Padilla-Docal B, Iglesias-González IM, Dorta-Contreras AJ

Language: Spanish
References: 15
Page: 744-751
PDF size: 196.08 Kb.

ABSTRACT

Introduction: Meningitis/meningoencephalitis is a non-frequent central nervous system infection produced by Cryptococcus neoformans.
Objective: To show the neuroimmunological response using reibergram in a patient with chronic meningoencephalitis due to Cryptococcus neoformans.
Case presentation: Serum and cerebrospinal fluid IgA, IgM, IgG and albumin levels were quantified in a patient suffering from the disease by means of five lumbar punctures during her evolution; the results were plotted in their corresponding reibergram. Syntheses of at least two intrathecal major immunoglobulin were confirmed. A percent bigger of IgG intrathecal synthesis was observed. There is no blood-brain barrier dysfunction.
Conclusion: Intrathecal immunoglobulin synthesis and blood-brain barrier situation constitute key element in the neuro-inflammation diagnosis.

REFERENCES

1. Meiring ST, Quan VC, Cohen C, Dawood H, Karstaedt AS, McCarthy KM, Whitelaw AC, Govender NP. A comparison of cases of paediatric-onset and adult-onset cryptococcosis detected through population-based surveillance,2005-2007. AIDS. 2012; 26: 2307-14.

2. Sarkis RA, Mays M, Isada C, Ahmed. MMRI findings in cryptococcal meningitis of the non-HIV population. Neurologist. 2015; 19 (2):40-5.

3. Peter G, Pappas MD. Cryptococcal Infections in Non-Hiv-Infected Patients Trans Am Clin Climatol Assoc. 2013; 124: 61-79.

4. Galindo PortuondoES, León Blasco AM, PérezRP, Ramírez Cancio O, Morell Artola AE. Meningoencefalitis causada por Cryptococcus neoformans: presentación de un caso. Rev Cubana Neurol Neurocir. 2014; 4(2):148-52.

5. Chirag P, Ramila R, Nima H, Ward M, Jayamalathy Mannar M. Chronic meningitis: a diagnostic challenge highlighted in a case of cryptococcal meningoencephalitis in an apparently immunocompetent older woman. BMJ Case Rep. 2011; 20 (11):1-3.

6. Padilla-Docal B, Wainshtok-Tomás D, Martínez-Larrarte J, Rivero-Arias E, Herrera- Wainshtok A, Callol-Barroso J, Dorta-Contreras A. Respuesta neuroinmunológica en la encefalitis asociada al virus del dengue. VacciMonitor [revista en Internet]. 2015 Dec 7; 22(3): [aprox. 4 p.]. [Citado 2016 Jul 22]. Disponible en: http://vaccimonitor.finlay.edu.cu/index.php/vaccimonitor/article/view/39

7. Reiber H, Peter JB. Cerebrospinal fluid analysis: disease-related data patterns and evaluation programs. J Neurol Sci. 2001; 184:101-22.

8. Storch-Hagenlocher B, Reiber H, Wildemann B, Otto M. Cerebrospinal Fluid Analysis. En: Wildemann B, Oschmann P, Reiber H, editors. Laboratory Diagnosis in Neurology. Sttugart: George Thieme Verlag; 2010, p. 30-69.

9. Dorta-Contreras AJ. Pattern of intrathecal immunoglobulin synthesis in pediatric patients with infectious meningoencephalitis. Biotecnol Apl. 2006; 4:382-6.

10. Dorta-Contreras AJ, Reiber H. Teoría de la difusión molecular/flujo del líquido cefalorraquídeo. Rev Neurol. 2004; 39: 564-9.

11. Joshi NS, Fisher BT, Prasad PA, Zaoutis TE. Epidemiology of cryptococcal infection in hospitalized children. Pediatr Infect Dis J. 2010; 29: 91-5.

12. Sivasangeetha K, Harish BN, Sujatha S, Parija SC, Dutta TK. Cryptococcal meningoencephalitis diagnosed by blood culture. Indian J Med Microbiol. 2007; 25(3):282-4.

13. Lin TY, Yeh KM, Lin JC, Wang NC, Peng MY, Chang FY. Cryptococcal disease in patients with or without human immunodeficiency virus: clinical presentation and monitoring of serum cryptococcal antigen titers. J Microbiol Immunol Infect. 2009; 42(3):220-6.

14. Dorta-Contreras AJ. Respuesta poliespecífica en el sistema nervioso central: uso del índice de anticuerpo. Rev Neurol. 2000; 31:1070-3.

15. Padilla-Docal B, Iglesias-González I, Bu-Coifiu-Fanego R, Socarrás-Hernández CA, Dorta-Contreras AJ. Review: Intrathecal activation as a typical immune response within the central nervous system in angiostrongyliasis. Am J Trop Med Hyg. 2013; 88(2): 230-5.