Sociedad Española de Ginecología y Obstetricia (S.E.G.O.)

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Quantitation of C-reactive protein in cerebrospinal fluid and serum by zone immunoelectrophoresis assay (ZIA).

The zone immunoelectrophoresis assay (ZIA) for C-reactive protein (CRP) determinations is easy to perform and requires only small amount of antiserum, e.g., 25-100 and 0.5-1.0 microliter anti-CRP antibody/20 serum and CSF samples, respectively. For quantitating CSF-CRP the immunoprecipitates formed were stained using alkaline phosphatase-conjugated secondary antibodies and the lowest standard concentration used was 30 micrograms/l. The immunoprecipitates formed when measuring CRP in serum were stained by Coomasie brilliant blue R250 with a detection limit of about 300 micrograms/l. CRP was determined in cerebrospinal fluid in 27 patients with bacterial meningitis (range less than 0.03-23.0 mg/l) and in 25 patients with viral meningitis (range less than 0.03-0.23 mg/l). CRP was quantitated in 52 sera by both the CRP ZIA method (y) and by electroimmunoassay (x). The correlation coefficient was r = 0.992 with the regression line y = 1.024 x + 0.855.

Evaluation of three qualitative tests for detection of chloroquine in urine--agreement with plasma concentrations determined with liquid chromatography.

Three qualitative tests for detection of chloroquine in urine were compared and evaluated against concomitant plasma concentrations determined with liquid chromatography. All urine tests from five volunteers taking a single dose of 5 mg chloroquine base kg-1 were positive for at least ten days with the Haskins test, and for at least three days with the Wilson Edeson test. Even on the first day, the Dill-Glazko test indicated chloroquine in the urine of one volunteer only. After a single dose of 10 mg kg-1 to five other volunteers the Haskins test was uniformly positive for 14 days while the Wilson Edeson test was positive for four days. The Dill-Glazko test was positive for one day only. No false negative results were obtained with the Haskins test when plasma concentrations were above 0.03 mumol 1(-1), as compared to 0.11 mumol 1(-1) with the Wilson Edeson test. The Dill-Glazko test was uniformly positive when plasma concentrations were above 0.38 mumol 1(-1). The Dill-Glazko test was affected by low urinary pH and by addition of erythrocytes to urine. We conclude that the Dill-Glazko test should not be used.

Whole blood concentrations of chloroquine and desethylchloroquine during and after treatment of adult patients infected with Plasmodium vivax, P. ovale or P. malariae.

Whole blood concentrations of chloroquine and desethychloroquine were determined during and after chloroquine treatment of 15 adult patients infected with P. vivax, P. ovale or P. malariae. The median of chloroquine concentrations remained practically unchanged in samples drawn three hours after initiation of treatment and in samples drawn immediately before the next dose of chloroquine. Concentrations of chloroquine remained above 1.0 mumol/litre for at least four days. The calculated sum of chloroquine and desethylchloroquine concentrations was above 1.0 mumol/litre for at least seven days. These concentrations are regarded as sufficient for treatment of P. vivax, P. ovale and P. malariae infections.

Creatine kinase isoenzyme BB in cerebrospinal fluid from patients with meningitis and encephalitis.

High CK BB isoenzyme activity has been demonstrated in the CSF of many patients with various neurologic disorders and is considered to reflect brain tissue damage [1, 2]. Increased CK BB activity in the CSF has been described in a patient with fatal pneumonococcal meningitis [3] and also in two patients with viral encephalitis [1]. Since routine laboratory tests are of limited value for assessing the prognosis of patients with CNS infections, the present investigation was undertaken to study the possibility of early detection of brain tissue damage in such patients by determining the CK BB activity in the CSF. The CK BB activity in the control subjects was less than or equal to 10 nkat/liter, which is in accordance with a previous study based on bioluminescence assay [2]. Six of the seven patients with neurologic complications in the present study had marked increases of the CK BB activity. In the patient with brain death due to HSV infection, serial measurements of the CK BB activity in the CSF have shown a maximal fourfold increase from the value of 45 nkat/liter found on admission. In one of the patients with purulent meningitis who developed a slight hydrocephalus, the CK BB activity was normal, but no focal brain damage was found by computed tomography in this case. The results indicate that increased CK BB activity in the CSF is related to the clinical outcome of patients with infections of the CNS. Thus, the determination of the CK BB activity seems to be useful for assessing the prognosis of patients with bacterial and viral meningitis and encephalitis.