Un liquor particolarmente informativo

Translated title of the contribution: Cerebrospinal Fluid (CSF) analysis and CSF Free Light Chains (FLC) indices in a patient with Varicella Zooster Encephalitis

Giovanni Del Mese, Pilar Nannini, Giovanna Zuin, Massimo Mastrangelo, Gian Vincenzo Zuccotti, Federica Fontana, Elena Corsini, Gaetano Bernardi

Research output: Contribution to journalArticle

Abstract

A 3-year-old child was admitted to our Emergency Department with neurological multifocal symptoms. Magnetic resonance imaging showed pulvinar and lenticular nucleus involvement. The parents reported an infection from Varicella Zooster Virus (VZV) a few days earlier. After taking lumbar puncture, the patient was hospitalized with a preliminary diagnosis of viral encephalitis. Cerebrospinal fluid (CSF) examination was negative for albumin quotient, quantitative IgG synthesis, isoelectric focusing and Polimerase Chain Reaction (PCR) for Herpes viruses. High CSF intrathecal total IgM fraction (48% r.v. ≤0) was detected as well with highly positive IgM antibody indices specific for VZV. CSF free light chain (FLC) kappa and lambda indices were highly positive: respectively 34.12 (r.v. <6.39) and 17.78 (r.v. <5.51). The diagnosis of VZV encephalitis, was possible only after specific CSF serology and CSF FLC measurement. IgG isoelectric focusing is considered the best screening test to detect immune activation in CNS, however, in this patient we observed mainly an IgM response. Our case indicates that CSF FLC determination is perhaps a better test to screen for an immune activation of the central nervous system, as it becomes positive also in case of IgM intrathecal synthesis.

Original languageItalian
Pages (from-to)e26-e28
JournalBiochimica Clinica
Volume42
Issue number2
DOIs
Publication statusPublished - Jan 1 2018

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Varicella Zoster Encephalitis
Cerebrospinal fluid
Cerebrospinal Fluid
Viruses
Light
Immunoglobulin M
Chickenpox
Isoelectric Focusing
Immunoglobulin G
Encephalitis Viruses
Chemical activation
Pulvinar
Viral Encephalitis
Corpus Striatum
Spinal Puncture
Neurology
Serology
Magnetic resonance imaging
Hospital Emergency Service
Albumins

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Medical Laboratory Technology
  • Biochemistry, medical

Cite this

Un liquor particolarmente informativo. / Mese, Giovanni Del; Nannini, Pilar; Zuin, Giovanna; Mastrangelo, Massimo; Zuccotti, Gian Vincenzo; Fontana, Federica; Corsini, Elena; Bernardi, Gaetano.

In: Biochimica Clinica, Vol. 42, No. 2, 01.01.2018, p. e26-e28.

Research output: Contribution to journalArticle

Mese, GD, Nannini, P, Zuin, G, Mastrangelo, M, Zuccotti, GV, Fontana, F, Corsini, E & Bernardi, G 2018, 'Un liquor particolarmente informativo', Biochimica Clinica, vol. 42, no. 2, pp. e26-e28. https://doi.org/10.19186/BC_2018.018
Mese GD, Nannini P, Zuin G, Mastrangelo M, Zuccotti GV, Fontana F et al. Un liquor particolarmente informativo. Biochimica Clinica. 2018 Jan 1;42(2):e26-e28. https://doi.org/10.19186/BC_2018.018
Mese, Giovanni Del ; Nannini, Pilar ; Zuin, Giovanna ; Mastrangelo, Massimo ; Zuccotti, Gian Vincenzo ; Fontana, Federica ; Corsini, Elena ; Bernardi, Gaetano. / Un liquor particolarmente informativo. In: Biochimica Clinica. 2018 ; Vol. 42, No. 2. pp. e26-e28.
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