Guy G, Comoy J, Chevet D, Thomas R, le Pogamp P
Neurochirurgie. 1976;22(6):631-8.
In these two patients, as in 13 others described in the literature, a typical meningitic syndrome with excitement, confusion and a fever of 104degrees F (40degrees C) appeared 4-6 hours following the intra-thecal injection. Subsequent lumbar puncture usually reveals a cloudy C.S.F. under increased pressure. The polymorphs and proteins are increased but the glucose remains normal. There are no bacteria either on direct examination or after culture. All the patients receive antibiotics. After a course of three days, the symptoms and the fever have disappeared and the C.S.F. became normal. Bacterial contamination can be ruled out. The relative roles of iodine, radio-acitivity itself, albumine and of the radio-active element which are only used for this radiotracer are discussed. The tracer contains neither stabilizer nor pH buffer. One must presume that the syndrome is due to a direct toxic action rather than to an immunological or allergic reaction. Furthermore, it is of interest that similar reactions, without infection, are seen after spinal anaesthesia and intra-thecal injection of such differing substances such as iodine contrast media, gamma globulins, other isotopes or toxic substances (Lysol) (111In-DTPA).
在这两名患者中，如同文献中描述的其他13名患者一样，鞘内注射后4 - 6小时出现了典型的脑膜炎综合征，伴有兴奋、意识模糊和104华氏度（40摄氏度）的发热。随后的腰椎穿刺通常显示脑脊液浑浊，压力升高。多形核白细胞和蛋白质增加，但葡萄糖仍正常。直接检查或培养后均未发现细菌。所有患者均接受抗生素治疗。经过三天的疗程，症状和发热消失，脑脊液恢复正常。可排除细菌污染。讨论了碘、放射性本身、白蛋白以及仅用于这种放射性示踪剂的放射性元素的相对作用。该示踪剂既不含稳定剂也不含pH缓冲剂。必须假定该综合征是由于直接的毒性作用而非免疫或过敏反应。此外，有趣的是，在脊髓麻醉和鞘内注射诸如碘造影剂、丙种球蛋白、其他同位素或有毒物质（来苏尔）（铟 - 1,4,7,10 - 四氮杂环十二烷 - N,N',N",N'" - 四乙酸）等不同物质后，也会出现类似的无感染反应。
