-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.
The events of the cellular immune response in neurocysticercosis (NC) are not fully understood. Studies of the CD3, CD3/CD4, CD3/CD8, CD45/CD19, and CD45/CD56 molecules and activation‐related CD69 molecule in cells from the cerebrospinal fluid (CSF) and peripheral blood (PB) of patients with NC may provide a better elucidation of the inflammatory and immunological events occurring in this disease. Seven patients with NC and 3 individuals with other disorders were evaluated by a three‐color flow cytometric method. CD69 was detected in a higher percentage of cells in all CSF samples from patients, but not in PB or CSF from the control group. The percentage of CD3+ cells did not differ significantly in CSF and PB cells from patients and controls. The predominance of CD3+CD8+ cells was observed in CSF from one patient and in PB from 2 patients, who were in stage III of the disease (inflammatory process). The percentage of CD45+CD19+ cells was higher in CSF than in PB from patients who presented anti‐cysticercus antibodies in CSF. The percentage of CD45+CD56+ cells in CSF was higher than in PB, but this rate was similar to reference values reported by other authors. Our data suggest that the cytometric method applied to a larger number of CSF samples may provide a better understanding of the cell‐mediated immune response involved in NC. Cytometry (Comm. Clin. Cytometry) 38:106–110, 1999. © 1999 Wiley‐Liss, Inc.
The events of the cellular immune response in neurocysticercosis (NC) are not fully understood. Studies of the CD3, CD3/CD4, CD3/CD8, CD45/CD19, and CD45/CD56 molecules and activation-related CD69 molecule in cells from the cerebrospinal fluid (CSF) and peripheral blood (PB) of patients with NC may provide a better elucidation of the inflammatory and immunological events occurring in this disease. Seven patients with NC and 3 individuals with other disorders were evaluated by a three-color flow cytometric method. CD69 was detected in a higher percentage of cells in all CSF samples from patients, but not in PB or CSF from the control group. The percentage of CD3 cells did not differ significantly in CSF and PB cells from patients and controls. The predominance of CD3CD8 cells was observed in CSF from one patient and in PB from 2 patients, who were in stage III of the disease (inflammatory process). The percentage of CD45CD19 cells was higher in CSF than in PB from patients who presented anti-cysticercus antibodies in CSF. The percentage of CD45CD56 cells in CSF was higher than in PB, but this rate was similar to reference values reported by other authors. Our data suggest that the cytometric method applied to a larger number of CSF samples may provide a better understanding of the cell-mediated immune response involved in NC. Cytometry (Comm. Clin.
RESUMO -Estudo prospectivo incluindo 67 pacientes adultos com linfoma não-Hodgkin, considerados segundo o "Working Formulation". A população foi estudada como um todo, quer apresentasse ou não anticorpos anti-HIV no soro. Todos os pacientes foram submetidos a avaliação neurológica e o exame do líquido cefalorraqueano (LCR) foi realizado em 63 deles. Os achados neurológicos e do exame do LCR foram correlacionados. Mostraramse significativas as associações: dor tóraco-lombar localizada e alterações do LCR (presença de células neoplásicas, aumento da concentração proteica e/ou aumento do teor de globulinas gama); anormalidade da força muscular nos membros inferiores e alterações do LCR nos pacientes HIV soro-negativos. Houve correlação entre o aparecimento de sinais de comprometimento dos nervos cranianos III, IV e VI e a detecção de células neoplásicas no LCR.PALAVRAS-CHAVE: linfoma não-Hodgkin, manifestações neurológicas, líquido cefalorraqueano. Neurologic evaluation of non-Hodgkin's lymphoma in adult patients: a prospective studyABSTRACT -This prospective study included 67 adult patients with low, intermediate or high malignancy degrees of non-Hodgkin' s lymphomas according to the Working Formulation. Patients with or without anti-HIV antibodies in the serum were considered. All patients were submitted to neurologic evaluation, and 63 of them to examination of the cerebrospinal fluid (CSF). Patients presenting neurologic signs and symptoms were 42 (62.7%). Neurologic findings and CSF changes were correlated. The association of localized thoraco-lumbar pain and CSF changes (presence of neoplastic cells, increased protein concentration and/or increased gamma globulin content) was statistically significant, as the association of abnormal muscle strength in the lower limbs and CSF changes in patients without HIV antibodies in the serum. Cranial nerve dysfunction (III, IV and VI cranial nerves) correlated with the finding of neoplastic cells in the cerebrospinal fluid.KEY WORDS: non-Hodgkin's lymphoma, neurologic manifestations, cerebrospinal fluid.A elaboração desta pesquisa surgiu do interesse que desperta a relação entre os sistemas nervoso, imunológico e endócrino [1][2][3][4] . Neste contexto podem ser incluídos tanto os linfomas não-Hodgkin (LNH) como neoplasias originadas no sistema imunológico 5 . A oportunidade deste estudo pode creditar-se, pelo menos em parte, ao aumento na incidência desses linfomas com o advento da síndrome da imunodeficiência adquirida (SIDA) 6 .Com o desenvolvimento de terapias mais agressivas e eficazes, houve aumento da sobrevida dos pacientes com neoplasias. Isto passou a exigir participação mais ativa do neurologista. A precisão no diagnóstico é essencial, por permitir estabelecer tratamento adequado e eficaz [7][8][9]
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