IgG intrathecal synthesis and specific antibody index in patients with neurocysticercosis.
We analyzed cerebrospinal fluid (CSF) and blood serum from 55 patients with neurocysticercosis (NC) at different clinical stages. According to inflammatory activity in the CSF, three stages were identified: (1) reactive, when there was at least an increase in the number of cells; (2) weakly reactive, when significant alterations were found in the CSF, including an increase in gamma globulins, albeit without hypercytosis; (3) non-reactive, when there was neither hypercytosis nor increase in gamma globulins. Nineteen patients had the reactive form; 18 had the weakly reactive form; 18 displayed the non-reactive form. Local immunoproduction was intense in the reactive group, moderate in the weakly reactive group, and absent in the non-reactive group. The specific antibody index was raised in approximately 2/3 of patients with the reactive form, 2/3 in those with the weakly reactive form, and 1/3 in those with the non-reactive form.


CONCLUSIONS
(1) the classical CSF syndrome in NC can present both in complete and partial modes; (2) local immunoproduction can occur in weakly reactive forms; (3) a raised specific antibody index can occur in the absence of an inflammatory reaction in the CSF.
Machado
Luís R
LR
Department of Neurology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil. lsflcr@terra.com.br
Livramento
José A
JA
Vaz
Adelaide J
AJ
Bueno
Ednéia C
EC
Mielli
Sylvia R
SR
Bastouly
Vitória
V
Nobrega
José Paulo S
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000096:biosynthesis* / Q000097:blood / Q000134:cerebrospinal fluid; D007964:Leukocytosis / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology*; D011446:Prospective Studies; D013577:Syndrome; D005719:gamma-Globulins / Q000134:cerebrospinal fluid
D007074:Immunoglobulin G; D005719:gamma-Globulins