Meningorradiculite esquistossomótica estudo clínico-laboratorial de três casos tratados

Filho, Antônio de Souza Andrade; Queiroz, Adriano

doi:10.1590/s0004-282x1991000100012

Cited by 6 publications

(2 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 Although advances in clinical, laboratory, and radiologic technology have improved the ability to diagnose NS, the validity of serologic tests in diagnosing NS is still controversial. 2,10,11,[15][16][17][18][19][20][21] Although some investigators have used the ELISA to quantify antibodies in CSF, these investigations evaluated only reactivity to antibodies against SEA. 2,15,16 In our study, 55% of the CSF samples were reactive to SEA (26% were reactive only to SEA and 29% to both SEA and SWAP), 34% were reactive to SWAP (5% only to SWAP and 29% to both SEA and SWAP), and 40% were not reactive to any antigen.…”

Section: Discussionmentioning

confidence: 99%

“…There have been few investigations of the serology of patients with NS, and most were limited to the search for antibodies in the cerebrospinal fluid (CSF) of patients with myeloradiculopathy. [9][10][11][12] Serologic techniques such as complement fixation, immunofluorescence, Western blotting, and enzyme-linked immunosorbent assay (ELISA) have been used, but none have yet achieved sufficient levels of sensitivity and specificity to justify their consideration as gold standard techniques. 2,[13][14][15][16] The main objective of this investigation was to verify the existence of specific antibodies against S. mansoni soluble egg antigen (SEA) and soluble worm adult preparation (SWAP) in the CSF of patients suspected of having NS without a history of a disease that could disrupt the blood-brain barrier.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antibodies to Schistosoma Mansoni in Human Cerebrospinal Fluid

Magalhães-Santos

Lemaire²,

Andrade-Filho³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Cerebrospinal fluid (CSF) and serum samples from patients suspected of having neuroschistosomiasis (NS) were evaluated by an enzyme-linked immunosorbent assay. Monoclonal antibodies of various immunoglobulin isotypes (IgM, IgA, IgE, total IgG, IgG1, IgG2, IgG3, and IgG4) were used to detect antibodies against Schistosoma mansoni soluble egg antigen (SEA) and soluble worm adult preparation (SWAP). Of the 83 CSF samples tested, 55% were reactive to SEA (26% were reactive only to SEA and 29% to both SEA and SWAP), 34% were reactive to SWAP (5% only to SWAP and 29% to both SEA and SWAP), and 40% were not reactive with any antigen. Cases that tested positive for SWAP in CSF and negative in serum were not found. Samples with high specific IgG antibody titers were selected for immunoglobulin isotype profiling. In the CSF samples, the antibodies against SEA and SWAP were mainly IgM, IgG1, and IgG4, although other immunoglobulins were also detected. Interestingly, nine patients had high levels of IgG1 only in the CSF. These results suggest that there is local synthesis of IgG1, and that this isotype could be an important immunologic marker in the diagnosis of NS.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antibodies to Schistosoma Mansoni in Human Cerebrospinal Fluid

Magalhães-Santos

Lemaire²,

Andrade-Filho³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

The value of an enzyme-linked immunosorbent assay for the diagnosis of schistosomiasis mansoni myeloradiculopathy

Ferrari

Moreira

Correa-Oliveira

et al. 1995

Transactions of the Royal Society of Tropical Medicine and Hygi

View full text Add to dashboard Cite

The role of serological tests on cerebrospinal fluid (CSF) in the diagnosis of neuroschistosomiasis has not been fully elucidated; the condition is essentially diagnosed on the basis of circumstantial evidence, which may lead to an erroneous diagnosis, especially in highly endemic areas. We therefore carried out a prospective case-control study in which we compared the concentrations of immunoglobulin G (IgG) specific for schistosome soluble egg antigen (SEA) present in the CSF of 54 patients with schistosomiasis mansoni myeloradiculopathy (SMMR) with those observed in a control group consisting of 41 patients with epidemiological and serological evidence of exposure to schistosomes, and with other neurological disorders that result in mild to moderate impairment of the blood-brain barrier. Anti-SEA IgG was estimated by an enzyme-linked immunosorbent assay. The sensitivity, specificity and positive and negative predictive values were 56%, 95%, 94% and 62% respectively. Likelihood ratios and the corresponding post-test probabilities were determined for 4 levels of anti-SEA IgG in CSF. A value below 0.1 micrograms/mL practically excluded the possibility of SMMR (post-test probability < 5%), a value above 1.4 micrograms/mL practically confirmed the diagnosis of SMMR (post-test probability > 96%), values of 0.1 to 0.5 microgram/mL had no diagnostic value (post-test probability approximately 45%), and values of 0.6 to 1.4 micrograms/mL were useful in some situations (post-test probability approximately 70%). We conclude that the estimation of anti-SEA IgG in the CSF is useful for the diagnosis of SMMR.

show abstract

Spinal Cord Schistosomiasis: A Report of 2 Cases and Review Emphasizing Clinical Aspects

Ferrari

1999

Medicine

View full text Add to dashboard Cite

Schistosomal myeloradiculopathy (SMR) is a severe and little known form of presentation of schistosomiasis mansoni and hematobic schistosomiasis. The literature concerning the entity is scarce, and most publications are limited to isolated case reports. Thus, to consolidate and analyze the knowledge currently available about the disease, I reviewed 231 cases, with emphasis on clinical aspects. Although variations occur, in most cases the clinical picture of SMR is highly suggestive in individuals with epidemiologic antecedents of the infection. Thus, a patient with SMR is usually a young male with no other manifestations of schistosomal infection who presents with lumbar pain, often of a radicular nature, soon followed by weakness and sensory loss of rapid progression in the lower limbs associated with autonomic dysfunction, particularly bladder dysfunction. The most suggestive elements of the entity, and therefore of higher diagnostic value, are the low localization of the spinal cord lesion, the acute or subacute onset of the disease, and the association of manifestations due to medullary and radicular involvement. SMR is commonly classified into clinical or anatomoclinical forms. However, I observed no consensus in this classification even in terms of the terminology used. The analysis performed in this review permitted the introduction of a new concept not yet reported in the literature regarding the possibility that the disease consists of a continuous spectrum, with asymptomatic egg laying in the spinal cord at 1 end of the spectrum and devastating forms at the other end, with most cases occupying an intermediate position and with the various types of damage overlapping and associated to different degrees. This concept applies not only to different patients but also to the same patient at different stages of the disease. Chemical and cytomorphologic examination of cerebrospinal fluid (CSF) almost always revealed mildly or moderately increased total protein concentration and predominantly lymphocytic pleocytosis. Eosinophils, the least nonspecific finding, were detected in the CSF of less than half (40.8%) the patients. Myelography and computed tomography-myelography were altered in 63.3% of cases, but this proportion may be an overestimate. The most frequent changes were images of a filling defect due to expansion of the spinal cord and were almost always demonstrated by the 2 imaging modalities. Although still few in number, early reports suggest that magnetic resonance imaging is more sensitive; however, the changes are also nonspecific, such as those revealed by myelography and computed tomography-myelography. Parasite eggs were demonstrated frequently in a biologic specimen (88.3%), but difficulty in detection was not uncommon. Peripheral blood eosinophilia was detected in 64.5% of patients and represented a nonspecific finding. The detection of anti-Schistosoma antibodies in the serum or CSF was also frequent (94.9% and 84.8%, respectively). The presence of anti-Schistosoma antibodies in serum is of li...

show abstract

Meningorradiculite esquistossomótica estudo clínico-laboratorial de três casos tratados

Cited by 6 publications

References 9 publications

Antibodies to Schistosoma Mansoni in Human Cerebrospinal Fluid

Antibodies to Schistosoma Mansoni in Human Cerebrospinal Fluid

The value of an enzyme-linked immunosorbent assay for the diagnosis of schistosomiasis mansoni myeloradiculopathy

Spinal Cord Schistosomiasis: A Report of 2 Cases and Review Emphasizing Clinical Aspects

Contact Info

Product

Resources

About