Evaluation of intrathecal synthesis of specific IgG antibodies against Toxoplasma gondii in the diagnosis assessment of presumptive toxoplasma encephalitis in aids patients Avaliação da síntese intratecal de anticorpos IgG anti-Toxoplasma gondii para o diagnóstico da neurotoxoplasmose em pacientes com síndrome da imunodeficiência adquirida

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Aercio Sebastião Borges, José Fernando de Castro Figueiredo
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2004
• Subjects: SIDA; Neurotoxoplasmose; Síntese de anticorpos; Sistema Nerevoso Central; AIDS; Neurotoxoplasmosis; Antibody synthesis; Central nervous system; Arctic medicine. Tropical medicine; RC955-962; Arctic; Sida
• Online Access: https://doi.org/10.1590/S0037-86822004000600010; https://doaj.org/article/c276a0e68c1441a1b4784cb6888aed82

The diagnosis of neurotoxoplasmosis in patients with acquired immunodeficiency syndrome is mainly based on tomographic or magnetic resonance findings and on the response to specific treatment. We studied 55 patients with AIDS and neurotoxoplasmosis according to these diagnostic criteria (group 1), 37 patients with AIDS and neurological involvement of other etiology (group 2), and 16 anti-HIV-negative individuals with neurological manifestations (group 3). Serum and cerebrospinal fluid were examined for the presence of anti-T. gondii IgG, by indirect immunofluorescence. In 72 of them, the total amounts of these antibodies were determined in order to assess local production of anti-T. gondii antibodies in the central nervous system and to correlate their titers with infection activity in patients with AIDS and neurotoxoplasmosis. IgG titers > 1/64 in cerebrospinal fluid reached 100% specificity for the diagnosis of neurotoxoplasmosis in AIDS. Evidence of local synthesis of these antibodies was detected in 42.8% of patients of group 1, in 29.1% of patients of group 2 and in no patient of group 3. The test showed 70.8% specificity and therefore was not useful in our study for the differential diagnosis of neurotoxoplasmosis in patients with AIDS. O diagnóstico da neurotoxoplasmose em pacientes com síndrome da imunodeficiência adquirida baseia-se fundamentalmente nos achados tomográficos ou de ressonância magnética e na resposta ao tratamento específico. Estudamos 55 pacientes com SIDA e neurotoxoplasmose, de acordo com estes critérios diagnósticos (grupo 1); 37 pacientes com SIDA e comprometimento neurológico por outra etiologia (grupo 2) e 16 indivíduos anti-HIV negativo, com outras doenças neurológicas (grupo 3), pesquisando IgG, anti-T. gondii, no soro e no líquor, utilizando a reação de imunofluorescência indireta. Em 72 casos, determinamos os teores totais destes anticorpos aí presentes, com objetivo de avaliar a produção local, no sistema nervoso central, de anticorpos específicos e correlacionar os títulos ...