Borges Aercio Sebastião, Figueiredo José Fernando de Castro
Centro de Ciências Biomédicas, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
Arq Neuropsiquiatr. 2004 Dec;62(4):1033-7. doi: 10.1590/s0004-282x2004000600019. Epub 2004 Dec 15.
We studied 55 patients with acquired immunodeficiency syndrome (AIDS) and neurotoxoplasmosis (group 1), 37 patients with AIDS and neurological involvement due to another etiology (group 2) and 18 anti-HIV-negative individuals with neurological manifestations, by searching for anti-T. gondii IgG, IgA and IgM immunoglobulins in serum, cerebrospinal fluid (CSF)and saliva, using ELISA. The negative predictive value of the test for IgG in serum was 100% and in CSF, 92.4%. There was no difference among the three groups studied regarding IgA in serum. For IgA, in CSF the test reached 72.7% specificity (p<0.05). In saliva, only the detection of IgG was found to be correlated with a diagnosis of neurotoxoplasmosis. We emphasize that the absence of anti-T. gondii IgG antibodies in serum and CSF strongly indicates the absence of a diagnosis of neurotoxoplasmosis and that specific IgA immunoglobulins in CSF and IgG in saliva may represent two auxiliary markers for the differential diagnosis of toxoplasmic encephalitis in AIDS.
我们通过酶联免疫吸附测定法（ELISA）检测血清、脑脊液（CSF）和唾液中抗弓形虫IgG、IgA和IgM免疫球蛋白，对55例获得性免疫缺陷综合征（AIDS）合并神经型弓形虫病患者（第1组）、37例AIDS合并其他病因所致神经病变患者（第2组）以及18例有神经症状的抗HIV阴性个体进行了研究。血清IgG检测的阴性预测值为100%，脑脊液中为92.4%。在研究的三组中，血清IgA无差异。对于IgA，脑脊液检测的特异性达到72.7%（p<0.05）。在唾液中，仅IgG检测结果与神经型弓形虫病诊断相关。我们强调，血清和脑脊液中缺乏抗弓形虫IgG抗体强烈提示不存在神经型弓形虫病诊断，脑脊液中的特异性IgA免疫球蛋白和唾液中的IgG可能是AIDS患者弓形虫性脑炎鉴别诊断的两个辅助标志物。
