RESUMO
An IgG subclass deficiency is often associated with bacterial infections. We studied four pediatric patients suffering from meningoencephalitis, two of them due to Streptococcus pneumoniae and two due to Haemophilus influenzae type b. Simultaneous diagnostic serum and cerebrospinal fluid samples were taken during income. The four subclasses of IgG and albumin were quantified in both biologic fluids by radial immunodiffusion. Very low levels of seric IgG2 with non detectable cerebrospinal fluid IgG2 were found in the patients. No intrathecal IgG subclass synthesis was found in two patients. One patient with S. pneumoniae had IgG3 intrathecal synthesis. Intrathecal IgG1, IgG3 and IgG4 synthesis was found in one patient suffering from H. influenzae according with reibergrams. Substitutive therapy with intravenous gammaglobulin was given to the patients as part of the treatment.
Assuntos
Infecções Bacterianas/imunologia , Deficiência de IgG/imunologia , Meningoencefalite/imunologia , Albuminas/líquido cefalorraquidiano , Infecções Bacterianas/tratamento farmacológico , Pré-Escolar , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/líquido cefalorraquidiano , Lactente , Recém-Nascido , Meningoencefalite/tratamento farmacológico , Albumina Sérica/análise , gama-Globulinas/uso terapêuticoRESUMO
INTRODUCTION: Childhood is sensibly affected by viral meningoencephalitis outbreaks. OBJECTIVE: To study the intrathecal humoral immune response in a group of children suffering from Coxsackie B5 meningoencephalitis outbreak. Patients and methods. Forty eight sick children were studied. Serum and cerebrospinal IgA, IgM, IgG and albumin were quantified by radial immunodiffusion. It had been evaluated by reibergrams. RESULTS: Seventeen children has blood-cerebrospinal fluid barrier dysfunction. Four different patterns of intrathecal immune humoral response were observed mainly IgG and three major immunoglobulins class. Mean cell counts was 624 +/- 517 x 10(6) cells/l with a lymphocyte predominance. CONCLUSION: An intrathecal humoral response were reported as an early patterns like in delayed non-diagnostic puncture and in evolutive puncture in adults patterns with viral meningoencephalitis.
Assuntos
Anticorpos Antivirais/imunologia , Infecções por Coxsackievirus , Enterovirus Humano B , Imunoglobulinas/biossíntese , Imunoglobulinas/líquido cefalorraquidiano , Meningoencefalite/imunologia , Anticorpos Antivirais/líquido cefalorraquidiano , Formação de Anticorpos/imunologia , Barreira Hematoencefálica/imunologia , Criança , Pré-Escolar , Humanos , Meningoencefalite/líquido cefalorraquidiano , Meningoencefalite/virologiaRESUMO
Four cases of eosinophil meningoencephalitis caused by Angiostrongylus cantonensis are studied. The cytochemical study of the cerebrospinal fluid of these patients found a prevalence of eosinophils with increased IgE. Serum showed a variable behavior of immunoglobulins except for the increase of total IgE. All patients showed IgG and IgA synthesis and there was IgM synthesis in one patient. The percentage of intrathecal synthesis was variable and IgE synthesis manifests in two trends with an equal number of cases.