Dorta-Contreras A J, Noris-García E, Escobar-Pérez X, Dueñas-Flores A, Mena-López R
Facultad de Ciencias Medicas Dr. Miguel Enriquez, La Habana, Cuba.
Rev Neurol. 2003;36(6):506-9.
There is a growing interest to know the characteristics of meningoencephalitis due to Angiostrongylus cantonensis because of it is an emergent disease.
To describe the intrathecal synthesis pattern of IgG subclasses in pediatric patients suffering from eosinophilic meningoencephalitis due to Angiostrongylus cantonensis.
Ten pediatric patients with the disease were studied. During the firs diagnostic lumbar puncture an eosinophilic pleocitosis was found. Simultaneously a serum sample was taken. Eight days later, a second lumbar and venous puncture was performed. To every serum and cerebrospinal fluid sample IgA, IgM, IgG, albumin and the four subclasses of IgG were quantified by immunodiffusion and a differential cell count.
During the first diagnostic lumbar puncture, all the cases had blood cerebrospinal fluid barrier dysfunction with absence of immunoglobulins intrathecal synthesis with a mean of 450 106cells/L and 48% of eosinophils average. In the second lumbar punction there was a 40% patients with dysfunction of the blood cerebrospinal fluid barrier and with a synthesis pattern IgA+IgM+IgG in the 50% o patients and with IgA+IgG in four patients. The synthesis pattern of IgG subclasses was IgG1+IgG2 in six patients, IgG1+IgG2+IgG3 in one patient, IgG1+IgG2+IgG4 in one more patient and two patients without intrathecal synthesis.
The intrathecal synthesis pattern of IgG subclasses can contribute to eosinophilic meningoencephalitis diagnosis due to Angiostrongylus cantonensis.
由于广州管圆线虫病是一种新发疾病，人们对了解其所致脑膜脑炎的特征越来越感兴趣。
描述广州管圆线虫所致嗜酸性粒细胞性脑膜脑炎患儿鞘内IgG亚类的合成模式。
对10例患有该病的患儿进行研究。在首次诊断性腰椎穿刺时发现嗜酸性粒细胞增多。同时采集血清样本。8天后，进行第二次腰椎穿刺和静脉穿刺。通过免疫扩散和细胞分类计数对每份血清和脑脊液样本中的IgA、IgM、IgG、白蛋白以及IgG的四个亚类进行定量分析。
在首次诊断性腰椎穿刺时，所有病例均存在血脑屏障功能障碍，鞘内无免疫球蛋白合成，平均细胞数为450×10⁶个/L，嗜酸性粒细胞平均占48%。在第二次腰椎穿刺时，40%的患者存在血脑屏障功能障碍，50%的患者合成模式为IgA+IgM+IgG，4例患者为IgA+IgG。IgG亚类的合成模式为：6例患者为IgG1+IgG2，1例患者为IgG1+IgG2+IgG3，1例患者为IgG1+IgG2+IgG4，2例患者无鞘内合成。
IgG亚类的鞘内合成模式有助于广州管圆线虫所致嗜酸性粒细胞性脑膜脑炎的诊断。
