RESUMO
To study the immune response within the subarachnoid space in patients with neurocysticercosis, we measured the cerebrospinal fluid contents of immunoglobulins A, E, G, and M in 38 patients and the contents of the proinflammatory cytokines TNF-alpha, IL-1b, IL-6 and IFN-gamma in 17 patients. The same measurements were made in 30 neurological patients without inflammatory or immune-mediated disorders. Each immunoglobulin and cytokine, including the gender and age of the patient, was compared by multiple regression analysis with the CSF contents of cells, protein and ELISA for cysticercal antigens. A direct correlation was found of IgM with cell content (p<0.058) and with ELISA values (p<0.027); of age with protein content (p<0.006); of IL-6 with protein content (p<0.018) and of IL-1b with ELISA values (p<0.004). An inverse correlation was found of glucose with ELISA values (p<0.008). A complex function of the immune response within the subarachonid space was observed: mean values of IgG, IgM, IgE and interleukins 1b and 6 were increased, whereas values of IgA, TNF-alpha and IFN-gamma were similar to those of controls
Assuntos
Humanos , Aracnoidite/fisiopatologia , Cisticercose/fisiopatologia , Ensaio de Imunoadsorção Enzimática , Formação de Anticorpos/fisiologia , Sistema Imunitário/citologia , Imunidade Celular/fisiologia , Imunoglobulinas/fisiologia , Interleucinas/imunologia , Líquido Cefalorraquidiano/química , Espaço Subaracnóideo/fisiologia , Fator de Necrose Tumoral alfa/fisiologiaRESUMO
La aracnoiditis espinal es un proceso inflamatorio que afecta las leptomeninges. Realizamos una revisión en la literatura de los diferentes métodos de imagen con los que se cuenta para el diagnóstico de la aracnoiditis espinal; presentamos dos pacientes, uno con cisticercosis, y otro con tuberculosis. Estos dos agentes etiológicos son frecuentes en nuestro medio a nivel intracraneal; en ellos describimos los hallazgos encontrados en la aracnoiditis; como son: engrosamiento de las meninges, engrosamiento de las raqices nerviosas, atrapamiento radicular en las meninges engrosadas, masa de tejidos blandos y bloqueo parcial o completo del espacio subaracnoideo raquídeo. Se concluyó que la Resonancia Magnética es el método ideal para estudiar los procesos inflamatorios intrarquídeos, pero la mielografía y la mielotomografía no han perdido su valor complementario para el diagnóstico de la eracnoiditis espinal.