Document Detail

Intrathecal synthesis of immunoglobulins in eosinophilic meningoencephalitis due to Angiostrongylus cantonensis.
MedLine Citation:
PMID:  9665947     Owner:  NLM     Status:  MEDLINE    
Eosinophilic meningoencephalitis due to the nematode Angiostrongylus cantonensis, which is endemic to Cuba, occurs in children and is due to accidental contact with soil snails. The course is less often fatal than in adult patients in southeastern Asia. Cerebrospinal fluid (CSF) and serum samples from 24 pediatric patients were analyzed and evaluated in CSF/serum quotient diagrams (Reiber graphs) to characterize the neuroimmunological response and the blood-CSF barrier dysfunction that occur in the course of the disease. At the time of the first diagnostic lumbar puncture, together with eosinophilic pleocytosis (1,920 +/- 400 cells/microl), intermediate blood-CSF barrier dysfunction (i.e., an increased CSF/serum albumin quotient) with no intrathecal immunoglobulin G (IgG), IgA, and IgM class response was observed in all cases. Seven days later, at the time of early clinical recovery, the blood-CSF barrier dysfunction was normalized in 75% of the patients, but meanwhile, intrathecal immunoglobulin synthesis emerged in all cases, as either a two-class response (IgG and IgA in 85% of the patients) or a three-class response (IgG, IgA, and IgM; 30%). The fraction of eosinophilic cells (40%) remained large despite a decreasing total cell count. The neuroimmunological pattern of this inflammatory response to the parasite and its toxins is discussed with regard to the CSF patterns of other infectious diseases caused by bacteria or viruses.
A J Dorta-Contreras; H Reiber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and diagnostic laboratory immunology     Volume:  5     ISSN:  1071-412X     ISO Abbreviation:  Clin. Diagn. Lab. Immunol.     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-10-09     Completed Date:  1998-10-09     Revised Date:  2013-06-11    
Medline Journal Info:
Nlm Unique ID:  9421292     Medline TA:  Clin Diagn Lab Immunol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  452-5     Citation Subset:  IM    
Lab Immunología, Hospital Pediátrico San Miguel del Padrón, Havana, Cuba.
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MeSH Terms
Angiostrongylus cantonensis* / immunology,  pathogenicity
Blood-Brain Barrier / immunology
Case-Control Studies
Child, Preschool
Eosinophilia / immunology*
Immunoglobulin A / blood,  cerebrospinal fluid
Immunoglobulin G / blood,  cerebrospinal fluid
Immunoglobulin M / blood,  cerebrospinal fluid
Immunoglobulins / blood,  cerebrospinal fluid*
Meningoencephalitis / diagnosis,  immunology*
Prospective Studies
Strongylida Infections / diagnosis,  immunology*
Reg. No./Substance:
0/Immunoglobulin A; 0/Immunoglobulin G; 0/Immunoglobulin M; 0/Immunoglobulins

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