Local IgG synthesis in three pediatric patients with cuban epidemic neuropathy

Abstract

ABSTRACT-Three pediatric patients with Cuban epidemic neuropathy were studied. Cerebrospinal fluid and sera were simultaneously obtained. Albumin and IgG were quantified by immunodifusion. Albumin quotient and local synthesis of IgG were calculated by Reiber/Felgenhauer formula. A patient with optic neuritis had a dysfunction of the blood-cerebrospinal fluid barrier. All the group had local synthesis of IgG.KEY WORDS: Cuban epidemic neuropathy, optic neuritis, peripheral neuropathy, cerebrospinal fluid, intrathecal synthesis. Sintesis local de IgG en tres pacientes pediátricos com neuropatía epidêmica cubanaRESUMEN -Se estudiaron tres pacientes pediátricos con neuropatia epidêmica cubana. Se obtuvieron suero y liquido cefalorraquídeo simultaneamente. Se cuantificaran los niveles de albúmina e IgG por inmunodifusion radial. Se calculo la razón albúmina y la fórmula de Reiber/Felgenhauer. Un paciente con neuritis óptica tuvo una disfunción de la barrera sangre-líquido cefaloraquídeo. Todo el grupo tuvo síntesis local de IgG.PALABRAS CLAVES: neuropatía epidêmica cubana, neuritis óptica, neuropatía periférica, líquido cefalorraquídeo, IgG, albúmina, síntesis intratecal.The etiology of the Cuban epidemic neuropathy (CEN) remains unknown. PAHO's report 4,5 has described it as being of multifactorial etiology, whereas involvement of nutritional deficit in combination with a neurotoxic and/or viral factor has been evoked.The aim of this paper is to present the evidence of the intrathecal IgG synthesis in three pediatric patients with CEN. PATIENTSSera and cerebrospinal fluid (CSF) from three pediatric patients suffering from symptoms of CEN were taken. The diagnosis of CEN was made by clinical criteria according to PAHO's Expert Committee. CEN has two main presentations: the first one, an optic neuritis and a second form as peripheral neuropathy. Optic neuritis is retrobulbar, the optic nerve head appears normal. The visual acuity is decreased, and there is abnormal color perception, an afferent pupillary defect, and always a central scotoma. Peripheral neuropathy produces a motor neuropathy with mild sensory impairment. The distribution of symmetrical distal weakness, with foot drop or wrist drop, paresthesias in the feet and legs. Sensation is decreased and the tendon reflexes are depressed. Cranial nerve involvement is unusual and the CSF protein content is normal, helping to differentiate from Guillain-Barre's syndrome.

sICAM-1 intrathecal synthesis and release during the acute phase in children suffering from Coxsackie A9 and S. pneumoniae meningoencephalitis

“…All cases of Coxsackie A9 and S. pneumoniae meningonencephalitis showed typical results on the routine CSF/serum analysis [4][5][6][7][8][9] ; increased CSF total protein with increased Q albumin in the majority of the cases with bac- Q albumin is a marker of the blood-CSF dysfunction. Mean Q albumin in GBS and in S. pneumoniae shown significative differences as compared with controls.…”