title: [Intrathecal synthesis pattern of immunoglobulins in meningoencephalitis epidemic due to echovirus 9].
abstract: BACKGROUND
  Epidemics of meningoencephalitis due to echovirus 9 were commonly occurred when a children population become susceptible for the first time in front the virus.
  
  
  OBJECTIVE
  To present the intrathecal synthesis pattern of immunoglobulins of the epidemic that affected Cuba in 1999 and to probe the usefulness of reibergram and antibody index in the diagnostic and characterization of the outbreak.
  
  
  METHODS
  23 pediatric patients suffering from viral meningoencephalitis due to echovirus 9 were studied in the income moment. Serum and cerebrospinal fluid IgA, IgM, IgG, albumin and glucose were quantified. Cerebrospinal fluid total protein content and lactate were quantified. Titles of antibodies against echo 9 and Coxsackie A9 and differential cell count were performed.
  
  
  RESULTS
  A mean of 555 cells/10 6 L mainly lymphocytes were obtained. Glucose in cerebrospinal fluid was over 50%, serum glucose and lactate levels below 2.1 mmol/L. In the reibergram an absence of intrathecal synthesis was predominant (15/23), IgM synthesis (6/23) and IgM+IgA (2/23). Blood cerebrospinal fluid dysfunction was observed in 15 patients. The mean antibody index was 1,8 for echo 9 and 0,9 for Coxsackie A9.
  
  
  CONCLUSIONS
  The intrathecal synthesis pattern of immunoglobulins was different from other enterovirus and from echovirus 9 in non epidemic situations before this epidemic, probably with alteration of viral genome.
authors.affiliation: Laboratorio de Líquido Cefalorraquídeo. Facultad de Ciencias Médicas Dr. Miguel Enriquez, Ciudad de la Habana, Cuba. adorta@infomed.sld.cu
authors.forename: A J
authors.initials: AJ
authors.lastname: Dorta-Contreras
authors.forename: H
authors.initials: H
authors.lastname: Reiber
authors.forename: M E
authors.initials: ME
authors.lastname: Magraner-Tarrau
authors.forename: B
authors.initials: B
authors.lastname: Weissbrich
authors.forename: M T
authors.initials: MT
authors.lastname: Interián-Morales
authors.forename: E
authors.initials: E
authors.lastname: Noris-García
authors.forename: X
authors.initials: X
authors.lastname: Escobar-Pérez
authors.forename: I O
authors.initials: IO
authors.lastname: González-Mujica
mesh_terms: D000914:Antibodies, Viral / Q000134:cerebrospinal fluid*; D002648:Child; D002675:Child, Preschool; D003462:Cuba / Q000453:epidemiology; D004196:Disease Outbreaks; D004459:Echovirus 9 / Q000276:immunology*; D004457:Echovirus Infections / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D007136:Immunoglobulins / Q000134:cerebrospinal fluid*; D008590:Meningoencephalitis / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000276:immunology* / Q000821:virology*
chemical_list: D000914:Antibodies, Viral; D007136:Immunoglobulins