Flow cytometrical analysis of cerebrospinal fluid leukocytes in pediatric patients

Three pediatric patients with Cuban epidemic neuropathy were studied. Cerebrospinal fluid and sera were simultaneously obtained. Albumin and IgG were quantified by immunodifusion. Albumin quotient and local synthesis of IgG were calculated by Reiber/Felgenhauer formula. A patient with optic neuritis had a dysfunction of the blood-cerebrospinal fluid barrier. All the group had local synthesis of IgG.

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Cerebrospinal fluid neopterin as a biomarker of neuroinflammatory diseases

Scientific Reports ◽

10.1038/s41598-020-75500-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Marta Molero-Luis ◽

Didac Casas-Alba ◽

Gabriela Orellana ◽

Aida Ormazabal ◽

Cristina Sierra ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Discriminant Analysis ◽

Bacterial Infections ◽

Pediatric Patients ◽

Canonical Discriminant Analysis ◽

Control Group ◽

Csf Biomarkers ◽

Molecular Testing ◽

Respiratory Pathogens

Abstract The elevation of neopterin in cerebrospinal fluid (CSF) has been reported in several neuroinflammatory disorders. However, it is not expected that neopterin alone can discriminate among different neuroinflammatory etiologies. We conducted an observational retrospective and case–control study to analyze the CSF biomarkers neopterin, total proteins, and leukocytes in a large cohort of pediatric patients with neuroinflammatory disorders. CSF samples from 277 subjects were included and classified into four groups: Viral meningoencephalitis, bacterial meningitis, acquired immune-mediated disorders, and patients with no-immune diseases (control group). CSF neopterin was analyzed with high-performance liquid chromatography. Microbiological diagnosis included bacterial CSF cultures and several specific real-time polymerase chain reactions. Molecular testing for multiple respiratory pathogens was also included. Antibodies against neuronal and glial proteins were tested. Canonical discriminant analysis of the three biomarkers was conducted to establish the best discriminant functions for the classification of the different clinical groups. Model validation was done by biomarker analyses in a new cohort of 95 pediatric patients. CSF neopterin displayed the highest values in the viral and bacterial infection groups. By applying canonical discriminant analysis, it was possible to classify the patients into the different groups. Validation analyses displayed good results for neuropediatric patients with no-immune diseases and for viral meningitis patients, followed by the other groups. This study provides initial evidence of a more efficient approach to promote the timely classification of patients with viral and bacterial infections and acquired autoimmune disorders. Through canonical equations, we have validated a new tool that aids in the early and differential diagnosis of these neuroinflammatory conditions.

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Value of Cerebrospinal Fluid Lactate Levels in Diagnosing Shunt Infections in Pediatric Patients

World Neurosurgery ◽

10.1016/j.wneu.2019.05.111 ◽

2019 ◽

Vol 129 ◽

pp. e207-e215

Author(s):

Jonathan Roth ◽

Jehuda Soleman ◽

Danil A. Kozyrev ◽

John N. Jabang ◽

Maya Stein ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Pediatric Patients ◽

Lactate Levels ◽

Shunt Infections

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(1→3)-β-d-Glucan in Cerebrospinal Fluid as a Biomarker forCandidaandAspergillusInfections of the Central Nervous System in Pediatric Patients

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piv014 ◽

2015 ◽

Vol 5 (3) ◽

pp. 277-286 ◽

Cited By ~ 34

Author(s):

Christine M. Salvatore ◽

Tempe K. Chen ◽

Sima S. Toussi ◽

Patricia DeLaMora ◽

Ruta Petraitiene ◽

...

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Pediatric Patients ◽

The Central Nervous System

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Pharmacokinetics and Cerebrospinal Fluid (CSF) Concentrations of Vancomycin in Pediatric Patients Undergoing CSF Shunt Placement

Chemotherapy ◽

10.1159/000238755 ◽

1990 ◽

Vol 36 (2) ◽

pp. 103-108 ◽

Cited By ~ 12

Author(s):

Patty Fan-Havard ◽

Milap C. Nahata ◽

Henry Bartkowski ◽

William J. Barson ◽

Edward J. Kosnik

Keyword(s):

Cerebrospinal Fluid ◽

Pediatric Patients ◽

Csf Shunt ◽

Shunt Placement

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An Increase of Cerebrospinal Fluid B-cell Activating Factor Level in Pediatric Patients With Acute Viral Encephalitis

Pediatric Neurology ◽

10.1016/j.pediatrneurol.2017.01.027 ◽

2017 ◽

Vol 70 ◽

pp. e3-e4

Author(s):

Mitsuo Motobayashi ◽

Tetsuhiro Fukuyama ◽

Jiu Okuno-Yuguchi ◽

Takahiro Shioiri ◽

Sachiko Nagaharu ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

B Cell ◽

Pediatric Patients ◽

Viral Encephalitis ◽

Factor Level ◽

B Cell Activating Factor

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Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children

Einstein (São Paulo) ◽

10.1590/s1679-45082017ao3880 ◽

2017 ◽

Vol 15 (2) ◽

pp. 167-172 ◽

Cited By ~ 4

Author(s):

Frederico Ribeiro Pires ◽

Andréia Christine Bonotto Farias Franco ◽

Alfredo Elias Gilio ◽

Eduardo Juan Troster

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Aseptic Meningitis ◽

Medical Records ◽

Pediatric Patients ◽

Tertiary Hospital ◽

Viral Meningitis ◽

Parenteral Antibiotic ◽

Score Analysis

ABSTRACT Objective To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. Methods A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in São Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture. Results The study included 503 patients. Sixty-four patients were excluded and 94 were not submitted to all tests for analysis. Of the remaining 345 patients, 7 were in the Bacterial Meningitis Group and 338 in the Aseptic Meningitis Group. There was no statistical difference between the groups. In the Bacterial Meningitis Score analysis, of the 338 patients with possible aseptic meningitis (negative cultures), 121 of them had one or more points in the Bacterial Meningitis Score, with sensitivity of 100%, specificity of 64.2%, and negative predictive value of 100%. Of the 121 patients with positive Bacterial Meningitis Score, 71% (86 patients) had a positive enterovirus detection in cerebrospinal fluid. Conclusion Enterovirus detection in cerebrospinal fluid was effective to differentiate bacterial from viral meningitis. When the test was analyzed together with the Bacterial Meningitis Score, specificity was higher when compared to Bacterial Meningitis Score alone.

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Cerebrospinal Fluid Concentrations of Neurotensin and Corticotropin-Releasing Factor in Pediatric Patients

Neonatology ◽

10.1159/000242927 ◽

1989 ◽

Vol 55 (4-5) ◽

pp. 260-267 ◽

Cited By ~ 7

Author(s):

J. Hedner ◽

T. Hedner ◽

K.-H. Lundell ◽

G. Bissette ◽

Laurel O’Connor ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Pediatric Patients ◽

Corticotropin Releasing Factor

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Determination of delta-aminobutyric acid and other amino acids in cerebrospinal fluid of pediatric patients by reversed-phase liquid chromatography.

Clinical Chemistry ◽

10.1093/clinchem/33.10.1736 ◽

1987 ◽

Vol 33 (10) ◽

pp. 1736-1740 ◽

Cited By ~ 34

Author(s):

R F Goldsmith ◽

J W Earl ◽

A M Cunningham

Keyword(s):

Amino Acids ◽

Cerebrospinal Fluid ◽

Pediatric Patients ◽

Reference Intervals ◽

Reversed Phase ◽

Aminobutyric Acid ◽

Control Group ◽

Precolumn Derivatization ◽

Gamma Aminobutyric Acid ◽

Phase Liquid

Abstract The reversed-phase liquid-chromatographic system described here is capable of resolving the neurotransmitter amino acids aspartic acid, glutamic acid, and gamma-aminobutyric acid (GABA) plus 21 other amino acids in cerebrospinal fluid (CSF) in a single analysis. The amino acids, derivatized with o-phthalaldehyde, are separated in 65 min. Concentrations of glutamine less than or equal to 600 mumol/L can be measured at the same time as GABA greater than or equal to 10 nmol/L. Using this method, we have determined reference intervals for amino acids, including GABA, in CSF in a group of pediatric patients who underwent lumbar puncture before myelography, and who were subsequently shown to have normal myelograms. These intervals are generally lower than those previously reported for childhood, but we believe this results from a more rigid selection of the control group. In addition, artifactual increases in concentrations of free neurotransmitters, caused by breakdown of amino acid conjugates, are minimized by (a) immediate freezing of the CSF samples to prevent enzyme-mediated changes, (b) omission of a deproteinization step, and (c) precolumn derivatization to reduce on-column breakdown of amide and peptide forms.

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