411)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-2 "Department of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan, R.O.C.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-3 "Biotech Research and Innovation Centre, University of Copenhagen, Copenhagen, Denmark.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-4 "The Finsen Laboratory, Rigshospitalet/National University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark."), [Yi-Jung Ho](https://pubmed.ncbi.nlm.nih.gov/?term=Ho+YJ&cauthor_id=42665411)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-5 "School of Pharmacy, National Defense Medical University, Taipei, Taiwan, R.O.C.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-6 "Graduate Institute of Life Sciences, National Defense Medical University, Taipei, Taiwan, R.O.C."), [Ming-Chu Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+MC&cauthor_id=42665411)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-7 "Nursing Department, Neihu Outpatient Clinic, Tri-Service General Hospital, Taipei, Taiwan, R.O.C."), [Shan-Wen Lui](https://pubmed.ncbi.nlm.nih.gov/?term=Lui+SW&cauthor_id=42665411)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-8 "Department of Internal Medicine, Linkou Chang-Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C."), [Ting-Yu Hsieh](https://pubmed.ncbi.nlm.nih.gov/?term=Hsieh+TY&cauthor_id=42665411)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-9 "Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C."), [Wun-Long Jheng](https://pubmed.ncbi.nlm.nih.gov/?term=Jheng+WL&cauthor_id=42665411)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-10 "Cancer Center, Hualien Tzu-Chi Hospital, Hualien, Taiwan, R.O.C.")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-11 "Department of Engineering Medicine, Shizuoka Center for Molecular Intelligence, Hamamatsu, Japan."), [Feng-Cheng Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+FC&cauthor_id=42665411)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#full-view-affiliation-12 "Rheumatology/Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan, R.O.C. lfc10399@mail.ndmutsgh.edu.tw.") Affiliations Expand ### Affiliations * 1 School of Medicine, National Taiwan University, Taipei, Taiwan, R.O.C. * 2 Department of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan, R.O.C. * 3 Biotech Research and Innovation Centre, University of Copenhagen, Copenhagen, Denmark. * 4 The Finsen Laboratory, Rigshospitalet/National University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. * 5 School of Pharmacy, National Defense Medical University, Taipei, Taiwan, R.O.C. * 6 Graduate Institute of Life Sciences, National Defense Medical University, Taipei, Taiwan, R.O.C. * 7 Nursing Department, Neihu Outpatient Clinic, Tri-Service General Hospital, Taipei, Taiwan, R.O.C. * 8 Department of Internal Medicine, Linkou Chang-Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C. * 9 Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C. * 10 Cancer Center, Hualien Tzu-Chi Hospital, Hualien, Taiwan, R.O.C. * 11 Department of Engineering Medicine, Shizuoka Center for Molecular Intelligence, Hamamatsu, Japan. * 12 Rheumatology/Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan, R.O.C. lfc10399@mail.ndmutsgh.edu.tw. * PMID: **42665411** * DOI: [ 10.21873/invivo.14471 ](https://doi.org/10.21873/invivo.14471) Item in Clipboard Case Reports # Unmasking a B-Cell Linkage Phenotype in Severe Acute Meningoencephalitis: A Case Report of IVIG and HydroBox-assisted Immunomodulatory Therapy Chang-Lung Wu et al. In Vivo. 2026 Sep-Oct. Show details Display options Display options Format Abstract PubMed PMID In Vivo Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22In+Vivo%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22In+Vivo%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665411/) . 2026 Sep-Oct;40(5):3242-3251. doi: 10.21873/invivo.14471. ### Authors [Chang-Lung Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+CL&cauthor_id=42665411)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-1 "School of Medicine, National Taiwan University, Taipei, Taiwan, R.O.C."), [Jeng-Wei Lu](https://pubmed.ncbi.nlm.nih.gov/?term=Lu+JW&cauthor_id=42665411)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-2 "Department of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan, R.O.C.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-3 "Biotech Research and Innovation Centre, University of Copenhagen, Copenhagen, Denmark.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-4 "The Finsen Laboratory, Rigshospitalet/National University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark."), [Yi-Jung Ho](https://pubmed.ncbi.nlm.nih.gov/?term=Ho+YJ&cauthor_id=42665411)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-5 "School of Pharmacy, National Defense Medical University, Taipei, Taiwan, R.O.C.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-6 "Graduate Institute of Life Sciences, National Defense Medical University, Taipei, Taiwan, R.O.C."), [Ming-Chu Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+MC&cauthor_id=42665411)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-7 "Nursing Department, Neihu Outpatient Clinic, Tri-Service General Hospital, Taipei, Taiwan, R.O.C."), [Shan-Wen Lui](https://pubmed.ncbi.nlm.nih.gov/?term=Lui+SW&cauthor_id=42665411)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-8 "Department of Internal Medicine, Linkou Chang-Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C."), [Ting-Yu Hsieh](https://pubmed.ncbi.nlm.nih.gov/?term=Hsieh+TY&cauthor_id=42665411)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-9 "Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C."), [Wun-Long Jheng](https://pubmed.ncbi.nlm.nih.gov/?term=Jheng+WL&cauthor_id=42665411)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-10 "Cancer Center, Hualien Tzu-Chi Hospital, Hualien, Taiwan, R.O.C.")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-11 "Department of Engineering Medicine, Shizuoka Center for Molecular Intelligence, Hamamatsu, Japan."), [Feng-Cheng Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+FC&cauthor_id=42665411)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42665411/#short-view-affiliation-12 "Rheumatology/Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan, R.O.C. lfc10399@mail.ndmutsgh.edu.tw.") ### Affiliations * 1 School of Medicine, National Taiwan University, Taipei, Taiwan, R.O.C. * 2 Department of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan, R.O.C. * 3 Biotech Research and Innovation Centre, University of Copenhagen, Copenhagen, Denmark. * 4 The Finsen Laboratory, Rigshospitalet/National University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. * 5 School of Pharmacy, National Defense Medical University, Taipei, Taiwan, R.O.C. * 6 Graduate Institute of Life Sciences, National Defense Medical University, Taipei, Taiwan, R.O.C. * 7 Nursing Department, Neihu Outpatient Clinic, Tri-Service General Hospital, Taipei, Taiwan, R.O.C. * 8 Department of Internal Medicine, Linkou Chang-Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C. * 9 Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C. * 10 Cancer Center, Hualien Tzu-Chi Hospital, Hualien, Taiwan, R.O.C. * 11 Department of Engineering Medicine, Shizuoka Center for Molecular Intelligence, Hamamatsu, Japan. * 12 Rheumatology/Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan, R.O.C. lfc10399@mail.ndmutsgh.edu.tw. * PMID: **42665411** * DOI: [ 10.21873/invivo.14471 ](https://doi.org/10.21873/invivo.14471) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background/aim:** Severe acute meningoencephalitis is a life-threatening neurological condition frequently associated with excessive inflammation, immune dysregulation, and secondary immune dysfunction. Immune exhaustion and abnormal immune cell remodeling may contribute to persistent inflammation and impaired recovery. Molecular hydrogen has emerged as a potential adjunctive therapy due to its selective antioxidant and immunomodulatory properties. **Case report:** A previously healthy 30-year-old male developed fulminant acute meningoencephalitis complicated by coma, respiratory failure, and severe systemic inflammation. Longitudinal immune profiling revealed profound immune dysregulation, including extensive T-cell exhaustion-associated phenotypes, abnormal regulatory T-cell remodeling, and marked humoral immune activation. The patient demonstrated widespread expression of inhibitory immune checkpoint markers, accompanied by excessive plasmablast expansion and impaired antibody homeostasis. A combined therapeutic strategy consisting of standard intensive care, intravenous immunoglobulin (IVIG), and molecular hydrogen-based adjunctive therapy (HydroBox strategy) was initiated. Following intervention, systemic inflammation rapidly resolved, immune profiles progressively normalized, and neurological function recovered completely. **Conclusion:** This case highlights the dynamic relationship between acute neuroinflammation and systemic immune remodeling in severe meningoencephalitis. Longitudinal immunophenotyping may provide valuable insights into disease-associated immune dysfunction and therapeutic response. The combination of IVIG and molecular hydrogen-based adjunctive therapy may represent a potential strategy for restoring immune homeostasis in critical neuroinflammatory conditions, warranting further investigation. **Keywords:** Case report; T-cell dysfunction; acute meningoencephalitis; deep immunophenotyping; neuroinflammation. Copyright © 2026, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Dynamic Immunomodulation by Hydrogen Capsule Therapy in SLE-associated Pulmonary Arterial Hypertension: A Case Report. ](https://pubmed.ncbi.nlm.nih.gov/41167678/) Liu C, Lu JW, Wu CH, Ho YJ, Lui SW, Hsieh TY, Wang KY, Liu FC.Liu C, et al.In Vivo. 2025 Nov-Dec;39(6):3656-3664. doi: 10.21873/invivo.14165.In Vivo. 2025.PMID: 41167678Free PMC article. * [ Adjuvant Molecular Hydrogen Therapy in SLE-associated Pulmonary Arterial Hypertension: A Case Report on Immunomodulatory Effects on Regulatory and Effector Lymphocytes. ](https://pubmed.ncbi.nlm.nih.gov/41482388/) Liu C, Lu JW, Wu CH, Ho YJ, Lui SW, Hsieh TY, Wang KY, Liu FC.Liu C, et al.In Vivo. 2026 Jan-Feb;40(1):551-560. doi: 10.21873/invivo.14220.In Vivo. 2026.PMID: 41482388Free PMC article. * [ Molecular Hydrogen Therapy in Sjögren's Syndrome With Pulmonary Arterial Hypertension and Right-sided Heart Failure: A Case Report of Improved Immune Markers Including Treg, B Cells and Plasma Cell. ](https://pubmed.ncbi.nlm.nih.gov/39477378/) Lin YT, Lu JW, Wu CH, Ho YJ, Lui SW, Hsieh TY, Liu FC.Lin YT, et al.In Vivo. 2024 Nov-Dec;38(6):3117-3124. doi: 10.21873/invivo.13797.In Vivo. 2024.PMID: 39477378Free PMC article. * [ Life-threatening multiorgan immune-related toxicities complicated by sepsis after anti-PD-1 therapy with complete tumor regression: a case report and literature review. ](https://pubmed.ncbi.nlm.nih.gov/42459692/) Dong J, Zhang L, Yu L, Wang J, Huang J, Wu X, Wu PA, Chen S, Chen X, Zhu W, Qu Y, Li J, Lee VHF.Dong J, et al.Front Immunol. 2026 Jul 1;17:1830699. doi: 10.3389/fimmu.2026.1830699. eCollection 2026.Front Immunol. 2026.PMID: 42459692Free PMC article.Review. * [ Chronic meningoencephalitis due to enterovirus A71 complicating rituximab therapy. ](https://pubmed.ncbi.nlm.nih.gov/41027817/) David A, Claudé M, Martin de Frémont G, Trédez G, Henry C.David A, et al.Rev Neurol (Paris). 2025 Dec;181(10):975-980. doi: 10.1016/j.neurol.2025.09.003. Epub 2025 Sep 29.Rev Neuro
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