ABSTRACT
We evaluated the diagnostic clinical performance characteristics (DCPC) of cerebrospinal fluid (CSF) total protein (TP), white blood cell count (WBC), and lactate (LA) with different cutoff points as adjunct biomarkers of confirmed or presumptive symptomatic neurosyphilis (NS) and the impact of HIV infection. From 5,640 participants who underwent lumbar punctures, 236 participants were included, and classified as either people with HIV (PWH) or people without HIV (PWoH) according to the CDC criteria for confirmed NS (n = 42), presumptive NS (n = 74), systemic syphilis (SS) (n = 38), serological diagnosis of syphilis (n = 18), PWH without SS and NS (n = 10), and negative control (n = 72). In PWoH, for presumptive NS, the combination of CSF TP > 45 mg/dL and/or WBC > 5.0 cells/mm3 is valuable for screening, whereas in PWH, it is not recommended for either screening or case-finding NS, however the DCPC were better in the suppressed group. In PWoH, the value of CSF TP > 45 mg/dL is adequate for both screening and confirmation of presumptive NS, subject to prevalence. For WBC count > 20 cell/mm3, the positive predictive value (PPV) of the test is almost perfect, suggesting a confirmatory test. In PWH, CSF TP is an inadequate marker of NS. The WBC count, with cutoffs of > 10 or > 20 cells/mm3, was moderately applicable for screening.As conclusions: CSF WBC count and TP showed distinct DCPC in confirmed or presumptive NS, better in the former. These biomarkers could be included for presumptive NS diagnosis. DCPC of these biomarkers for the diagnosis of NS is greatly affected by HIV co-infection.
ABSTRACT
Presentamos 6 casos de quiste de colédoco diagnosticados por Pancreatocolangiografía Retrograda Endoscópica (PCRE), las edades de los pacientes fueron 12, 13, 17, 20, 29 y 36 años, 5 pacientes fueron de sexo femenino y 1 de sexo masculino, el síntoma principal fue dolor abdominal. La Pancreatocolangiografía Retrógrada Endoscópica demuestra detalles anatómicos de los conductos biliares, pacreático y unión pancreático biliar que permite tomar actitudes de manejo quirúrgico o endoscópico adecuadas.
We presented six cases of choledochal cysts all of which were diagnosed by ERCP. Patients were 12,13, 17,20, 29 and 36 years old. Five were female and one was a male. The main symptom was abdominal pain. The Endoscopic Retrograde Cholangiopancreatograplty showed the anatomic details of the biliary tree and the pancreaticobiliary ductal junction and also allowed us to decide the adecuate management of the patient.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Cholangiopancreatography, Endoscopic Retrograde , Choledochal Cyst , Choledochal Cyst/diagnosisABSTRACT
We presented six cases of choledochal cysts all of whichwere diagnosed by ERCP. Patients were 12,13,17,20,29 and 36 years old. Five were female and one was a male. The main symptom was abdominal pain.The Endoscopic Retrograde Cholangiopancreatography showed the anatomic details of the biliary tree and the pancreaticobiliary ductal junction and also allowed us to decide the adecuate management of the patient.
