Biochemical parameters of cerebrospinal fluid in patients with acute viral meningitis and meningoencephalitis
Keywords:cerebrospinal fluid, meningitis, meningoencephalitis, acid phosphatase, creatininekinase, lactate, lactatedehydrogenase, cholinesterase
The aim. Determination of the diagnostic value of lactate, lactate dehydrogenase, cholinesterase, acid phosphatase and cholinesterase in CSF for early diagnosis and prognosis of acute viral meningitis and meningoencephalitis.
Materials and methods. 92 patients with a confirmed viral etiology of the disease were examined. Among them – 20 patients with HSV 1,2 neuroinfection, 19 patients with EBV, 15 with VZV, 14 with HHV-6 and 24 patients with enterovirus neuroinfection. Patients were divided into groups depending on the etiology and severity of the disease. In addition to analyzing the clinical course of the disease, we conducted a CSF study to determine the level of lactate, lactate dehydrogenase, creatinine kinase, cholinesterase and acid phosphatase on admission to hospital and after 10-12 days of treatment.
Results of the study. The highest mean age was observed in patients with VZV meningitis – 38.27±18.24 years, the youngest were patients with enterovirus infection – 24.05±5.72 (р˂0.001). The number of women and men was the same in almost all groups, but among patients with HSV 1, 2 neuroinfection women were significantly prevalent – 16 (80 %) out of 20 cases. The most severe course was observed in groups of EBV and HHV-6 neuroinfections. Neuroinfections of enterovirus etiology had the most favorable course.
The obtained data indicate the dependence of the levels of indicators, which were determined primarily from the severity of the disease. So the level of creatinine kinase and acid phosphatase in patients with moderate severity was significantly higher in comparison with severe patients (p<0.05). The lactate level was higher in patients with severe neuroinfection (p<0.05). The highest levels of lactate were detected in patients with HHV-6 meningoencephalitis (p<0.05). The level of cholinesterase was significantly lower in severe patients.
Conclusions. The obtained data confirm the presence of deep metabolic disturbances in the brain tissues in all patients with acute viral neuroinfections both at the onset of the disease and in the dynamics of treatment. Determination of levels of creatinine kinase, acid phosphatase, lactate and cholinesterase in CSF of patients with acute viral neuroinfection has a high diagnostic value, but cannot be used to predict an unfavorable course of the disease
- Soares, C. N., Cabral-Castro, M. J., Peralta, J. M., de Freitas, M. R. G., Zalis, M., Puccioni-Sohler, M. (2011). Review of the etiologies of viral meningitis and encephalitis in a dengue endemic region. Journal of the Neurological Sciences, 303 (1-2), 75–79. doi: 10.1016/j.jns.2011.01.012
- Lee, B. E., Davies, H. D. (2007). Aseptic meningitis. Current Opinion in Infectious Diseases, 20 (3), 272–277. doi: 10.1097/qco.0b013e3280ad4672
- Irani, D. N. (2008). Aseptic Meningitis and Viral Myelitis. Neurologic Clinics, 26 (3), 635–655. doi: 10.1016/j.ncl.2008.03.003
- Domingues, R. (2009). Treatment of Viral Encephalitis. Central Nervous System Agents in Medicinal Chemistry, 9 (1), 56–62. doi: 10.2174/187152409787601905
- Silva, M. T. T. (2013). Viral encephalitis. Arquivos de Neuro-Psiquiatria, 71 (9), 703–709. doi: 10.1590/0004-282x20130155
- Dash, P. C., Patro, D. (2014). Role of CSF CK, LDH, GGTP Enzyme Levels in Diagnostic and Prognostic Evaluation of Meningitis. Journal of Clinical and Diagnostic Research, 8 (7), 19–22. doi: 10.7860/jcdr/2014/9675.4615
- Koz'ko, V. N., Sokhan', A. V., Zots, Ya. V., Kononenko, A. E., Pavlov, V. V., Gavrilov, A. V. et. al. (2015). Biokhimicheskie pokazateli tserebrospinal'noy zhidkosti bol'nykh ostrymi meningokokkovymi i enterovirusnymi meningitami. Mezhdunarodnyy meditsinskiy zhurnal, 3, 70–74.
- Huy, N. T., Thao, N. T., Diep, D. T., Kikuchi, M., Zamora, J., Hirayama, K. (2010). Cerebrospinal fluid lactate concentration to distinguish bacterial from aseptic meningitis: a systemic review and meta-analysis. Critical Care, 14 (6), 240. doi: 10.1186/cc9395
- Lenz, D. E., Yeung, D., Smith, J. R., Sweeney, R. E., Lumley, L. A., Cerasoli, D. M. (2007). Stoichiometric and catalytic scavengers as protection against nerve agent toxicity: A mini review. Toxicology, 233 (1-3), 31–39. doi: 10.1016/j.tox.2006.11.066
- Girard, E., Bernard, V., Minic, J., Chatonnet, A., Krejci, E., Molgo, J. (2007). Butyrylcholinesterase and the control of synaptic responses in acetylcholinesterase knockout mice. Life Sciences, 80 (24-25), 2380–2385. doi: 10.1016/j.lfs.2007.03.011
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Copyright (c) 2018 Volodymyr Kozko, Anton Sokhan, Yaroslava Burma, Anastasiia Kuznietsova, Anatoliy Gavrylov
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