Evaluation of intrathecal synthesis of specific IgG antibodies against Toxoplasma gondii in the diagnosis assessment of presumptive toxoplasma encephalitis in aids patients



Document title: Evaluation of intrathecal synthesis of specific IgG antibodies against Toxoplasma gondii in the diagnosis assessment of presumptive toxoplasma encephalitis in aids patients
Journal: Revista da Sociedade Brasileira de Medicina Tropical
Database: PERIÓDICA
System number: 000282523
ISSN: 0037-8682
Authors: 1
2
Institutions: 1Universidade Federal de Uberlandia, Faculdade de Medicina, Uberlandia, Minas Gerais. Brasil
2Universidade de Sao Paulo, Faculdade de Medicina, Sao Paulo. Brasil
Year:
Season: Sep-Oct
Volumen: 37
Number: 5
Pages: 480-484
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Descriptivo
English abstract The diagnosis of neurotoxoplasmosis in patients with acquired immunodeficiency syndrome is mainly based on tomographic or magnetic resonance findings and on the response to specific treatment. We studied 55 patients with AIDS and neurotoxoplasmosis according to these diagnostic criteria (group 1), 37 patients with AIDS and neurological involvement of other etiology (group 2), and 16 anti-HIV-negative individuals with neurological manifestations (group 3). Serum and cerebrospinal fluid were examined for the presence of anti-T. gondii IgG, by indirect immunofluorescence. In 72 of them, the total amounts of these antibodies were determined in order to assess local production of anti-T. gondii antibodies in the central nervous system and to correlate their titers with infection activity in patients with AIDS and neurotoxoplasmosis. IgG titers > 1/64 in cerebrospinal fluid reached 100% specificity for the diagnosis of neurotoxoplasmosis in AIDS. Evidence of local synthesis of these antibodies was detected in 42.8% of patients of group 1, in 29.1% of patients of group 2 and in no patient of group 3. The test showed 70.8% specificity and therefore was not useful in our study for the differential diagnosis of neurotoxoplasmosis in patients with AIDS
Portuguese abstract O diagnóstico da neurotoxoplasmose em pacientes com síndrome da imunodeficiência adquirida baseia-se fundamentalmente nos achados tomográficos ou de ressonância magnética e na resposta ao tratamento específico. Estudamos 55 pacientes com SIDA e neurotoxoplasmose, de acordo com estes critérios diagnósticos (grupo 1); 37 pacientes com SIDA e comprometimento neurológico por outra etiologia (grupo 2) e 16 indivíduos anti-HIV negativo, com outras doenças neurológicas (grupo 3), pesquisando IgG, anti-T. gondii, no soro e no líquor, utilizando a reação de imunofluorescência indireta. Em 72 casos, determinamos os teores totais destes anticorpos aí presentes, com objetivo de avaliar a produção local, no sistema nervoso central, de anticorpos específicos e correlacionar os títulos com atividade da infecção, em pacientes com SIDA e neurotoxoplasmose. Evidência de produção local destes anticorpos foi detectada em 42,8% dos pacientes do grupo 1, em 29,1% dos pacientes do grupo 2 e em nenhum paciente do grupo 3. O teste apresentou especificidade intermediária (70,8%), porém não foi útil para o diagnóstico diferencial da neurotoxoplasmose em pacientes com SIDA, em nosso estudo. Por outro lado, títulos de IgG no líquor > 1/64 alcançaram 100% de especificidade para o diagnóstico de neurotoxoplasmose na SIDA
Disciplines: Medicina,
Biología
Keyword: Diagnóstico,
Neurología,
Virus,
SIDA,
Neurotoxoplasmosis,
Anticuerpos,
Sistema nervioso central
Keyword: Medicine,
Biology,
Diagnosis,
Neurology,
Virus,
AIDS,
Neurotoxoplasmosis,
Antibodies,
Central nervous system
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