Neurotoxoplasmosis and aids cerebrospinal, fluid analysis in 96 patients: estudo do líquido cefalorraqueano em 96 pacientes

Machado, L. R.; Livramento, J. A.; Spina -França, A.

doi:10.1590/S0004-282X1992000400013

Abstracts

The behavior of CSF inflammatory pattern in patients with AIDS and/or toxoplasmosis of the CNS is studied in 176 patients, divided in three groups. In the first group, 96 patients with toxoplasmosis and AIDS are considered; in the second group, 50 patients with toxoplasmosis without AIDS; in the third group, 30 AIDS patients without toxoplasmosis nor any other opportunistic infection. It is possible to conclude that patients with toxoplasmosis associated to AIDS exhibit CSF inflammatory pattern similar to patients with neurotoxoplasmosis without AIDS, except in respect to gamma globulin rates for which a cumulative effect can be detected.

toxoplasmosis; central nervous system; cerebrospinal fluid; acquired immunodeficiency syndrome

Foram estudados 176 pacientes com o objetivo de avaliar o comportamento da reação inflamatória no líquido cefalorraqueano (LCR) de pacientes com toxoplasmose do sistema nervoso central (SNC). Foram considerados três grupos de pacientes: o primeiro com toxoplasmose do SNC associada à síndrome de imunodeficiência adquirida (AIDS), com 96 pacientes; o segundo, com toxoplasmose, sem AIDS, com 50 pacientes; o terceiro, apenas com AIDS, sem qualquer infecção oportunista, com 30 pacientes. Verificou-se que o comportamento da reação inflamatória da toxoplasmose do SNC estudada pelo exame de LCR predomina sobre as características de base da AIDS, excepto no que diz respeito aos teores de globulinas gama; para estas, parece haver efeito cumulativo das duas patologias.

toxoplasmose; sistema nervoso central; líquido cefalorraqueano; síndrome de imunodeficiência adquirida

Neurotoxoplasmosis and aids cerebrospinal, fluid analysis in 96 patients

Neurotoxoplasmose e AIDS: estudo do líquido cefalorraqueano em 96 pacientes

L. R. Machado^I; J. A. Livramento^I; A. Spina -França^II

^IAssistant Professor. CIN (Neurology Investigation Center, Departament of Neurology, Faculty of Medicine, São Paulo University) / LSF (Neurodiagnostic Laboratory)

^IIEmeritus Professor. CIN (Neurology Investigation Center, Departament of Neurology, Faculty of Medicine, São Paulo University) / LSF (Neurodiagnostic Laboratory)

SUMMARY

The behavior of CSF inflammatory pattern in patients with AIDS and/or toxoplasmosis of the CNS is studied in 176 patients, divided in three groups. In the first group, 96 patients with toxoplasmosis and AIDS are considered; in the second group, 50 patients with toxoplasmosis without AIDS; in the third group, 30 AIDS patients without toxoplasmosis nor any other opportunistic infection. It is possible to conclude that patients with toxoplasmosis associated to AIDS exhibit CSF inflammatory pattern similar to patients with neurotoxoplasmosis without AIDS, except in respect to gamma globulin rates for which a cumulative effect can be detected.

Key words: toxoplasmosis, central nervous system, cerebrospinal fluid, acquired immunodeficiency syndrome.

RESUMO

Foram estudados 176 pacientes com o objetivo de avaliar o comportamento da reação inflamatória no líquido cefalorraqueano (LCR) de pacientes com toxoplasmose do sistema nervoso central (SNC). Foram considerados três grupos de pacientes: o primeiro com toxoplasmose do SNC associada à síndrome de imunodeficiência adquirida (AIDS), com 96 pacientes; o segundo, com toxoplasmose, sem AIDS, com 50 pacientes; o terceiro, apenas com AIDS, sem qualquer infecção oportunista, com 30 pacientes. Verificou-se que o comportamento da reação inflamatória da toxoplasmose do SNC estudada pelo exame de LCR predomina sobre as características de base da AIDS, excepto no que diz respeito aos teores de globulinas gama; para estas, parece haver efeito cumulativo das duas patologias.

Palavras-chave: toxoplasmose, sistema nervoso central, líquido cefalorraqueano, síndrome de imunodeficiência adquirida.

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Dr. Luís dos Ramos Machado Caixa Postal 5199 - 01061-970 São Paulo SP - Brasil.

1. Bishburg E, Eng RHK, Slim J, Perez G, Jonhson E. Brain lesions in patients with acquired immunodeficientcy syndrome. Arch Intern Med 1989, 149:941-943.
2. Conley FK, Jenkins KA, Remington JS. Toxoplasma gondii infection of the central nervous system. Hum Pathol 1981, 12:690-698.
3. Gill PS, Graham RA, Boswell W, Meyer P, Krailo M, Levine AM. A comparison of imaging, clinical, and pathologic aspects of space-occupying lesions within the brain in patients with acquire immune deficiency syndrome. Am J Physiol Imag 1986:134-141.
4. Kass EH, Andrus SB, Adams RD, Turner FC, Feldman HA. Toxoplasmosis in the human adult. Arch Intern Med 1952, 89:759-782.
5. Levy RM, Bredesen DE, Rosemblum ML. Opportunistic central nervous system pathology in patients with AIDS. Ann Neurol 1988, 23 (Suppl) :S7-S12.
6. Livramento JA, Machado LR, Spina-França A. Anormalidades do liquido cefalorraqueano em 170 casos de AIDS. Arq Neuro-Psiquiat (São Paulo) 1989, 47:326-331.
7. Livramento JA, Machado LR, Gomes HR, Vianna LS, Spina-França A. AIDS: a CSF laboratory experience on 470 cases in a seven year time period. Arq Neuro-Psiquiat (São Paulo) 1992, 50:56-59.
8. Nolla-Salas J, Ricart C, Dolhaberriague D, Galli F, Lamarca J. Hydrocephalus: an unusual CT presentation of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome. Eur Neurol 1987, 27:130-132.
9. Potasman I, Resnick L, Luft BJ, Remington JS. Intrathecal production of antibodies against Toxoplasma gondii in patients with toxoplasmatic encephalitis and the acquired immunodeficiency syndrome (AIDS). Ann Interm Med 1988, 108:49-51.
10. Sabin A. Toxoplasmic encephalitis in children. JAMA 1941, 116:801-814.
11. Tognetti F, Galassi E, Gaist G. Neurological toxoplasmosis presenting as a brain tumor. J Neurosurg 1982, 56:716-721.

Publication Dates

Publication in this collection
22 Feb 2011
Date of issue
Dec 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Bishburg E, Eng RHK, Slim J, Perez G, Jonhson E. Brain lesions in patients with acquired immunodeficientcy syndrome. Arch Intern Med 1989, 149:941-943.

[2] 2. Conley FK, Jenkins KA, Remington JS. Toxoplasma gondii infection of the central nervous system. Hum Pathol 1981, 12:690-698.

[3] 3. Gill PS, Graham RA, Boswell W, Meyer P, Krailo M, Levine AM. A comparison of imaging, clinical, and pathologic aspects of space-occupying lesions within the brain in patients with acquire immune deficiency syndrome. Am J Physiol Imag 1986:134-141.

[4] 4. Kass EH, Andrus SB, Adams RD, Turner FC, Feldman HA. Toxoplasmosis in the human adult. Arch Intern Med 1952, 89:759-782.

[5] 5. Levy RM, Bredesen DE, Rosemblum ML. Opportunistic central nervous system pathology in patients with AIDS. Ann Neurol 1988, 23 (Suppl) :S7-S12.

[6] 6. Livramento JA, Machado LR, Spina-França A. Anormalidades do liquido cefalorraqueano em 170 casos de AIDS. Arq Neuro-Psiquiat (São Paulo) 1989, 47:326-331.

[7] 7. Livramento JA, Machado LR, Gomes HR, Vianna LS, Spina-França A. AIDS: a CSF laboratory experience on 470 cases in a seven year time period. Arq Neuro-Psiquiat (São Paulo) 1992, 50:56-59.

[8] 8. Nolla-Salas J, Ricart C, Dolhaberriague D, Galli F, Lamarca J. Hydrocephalus: an unusual CT presentation of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome. Eur Neurol 1987, 27:130-132.

[9] 9. Potasman I, Resnick L, Luft BJ, Remington JS. Intrathecal production of antibodies against Toxoplasma gondii in patients with toxoplasmatic encephalitis and the acquired immunodeficiency syndrome (AIDS). Ann Interm Med 1988, 108:49-51.

[10] 10. Sabin A. Toxoplasmic encephalitis in children. JAMA 1941, 116:801-814.

[11] 11. Tognetti F, Galassi E, Gaist G. Neurological toxoplasmosis presenting as a brain tumor. J Neurosurg 1982, 56:716-721.