Elevated cerebrospinal fluid levels of total protein in patients with secondary central nervous system vasculitis and giant cell arteritis

2019 ◽  
Vol 30 (6) ◽  
pp. 1033-1038
Author(s):  
Yoshiyuki Abe ◽  
Mariko Harada ◽  
Kurisu Tada ◽  
Ken Yamaji ◽  
Naoto Tamura
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Total Protein ◽  
Central Nervous System Vasculitis ◽  
Cerebrospinal Fluid Levels ◽  
Fluid Levels ◽  
Secondary Central Nervous System

Rituximab Cerebrospinal Fluid Levels in Patients with Primary Central Nervous System Lymphoma Treated with Intravenous High Dose Rituximab

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1644-1644 ◽  
Author(s):  
Jean-Francois Larouche ◽  
Marc Bergeron ◽  
Grace Hampson ◽  
Tim Illidge ◽  
Robert Delage
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Primary Cns Lymphoma ◽  
Serum Levels ◽  
Cns Lymphoma ◽  
High Dose ◽  
Serum Samples ◽  
Cerebrospinal Fluid Levels ◽  
Fluid Levels

Abstract Abstract 1644 INTRODUCTION: Rituximab penetration in central nervous system is largely unknown in human. Experiments in monkeys showed that 0,1% of serum rituximab concentration was achieved in cerebrospinal fluid. Reports in patients are limited (Rubenstein JL, Blood 2003 and Petereit HF, Multiple Sclerosis 2009). They demonstrated similar low levels of cerebrospinal fluid penetration with standard dose (375 mg /m2) rituximab in patients with central nervous system (CNS) lymphoma or multiple sclerosis. METHOD: We conducted a phase 2 trial in patients with primary CNS lymphoma. Patients were treated with an intravenous combination of high dose methotrexate (8 g/m2), high dose cytarabine (2 g/m2) and high dose rituximab (750 mg/m2 every 1–2 weeks × 13 infusions). We obtained from four patients paired cerebrospinal fluid and serum samples and rituximab concentration were determined in each. Samples were collected at different time points just before rituximab infusion and represent trough levels. RESULTS: 11 cerebrospinal fluid samples were available and their 11 paired serum samples. Mean cerebrospinal fluid and serum levels were 2,04 ug/mL (0,49–4,08) and 297,09 ug/mL (211,26–504,47) respectively. Mean cerebrospinal fluid levels were 0,71% (0,18–1,5%) of serum levels. No relationship was made between cerebrospinal fluid level and the number of rituximab dose administered. CONCLUSION: In patients with primary CNS lymphoma receiving high dose 1–2 weekly rituximab. cerebrospinal fluid concentration achieve is low compared to serum levels. However, administration of higher dose of intravenous rituximab can increase penetration in central nervous system but its clinical impact is unknown as cerebrospinal fluid levels are still low. Disclosures: No relevant conflicts of interest to declare.

Cerebrospinal fluid levels of chemokines in HIV infected patients with and without opportunistic infection of the central nervous system

2009 ◽  
Vol 287 (1-2) ◽  
pp. 79-83 ◽  
Author(s):  
Paulo Pereira Christo ◽  
Márcia de Carvalho Vilela ◽  
Thales Lage Bretas ◽  
Renan Barros Domingues ◽  
Dirceu Bartolomeu Greco ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Opportunistic Infection ◽  
Cerebrospinal Fluid Levels ◽  
The Central Nervous System ◽  
Fluid Levels

Giant cell arteritis and primary central nervous system vasculitis as causes of headache

2020 ◽  
pp. 418-427
Author(s):  
Mamoru Shibata ◽  
Norihiro Suzuki ◽  
Gene Hunder
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Temporal Artery ◽  
Temporal Artery Biopsy ◽  
Central Nervous System Vasculitis ◽  
Cerebral Vasoconstriction ◽  
Primary Angiitis ◽  
Cranial Arteries

Giant cell arteritis (GCA) is a granulomatous vasculitic disorder that affects cranial arteries, as well as large arteries, including the aorta. The possibility of GCA should always be considered in headache developing in elderly people. Temporal artery biopsy is usually required to establish the diagnosis. Prompt institution of steroid therapy reduces the risk of complications, such as visual loss and major ischaemic events. Primary central nervous system vasculitis (PCNSV), or primary angiitis of the central nervous system (PACNS), causes headache and neurological symptoms. Patients affected by PCNSV can exhibit thunderclap headache. In such cases, scrutiny for subarachnoid haemorrhage, pituitary apoplexy, and venous thrombosis is warranted. Differential diagnosis between PCNSV and reversible cerebral vasoconstriction syndrome can be challenging. However, this differentiation is important, because they require distinct therapeutic strategies. Steroid and cyclophosphamide are used to treat PCNSV.

Cerebrospinal Fluid Levels of IL-6 in Patients with Acute Infections of the Central Nervous System

1992 ◽  
Vol 24 (6) ◽  
pp. 787-791 ◽  
Author(s):  
Donato Torre ◽  
Claudia Zeroli ◽  
Giorgio Ferraro ◽  
Filippo Speranza ◽  
Roberto Tambini ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Cerebrospinal Fluid Levels ◽  
Acute Infections ◽  
The Central Nervous System ◽  
Fluid Levels

scholarly journals Elevated Neurofilament Light Chain in Cerebrospinal Fluid and Plasma Reflect Inflammatory MRI Activity in Neurosarcoidosis

2021 ◽  
Vol 11 (2) ◽  
pp. 238
Author(s):  
Keld-Erik Byg ◽  
Helle H. Nielsen ◽  
Tobias Sejbaek ◽  
Jonna Skov Madsen ◽  
Dorte Aalund Olsen ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Light Chain ◽  
Plasma Levels ◽  
Healthy Controls ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Potential Biomarker ◽  
Fluid Levels

Background: Damage to axonal cells releases neurofilament light chain (NFL) into the cerebrospinal fluid and plasma. The objective of this study was to investigate NFL as a potential biomarker of disease activity in neurosarcoidosis. MRIs were graded according to enhancing lesions at different central nervous system (CNS) sites. Results: In cerebrospinal fluid, levels of NFL were higher in neurosarcoidosis patients (n = 20) median 2304 pg/mL (interquartile range (IQR) 630–19,612) compared to 426 pg/mL (IQR 261-571) in extra-neurologic sarcoidosis patients (n = 20) and 336 pg/mL (IQR 194–402) in healthy controls (n = 11) (p = 0.0002). In plasma, levels of NFL were higher in neurosarcoidosis patients median 28.2 pg/mL (IQR 11.5–49.3) compared to 6.2 pg/mL (IQR 4.3–8.2) in extra-neurologic sarcoidosis patients and 7.1 pg/mL (IQR 6.2–9.0) in healthy controls (p = 0.0001). Levels in both cerebrospinal fluid and plasma were higher in neurosarcoidosis patients with moderate/severe enhancement than patients with mild enhancement on MRI (p = 0.009 and p = 0.005, respectively). To distinguish neurosarcoidosis patients from extra-neurologic patients and healthy controls, a cut-off level of 630 pg/mL in cerebrospinal fluid had 94% specificity and 79% sensitivity, while a cut-off level of 11.4 pg/mL in plasma had 97% specificity and 75% sensitivity. Conclusions: NFL levels in cerebrospinal fluid and plasma are significantly higher in neurosarcoidosis patients compared to extra-neurologic patients and healthy controls, and the levels correlate to the extent of inflammation on MRI.

Primary and Secondary Central Nervous System Vasculitis

2012 ◽  
Vol 27 (11) ◽  
pp. 1448-1459 ◽  
Author(s):  
Peter Gowdie ◽  
Marinka Twilt ◽  
Susanne M. Benseler
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Clinical Laboratory ◽  
Early Recognition ◽  
Brain Diseases ◽  
Neurological Deficits ◽  
Healthy Children ◽  
Central Nervous System Vasculitis ◽  
Secondary Central Nervous System

Central nervous system vasculitis is an increasingly recognized inflammatory brain disease causing devastating neurological deficits and psychiatric manifestations in previously healthy children. Primary central nervous system vasculitis represents an isolated inflammatory attack targeting the cerebral vessels. In contrast, in children with secondary central nervous system vasculitis, an underlying condition can be identified. The spectrum of childhood primary and secondary central nervous system vasculitis is rapidly expanding, as is the differential diagnosis including nonvasculitic inflammatory brain diseases and noninflammatory vasculopathies. Early recognition, rapid diagnostic evaluation, and initiation of treatment have led to improved morbidity and mortality. This review focuses on clinical, laboratory, and neuroimaging characteristics of the distinct subtypes of primary childhood central nervous system vasculitis, reports the etiology of secondary central nervous system vasculitis, provides an overview of the differential diagnosis, and reviews the current approaches in treatment.

Electrophoretic analysis of cerebrospinal fluid proteins in patients with central nervous system mass lesions

1972 ◽  
Vol 36 (6) ◽  
pp. 679-686 ◽  
Author(s):  
Emil Lee Weber
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Total Protein ◽  
Gamma Globulin ◽  
Protein Fractions ◽  
Common Finding ◽  
Benign Tumors ◽  
Glial Tumors ◽  
Mass Lesions

✓ The protein constituents of the cerebrospinal fluid (CSF) from 234 patients with central nervous system mass lesions and nine patients with pseudotumor syndrome were analyzed by cellulose acetate electrophoresis. The alpha 2 and gamma globulin fractions were most frequently elevated, and more so with metastatic and malignant glial tumors than with benign tumors. Elevation of either fraction frequently occurred independent of the total protein content of the CSF and appears to indicate a primary parenchymal involvement of the brain. Gamma globulin elevations in patients with benign glial tumors were often associated with intracerebral cyst formation. Pituitary adenomas were not associated with elevation of the gamma globulin fraction whereas this was a common finding with other parasellar lesions. All CSF specimens associated with masses of infectious origin had markedly elevated gamma globulin levels irrespective of normal total protein levels. Two metastatic tumors from the gastrointestinal tract, a solitary plasmacytoma, and a case of increased intracranial pressure secondary to nalidixic acid therapy showed dramatic and specific increases in certain CSF protein fractions. The origin of the various protein fractions is discussed as well as the overall clinical applicability of CSF protein electrophoresis in patients with intracranial mass lesions.

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