Rapid Non-Invasive Diagnosis of Herpes Encephalitis

Klapper, Paul E.; Laing, Ian; Longson, Maurice

doi:10.1016/s0140-6736(81)92744-6

Cited by 111 publications

(38 citation statements)

References 8 publications

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“…It can diffuse from plasma into lung secretions in the same manner as antibodies do. Thus, transudation of antibodies can be estimated by a method previously described to quantify locally produced antibodies in the central nervous system in patients with herpes simplex encephalitis (12) and in the lung mucosa (17,24). Albumin concentrations in BAL and serum were determined by immunoephelometry using a protein analyzer (BN 10; Behringwerke AG, Marburg, Germany).…”

Section: Methodsmentioning

confidence: 99%

Decreased Production of Local Immunoglobulin A toPneumocystis cariniiin Bronchoalveolar Lavage Fluid from Human Immunodeficiency Virus-Positive Patients

Jalil¹,

Moja²,

Lambert³

et al. 2000

Infect Immun

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An enzyme-linked immunosorbent assay and a Western blot analysis were developed to study the antibody response to Pneumocystis carinii in serum and bronchoalveolar lavage fluid from 27 human immunodeficiency virus 27 (HIV)-infected patients with P. carinii pneumonia (Pcp), 32 patients without Pcp, and 51 HIV-negative controls. Urea was used for the correct dilution of epithelial lining fluid, and albumin was used to evaluate transudation from plasma for the assessment of local production of antibodies to P. carinii. By contrast with those of immunoglobulin G (IgG), IgA responses to P. carinii were increased in serum from HIV-positive patients compared to negative controls. Local production of antibodies to P. carinii, especially IgA, was decreased in patients with Pcp. In a study of 10 patients of each group, IgG and IgA responses to gp116 from P. carinii were lower in patients with Pcp than in other groups. These results suggest that, in addition to alveolar macrophages, local antibodies may play a role in host defense against P. carinii.

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Section: Methodsmentioning

confidence: 99%

Decreased Production of Local Immunoglobulin A toPneumocystis cariniiin Bronchoalveolar Lavage Fluid from Human Immunodeficiency Virus-Positive Patients

Jalil¹,

Moja²,

Lambert³

et al. 2000

Infect Immun

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“…A tentative diagnosis of HSV encephalitis can be performed by the demonstration of intrathecally produced anti-HSV antibodies as expressed in an increased ratio of HSV CSF and serum antibodies. By using immunoprecipitation, radioimmunoassay, enzyme-linked immunosorbent assay (ELISA), and immunoblotting, several authors suggested that an increased CSF-toserum antibody ratio is a reliable measure for the diagnosis of HSV encephalitis (5,10,15,20,26,31). By contrast, other authors hypothesized that prolonged antigen stimulation is present in the CNS after acute HSV encephalitis and that serological measurements combined with immunoglobulin and albumin determinations provide only a tentative, not definite, diagnosis (18).…”

mentioning

confidence: 99%

Laboratory Diagnosis of Common Herpesvirus Infections of the Central Nervous System by a Multiplex PCR Assay

et al. 2001

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A sensitive multiplex PCR assay for single-tube amplification that detects simultaneous herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), varicella-zoster virus (VZV), human cytomegalovirus (CMV), and Epstein-Barr virus (EBV) is reported with particular emphasis on how the method was optimized and carried out and its sensitivity was compared to previously described assays. The assay has been used on a limited number of clinical samples and must be thoroughly evaluated in the clinical context. A total of 86 cerebrospinal fluid (CSF) specimens from patients which had the clinical symptoms of encephalitis, meningitis or meningoencephalitis were included in this study. The sensitivity of the multiplex PCR was determined to be 0.01 and 0.03 50% tissue culture infective doses/the reciprocal of the highest dilution positive by PCR for HSV-1 and HSV-2 respectively, whereas for VZV, CMV and EBV, 14, 18, and 160 ag of genomic DNA were detected corresponding to 48, 66, and 840 genome copies respectively. Overall, 9 (10.3%) of the CSF samples tested were positive in the multiplex PCR. HSV-1 was detected in three patients (3.5%) with encephalitis, VZV was detected in four patients (4.6%) with meningitis, HSV-2 was detected in one neonate (1.16%), and CMV was also detected in one neonate (1.16%). None of the samples tested was positive for the EBV genome. None of the nine positive CSF samples presented herpesvirus coinfection in the central nervous system. Failure of DNA extraction or failure to remove any inhibitors of DNA amplification from CSF samples was avoided by the inclusion in the present multiplex PCR assay of ␣-tubulin primers. The present multiplex PCR assay detects simultaneously five different herpesviruses and sample suitability for PCR in a single amplification round of 40 cycles with an excellent sensitivity and can, therefore, provide an early, rapid, reliable noninvasive diagnostic tool allowing the application of antiviral therapy on the basis of a specific viral diagnosis. The results of this preliminary study should prompt a more exhaustive analysis of the clinical value of the present multiplex PCR assay.

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“…The presence of antibody in the CSF detected by indirect immunofluoresence has been strongly associated with encephalitis and is rarely found in patients lacking neurological involvement (Gershon et al, 1980). In an attempt to distinguish local antibody production within the central nervous system (CNS) from that due to diffusion across the blood/CSF barrier an index has been described, (Klapper et al, 1981). In herpes simplex encephalitis a value above 1.9 is diagnostic.…”

Section: Discussionmentioning

confidence: 99%

A case of herpes zoster associated encephalitis with rapid response to acyclovir

Cheesbrough

Finch

Ward

1985

Postgraduate Medical Journal

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Rapid Non-Invasive Diagnosis of Herpes Encephalitis

Cited by 111 publications

References 8 publications

Decreased Production of Local Immunoglobulin A toPneumocystis cariniiin Bronchoalveolar Lavage Fluid from Human Immunodeficiency Virus-Positive Patients

Decreased Production of Local Immunoglobulin A toPneumocystis cariniiin Bronchoalveolar Lavage Fluid from Human Immunodeficiency Virus-Positive Patients

Laboratory Diagnosis of Common Herpesvirus Infections of the Central Nervous System by a Multiplex PCR Assay

A case of herpes zoster associated encephalitis with rapid response to acyclovir

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