Adenosino-deaminase no líquido celalorraqueano de pacientes com a síndrome da imunodeficiência adquirida

Machado, Luís Dos Ramos; Livramento, José Antonio; Spina-França, Antonio

doi:10.1590/S0004-282X1995000500007

Resumos

A determinação da atividade enzimática da adenosino-deaminase (ADA) no líquido cefalorraqueano (LCR) de pacientes com síndrome da imunodeficiência adquirida (AIDS) pode sinalizar, ainda que de modo inespecífico, a atividade de patologias associadas. Os níveis de atividade de ADA, estudados no LCR de 263 pacientes, estavam aumentados naqueles com patologias associadas em relação aos controles normais e em relação aos pacientes com AIDS que não apresentam alterações ao exame de LCR. No entanto, os níveis de ADA detectados no LCR não apresentaram diferença estatística ao se considerarem os seguintes grupos de pacientes distribuídos segundo os achados no próprio LCR: com anticorpos para toxoplasmose, sífilis ou citomegalovírus; com C. neoformans ou seus antígenos; com bacilos álcool-ácido-resistentes; com linfomas.

adenosino-deaminase; líquido cefalorraqueano; AIDS (SIDA); citomegalovírus; criptococose; sífilis; toxoplasmose; tuberculose; linfoma

The adenosine-deaminase (ADA) activity was evaluated in CSF samples from 263 patients with AIDS. An elevated ADA activity in CSF was found in patients with: antibodies to toxoplasmosis, syphilis or cytomegalovirus; Cryptococcus neoformans or their antigens; tuberculous meningitis; lymphoma. There was no statistical difference among all these groups in respect to ADA activity. However, the ADA activity in CSF from AIDS patients without CSF changes other than HIV antibodies, even unspecific changes, was not elevated. This may suggest that ADA is related to AIDS associated pathologies activity rather than to HIV infection itself.

adenosine-deaminase; cerebrospinal fluid; AIDS; cytomegalovirus; cryptococosis; toxoplasmosis; tuberculous meningitis; syphilis; lymphoma

Adenosino-deaminase no líquido celalorraqueano de pacientes com a síndrome da imunodeficiência adquirida

Adenosine-deaminase in the cerebrospinal fluid of patients with the acquired immunodeficiency syndrome

Luís Dos Ramos Machado^I; José Antonio Livramento^II; Antonio Spina-França^III

^IProfessor Assistente do Departamento de Neurologia da Faculdade de Medicina da Universidade de São Paulo

^IIProfessor Docente-Livre do Departamento de Neurologia da Faculdade de Medicina da Universidade de São Paulo

IIIProfessor Titular Emérito do Departamento de Neurologia da Faculdade de Medicina da Universidade de São Paulo

RESUMO

A determinação da atividade enzimática da adenosino-deaminase (ADA) no líquido cefalorraqueano (LCR) de pacientes com síndrome da imunodeficiência adquirida (AIDS) pode sinalizar, ainda que de modo inespecífico, a atividade de patologias associadas. Os níveis de atividade de ADA, estudados no LCR de 263 pacientes, estavam aumentados naqueles com patologias associadas em relação aos controles normais e em relação aos pacientes com AIDS que não apresentam alterações ao exame de LCR. No entanto, os níveis de ADA detectados no LCR não apresentaram diferença estatística ao se considerarem os seguintes grupos de pacientes distribuídos segundo os achados no próprio LCR: com anticorpos para toxoplasmose, sífilis ou citomegalovírus; com C. neoformans ou seus antígenos; com bacilos álcool-ácido-resistentes; com linfomas.

Palavras-chave:adenosino-deaminase, líquido cefalorraqueano, AIDS (SIDA), citomegalovírus, criptococose, sífilis, toxoplasmose, tuberculose, linfoma.

SUMMARY

The adenosine-deaminase (ADA) activity was evaluated in CSF samples from 263 patients with AIDS. An elevated ADA activity in CSF was found in patients with: antibodies to toxoplasmosis, syphilis or cytomegalovirus; Cryptococcus neoformans or their antigens; tuberculous meningitis; lymphoma. There was no statistical difference among all these groups in respect to ADA activity. However, the ADA activity in CSF from AIDS patients without CSF changes other than HIV antibodies, even unspecific changes, was not elevated. This may suggest that ADA is related to AIDS associated pathologies activity rather than to HIV infection itself.

Key-words: adenosine-deaminase, cerebrospinal fluid, AIDS, cytomegalovirus, cryptococosis, toxoplasmosis, tuberculous meningitis, syphilis, lymphoma.

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Aceite: 27-julho-1995

Dr. Luís dos Ramos Machado - Praça Amadeu Amaral 47 conj 33 - 01327-010 São Paulo SP - Brasil. FAX 011 289 8879

1. Carilaos G, Calia GM, Naitana AG. Adenosine deaminase (ADA) activity in cerebrospinal fluid. Scand J Infect Dis 1992, 24:121-122.
2. Chawla RK, Set RK, Raj B, Saini AS. Adenosine deaminase levels in cerebrospinal fluid in tuberculosis and bacterial meningitis. Tubercle 1991, 72:190-192.
3. Egido JA, Gonzales JL, Cubo E. False positive of ADA determination in cerebrospinal fluid. Acta Neurol 1994, 16:288-290.
4. Giblett ER, Anderson JE, Cohen F, Pollara B, Meuwissen HJ. Adenosine deaminase deficiency in two patients with severely impaired cellular immunity. Lancet 1972, 2:1067-1069.
5. Giusti G. Adenosine deaminase. In Bergmeyer HU. (ed). Methods of enzymatic analysis. New York: Academic Press., 1974, pl092-1099.
6. Inigo MA, Rui Lopez de Tejada M, Torres-Tortosa M, Sanchez-Porto A, Ugarte J, Garcia de Lomas E, Moran Nestares A. Serum adenosine deaminase in human immunodeficiency virus infection: its relationship with CD4 lymphocytes and 62 microglobulin. Med Clin (Barc) 1992, 99:766-768.
7. Livramento JA, Machado LR, Gomes HR, Vianna LS, Spina-França A. AIDS: a CSF laboratory experience on 470 cases in a 7 year time period. Arq Neuropsiquiatr 1992, 50:56-59.
8. Livramento JA, Machado LR, Nóbrega JPS, Spina-França A. AIDS: a CSF laboratory experience on 610 cases in a 8 year time period. Can J Neurol Sci 1993, 20(Suppl 4):S118.
9. Malan C, Donald PR, Golden M, Taljaard JJF. Adenosine deaminase levels in cerebrospinal fluid in the diagnosis of tuberculous meningitis. J Trop Med Hyg 1984, 87:33-40.
10. Meyers BR. Tuberculous meningitis. Med Clin North Am 1982, 66:755-762.
11. Ocana I, Martinez-Vazquez JM, Ribera E, Segura RM, Pascual C. Adenosine deaminase activity in the diagnosis of lymphocytic pleural effusions of tuberculous, neoplastic and lymphomatous origin. Tubercle 1986, 67:141-145.
12. Piras MA, Gakis C. Cerebrospinal fluid adenosine deaminase activity in tuberculous meningitis. Enzyme 1973, 14:311-317.
13. Ribera E, Martinez-Vazques JM, Ocana I, Segura R, Pascual C. Activity of adenosine deaminase in cerebrospinal fluid for the diagnosis and follow up of tuberculous meningitis. J Infect Dis 1987, 155:603-607.
14. Segura RM, Pascual C, Ocana I, Martin-Vazquez JM, Ribera E, Ruiz I, Pelegri MD. Adenosine deaminase in body fluids: a useful diagnostic tool in tuberculosis. Clin Biochem 1989, 22:141-148.
15. Sullivan JL, Osborne WRA, Wedgwood RJ. Adenosine deaminase activity in lymphocytes. Br J Haematol 1977, 37:157-158.

Datas de Publicação

Publicação nesta coleção
06 Jan 2011
Data do Fascículo
Dez 1995

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

[1] 1. Carilaos G, Calia GM, Naitana AG. Adenosine deaminase (ADA) activity in cerebrospinal fluid. Scand J Infect Dis 1992, 24:121-122.

[2] 2. Chawla RK, Set RK, Raj B, Saini AS. Adenosine deaminase levels in cerebrospinal fluid in tuberculosis and bacterial meningitis. Tubercle 1991, 72:190-192.

[3] 3. Egido JA, Gonzales JL, Cubo E. False positive of ADA determination in cerebrospinal fluid. Acta Neurol 1994, 16:288-290.

[4] 4. Giblett ER, Anderson JE, Cohen F, Pollara B, Meuwissen HJ. Adenosine deaminase deficiency in two patients with severely impaired cellular immunity. Lancet 1972, 2:1067-1069.

[5] 5. Giusti G. Adenosine deaminase. In Bergmeyer HU. (ed). Methods of enzymatic analysis. New York: Academic Press., 1974, pl092-1099.

[6] 6. Inigo MA, Rui Lopez de Tejada M, Torres-Tortosa M, Sanchez-Porto A, Ugarte J, Garcia de Lomas E, Moran Nestares A. Serum adenosine deaminase in human immunodeficiency virus infection: its relationship with CD4 lymphocytes and 62 microglobulin. Med Clin (Barc) 1992, 99:766-768.

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

[8] 8. Livramento JA, Machado LR, Nóbrega JPS, Spina-França A. AIDS: a CSF laboratory experience on 610 cases in a 8 year time period. Can J Neurol Sci 1993, 20(Suppl 4):S118.

[9] 9. Malan C, Donald PR, Golden M, Taljaard JJF. Adenosine deaminase levels in cerebrospinal fluid in the diagnosis of tuberculous meningitis. J Trop Med Hyg 1984, 87:33-40.

[10] 10. Meyers BR. Tuberculous meningitis. Med Clin North Am 1982, 66:755-762.

[11] 11. Ocana I, Martinez-Vazquez JM, Ribera E, Segura RM, Pascual C. Adenosine deaminase activity in the diagnosis of lymphocytic pleural effusions of tuberculous, neoplastic and lymphomatous origin. Tubercle 1986, 67:141-145.

[12] 12. Piras MA, Gakis C. Cerebrospinal fluid adenosine deaminase activity in tuberculous meningitis. Enzyme 1973, 14:311-317.

[13] 13. Ribera E, Martinez-Vazques JM, Ocana I, Segura R, Pascual C. Activity of adenosine deaminase in cerebrospinal fluid for the diagnosis and follow up of tuberculous meningitis. J Infect Dis 1987, 155:603-607.

[14] 14. Segura RM, Pascual C, Ocana I, Martin-Vazquez JM, Ribera E, Ruiz I, Pelegri MD. Adenosine deaminase in body fluids: a useful diagnostic tool in tuberculosis. Clin Biochem 1989, 22:141-148.

[15] 15. Sullivan JL, Osborne WRA, Wedgwood RJ. Adenosine deaminase activity in lymphocytes. Br J Haematol 1977, 37:157-158.