Critical evaluation of cerebrospinal fluid alterations in neuroschistosomiasis

Avaliação crítica das alterações do líquido cefalorraqueano na neuroesquistossomose

THESES

CRITICAL EVALUATION OF CEREBROSPINAL FLUID ALTERATIONS IN NEUROSCHISTOSOMIASIS (ABSTRACT)^*. DISSERTATION. SÃOPAULO, 2000.

ALEXANDRE REMENCIUS^**

OBJECTIVE:The aim of this study was a bibliographical revision about cerebrospinal (CSF) from patients with schistosomiasis (sch) and neuroschistosomiasis (nsch) published in the literature from 1930 to 1998.

METHOD:383 samples of CSF from patients with sch and nsch were studied in respect to: aspect and color, opening pressure, manometry, number and type of cells, protein content, protein electrophoresis, glucose content, and immunological tests for sch.

RESULTS: The lowest number of samples was reported in the 1930 and 1940 decades and the major in the 1980 and 1990 decades. Age-bracket more compromised was between 20 and 39 years-old. Masculine gender predominated over the feminin. Mansonic sch was the more frequent, followed by japonic sch and hematobic sch. In 199 cases the indication for puncture was myelopathy without granulomatous pseudotumor. This form represented 41 cases (12.9%). Convulsion corresponded to 24 cases (7.6%) and headache to 22 cases (6,9%) of total cases for which puncture was indicated. In 157 (69.2%) samples the puncture was at lumbar level. CSF was clear and colorless in 100 (80%). CSF cytology was normal in 116 (36.5%). Hypercytosis occurred in 140; it was discrete in 83 (26.1%) and moderate in 57 (17.9%). Protein content is referred in 327; it was normal in 101 (30.9%) and increased in the remaining. Moderate protein increase was more frequent, occurring in 153 (46.8%). Eosinophil cells were cited in 91 samples, corresponding to 44.4% of the total 205 samples with cell description. Gamma globulins were normal in 39 (42.4%) and increased in 53 (57.6%). Glucosis was normal in 177 (76.0%) of the 233 samples in which it was referred; it was decreased in 56 (24.1%).

CONCLUSION:Cytology, with special attention to eosinophil cells, protein content and protein electrophoresis, and glucose content should always be investigated in CSF samples from patients with suspicion of nsch. Immunologic tests to sch in CSF should always be done to help diagnosis confirmation.

KEY WORDS: schistosomiasis, central nervous system, cerebrospinal fluid.

**Address: Rua Drausio 383, 05511-010 São Paulo SP, Brasil.

*

Avaliação crítica das alterações do líquido cefalorraqueano na neuroesquistossomose (Resumo). Dissertação de Mestrado, Universidade de São Paulo (Área: Neurologia). Orientador: José Antonio Livramento.

Publication Dates

• Publication in this collection
  06 Dec 2000
• Date of issue
  June 2000