Immunoglobulin pattern in cerebrospinal fluid of patients with acute arterial meningitis

ABSTRACT

This study was carried out on 18 patients having symptoms and signs of meningitis. They were selected from Abbasia fever hospital. Their ages ranged between 3 mo and 10 yr [mean = 8.70 +/- 1.30 yr]. The aim of this study was to perform quantitative assay of IgA, IgM and IgG in the CSF of those patients and to find out a relationship between these levels and the type and severity of infection. All studied patients were subjected to history taking, physical and neurological examination and CSF examination including Gram's and Z.N. stains, culture and cytological and chemical analysis. The levels of IgA, IgM and lgG in CSF were determined using Single Radial Immunodiffusion [SRID] plates. Patients were classified into [1] Group I which comprised 10 culture-positive cases and [2] Group II which comprised 8 culture negative cases. Group II was further subdivided into two subgroups namely; [A] Group IIA with normal CSF glucose and [B] Group IIB with low CSF glucose. Culture negative cases were considered to be due to aspectic or partially treated meningitis. CSF IgM was significantly higher in group I when compared with group II. Also, it was significantly higher in group IIB compared to group IIA indicating that increased CSF IgM is more common in bacterial than in aseptic or partially treated meningitis. Also, out of the 3 cases who died in group 1, 2 cases had increased CSF IgM indicating that increased CSF IgM might be associated with bad prognosis. On the other hand, the 3 immunoglobulins increased in the CSF of 30% of culture - positive cases which might reflect marked disruption of blood brain barrier. In conclusion, extermination of immunoglobulin levels in CSF of patients suspected to have meningitis may be valuable in diagnosis and prognosis. However, further studies on a larger number of patients is recommended in order to get more accurate and reliable results: