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Clinical and Diagnostic Laboratory Immunology, July 1998, p. 452-455, Vol. 5, No. 4
Lab Immunología, Hospital
Pediátrico San Miguel del Padrón, Havana,
Cuba,1 and
Neurochemisches Labor der
Neurologischen Klinik, Universität Göttingen,
Göttingen, Germany2
Received 12 November 1997/Returned for modification 23 December
1997/Accepted 17 March 1998
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/µl), 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.
1071-412X/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Intrathecal Synthesis of Immunoglobulins in
Eosinophilic Meningoencephalitis Due to Angiostrongylus
cantonensis
*
Corresponding author. Mailing address: Neurochemisches
Labor, Robert-Koch-Str. 40, D-37075 Göttingen, Germany. Phone:
49-551/39 66 19. Fax: 49-551/39 20 28. E-mail:
hreiber{at}med.uni-goettingen.de.
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