广州管圆线虫引起的嗜酸性粒细胞性脑膜脑炎患儿鞘内IgE的合成
Intrathecal synthesis of IgE in children with eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis.
作者信息
Padilla-Docal Barbara, Dorta-Contreras Alberto J, Bu-Coifiu-Fanego Raisa, Hernández Hermes Fundora, Barroso Jesús Callol, Sanchez-Martinez Consuelo
机构信息
Central laboratory of CSF (LABCEL), Faculty of Medical Sciences "Dr Miguel Enríquez", Superior Institute of Medical Sciences of Havana, Section 10049, 11000 CP Havana City, Cuba.
出版信息
Cerebrospinal Fluid Res. 2008 Nov 25;5:18. doi: 10.1186/1743-8454-5-18.
BACKGROUND
Eosinophilic meningoencephalitis caused by the helminth Angiostrongylus cantonensis, is an emerging infectious disease in America. The objective of this paper was to determine if the intrathecal synthesis of immunoglobulin E is produced during the acute phase of the disease.
METHODS
Thirteen patients, mean age 4.5 years were studied; a diagnostic lumbar puncture was performed and serum samples taken. Immunoglobulin E (IgE) in serum and in cerebrospinal fluid (CSF) was quantified by nephelometry. Control patients had other infections or other neurological diseases.
RESULTS
The mean cell count in the CSF was 500 x 10-6 cells/L and of these 23% were eosinophils. In blood the eosinophils were 13%. The chief symptoms of the patients were migraine, vomiting and fever and 50% presented some meningeal signs. IgE intrathecal synthesis analyzed by the corresponding quotient diagram (Reibergram) was observed in all patients. No intrathecal IgE synthesis was seen in control patients.
CONCLUSION
Intrathecal synthesis of IgE demonstrates the participation of this immunoglobulin in the destruction of the third stage larvae of the parasite in the CSF. The test should be considered in our environment as a tool to aid diagnosis.
背景
由广州管圆线虫引起的嗜酸性粒细胞性脑膜脑炎是美国一种新出现的传染病。本文的目的是确定在该疾病急性期是否会产生鞘内免疫球蛋白E合成。
方法
研究了13名平均年龄4.5岁的患者；进行了诊断性腰椎穿刺并采集血清样本。通过散射比浊法对血清和脑脊液（CSF）中的免疫球蛋白E（IgE）进行定量。对照患者患有其他感染或其他神经系统疾病。
结果
脑脊液中的平均细胞计数为500×10⁻⁶个细胞/L，其中23%为嗜酸性粒细胞。血液中的嗜酸性粒细胞为13%。患者的主要症状为偏头痛、呕吐和发热，50%的患者出现一些脑膜刺激征。通过相应的商图（赖伯图）分析，所有患者均观察到鞘内IgE合成。对照患者未观察到鞘内IgE合成。
结论
鞘内IgE合成表明该免疫球蛋白参与了脑脊液中寄生虫第三期幼虫的破坏。在我们的环境中，该检测应被视为辅助诊断的工具。
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