[A case of measles meningoencephalitis with marked increase of plasma cells in cerebrospinal fluid].
Marked increase of plasma cells in cerebrospinal fluid (CSF) was observed in a 22-year-old female patient with measles meningoencephalitis. Typical measles exanthema was followed, 3 days later, by neurological abnormalities such as confusion, severe meningeal signs and bilateral pyramidal signs. Immunological examination showed slight elevation of IgG, normal T cell subsets and NK cell activity in peripheral blood. The antibody titer of measles was 32x in serum (4x after 2 months). CSF contained 167 cells/mm3, 66% of which was plasma cells. Total protein was 75 mg/dl, and IgG (24.5 mg/dl) showed high values. The antibody titer of measles was 4x (1x after 2 months). The antibody index was 7.15 (N = 2). The anti-myelin antibody was 8x. Oligoclonal band in CSF was negative. The appearance of large number of plasma cells in CSF in viral meningoencephalitis is extremely rare in the literature. However, B cell activation in peripheral blood in measles encephalitis has been reported. Therefore, immunologically abnormal findings in CSF of this case suggest marked B cell activation occurring in the central nervous system in measles meningoencephalitis.
Nozaki
M
M
First Department of Internal Medicine, Kyorin University School of Medicine.
Nakagihara
K
K
Koike
H
H
Yoshino
Y
Y
D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D002452:Cell Count; D002555:Cerebrospinal Fluid / Q000166:cytology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008457:Measles / Q000134:cerebrospinal fluid* / Q000276:immunology; D008459:Measles virus / Q000276:immunology; D008590:Meningoencephalitis / Q000134:cerebrospinal fluid* / Q000276:immunology; D010950:Plasma Cells / Q000166:cytology*
D000914:Antibodies, Viral; D007074:Immunoglobulin G