Research

Intrathecal synthesis of IgE in children with eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis

Barbara Padilla-Docal , Alberto J Dorta-Contreras , Raisa Bu-Coifiu-Fanego , Hermes Fundora Hernández , Jesús Callol Barroso and Consuelo Sanchez-Martinez

Central laboratory of CSF (LABCEL), Faculty of Medical Sciences "Dr Miguel Enríquez", Superior Institute of Medical Sciences of Havana, Section 10049, 11000 CP Havana City, Cuba

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Cerebrospinal Fluid Research 2008, 5:18doi:10.1186/1743-8454-5-18

Published:	25 November 2008

Abstract

Background

Eosinophilic meningoencephalitis caused by the helminth Angiostrongylus cantonensis, is an emerging infectious disease in America. The objective of this paper was to determine if the intrathecal synthesis of immunoglobulin E is produced during the acute phase of the disease.

Methods

Thirteen patients, mean age 4.5 years were studied; a diagnostic lumbar puncture was performed and serum samples taken. Immunoglobulin E (IgE) in serum and in cerebrospinal fluid (CSF) was quantified by nephelometry. Control patients had other infections or other neurological diseases.

Results

The mean cell count in the CSF was 500 × 10^-6 cells/L and of these 23% were eosinophils. In blood the eosinophils were 13%. The chief symptoms of the patients were migraine, vomiting and fever and 50% presented some meningeal signs. IgE intrathecal synthesis analyzed by the corresponding quotient diagram (Reibergram) was observed in all patients. No intrathecal IgE synthesis was seen in control patients.

Conclusion

Intrathecal synthesis of IgE demonstrates the participation of this immunoglobulin in the destruction of the third stage larvae of the parasite in the CSF. The test should be considered in our environment as a tool to aid diagnosis.