Immunoglobulin‐Producing Cells in Blood and Cerebrospinal Fluid during the Course of Aseptic Meningoencephalitis

Abstract

The protein A plaque assay was used to quantitate the number of IgG-, IgA-, and IgM-producing cells per 20 X 10(3) lymphocytes in cerebrospinal fluid (CSF) and peripheral blood (PB) from 23 patients with aseptic meningoencephalitis (AM) in the acute stage 1-10 days after onset (group I) and during late convalescence after 19-38 days (group II) and in PB from healthy controls. In the acute stage, IgG- and IgM-producing cells were found with significantly higher frequency in both CSF and PB than in the late convalescence. In both patient groups there were more Ig-producing cells in PB than in CSF. The predominant Ig class in PB of AM patients was IgA, just as in healthy individuals. In CSF, IgA- and IgG-producing cells predominated at similar frequencies. In the group I patients, there were positive correlations between numbers of Ig-producing cells of each class and the corresponding CSF Ig index, an indicator of intrathecal Ig synthesis. Since high numbers of Ig-producing cells could be found in CSF that was otherwise normal, enumeration of Ig-producing cells is considered a more sensitive indicator of the immune response intrathecally than measurement of free Igs.

Diagnostic significance of IgG-synthesizing activated B cells in acute inflammatory diseases of the central nervous system

“…Though the mechanisms that influence the intrathecal B cell activation are currently only poorly understood, the demonstration of IgG-synthesizing cells in CSF has become an important diagnostic criterion, since up to now these cells have been found exclusively in inflammatory diseases of the CNS (Sch/idlich et al 1980; Forsberg and Kam-Hansen 1983;Schfidlich et al 1984). In cases with acute viral or bacterial meningitis without any local IgG synthesis, the detection of activated B cells is an especially reliable parameter for the inflammatory nature of the disease.…”

Appearance of antibodies to two viruses in cerebrospinal fluid of patients with aseptic meningitis

“…The detection of antibodies in cerebrospinal fluid (CSF) to herpes simplex virus (HSV) is one of the important criteria for the diagnosis of herpes simplex virus encephalitis (8,9). Recently, some authors have proposed prospective methods for early diagnosis of infections of the CNS (10,11). This paper reports 2 cases of aseptic meningitis with simultaneous presence of antibodies to the lymphocytic choriomeningitis (LCM) and mumps viruses.…”