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Laboratory findings in tick-borne encephalitis--correlation with clinical outcome (see comments)

机译：tick传播性脑炎的实验室检查结果-与临床结局的相关性（见评论）

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摘要

Infection with the tick-borne encephalitis virus (TBEV) can result in various neurological complications. At present, there are little data available on laboratory findings that might help predict the clinical course and prognosis of tick-borne encephalitis (TBE). In the present study 100 patients with TBE were examined in respect to various laboratory parameters potentially characteristic for the disease and indicative for the prognosis in TBE. Pleocytosis, impairment of the blood-CSF barrier and intrathecal synthesis of immunoglobulins (IgM > IgG, IgA) were common findings in most patients. On admission to the hospital, 84% of the patients presented with an intrathecal synthesis of TBEV-specific IgM and/or IgG antibodies in the CSF. At follow-up, intrathecal synthesis of TBEV-specific antibodies was demonstrated in all patients studied within 15 days after the first examination, but changes of CSF parameters did not correlate with the clinical course of disease. In contrast to those with moderate course of disease, patients with severe courses of TBE displayed higher cell counts in the CSF and lower concentrations of neutralizing antibodies in serum, and more frequently revealed an intrathecal synthesis of total IgG. TBE-specific oligoclonal IgG antibodies in the CSF were demonstrated only in three patients with prior, incomplete, vaccination against TBE. The severe course of disease in individual patients with TBE may result from a slow or low production of neutralizing antibodies. In these patients, the more intense damage of the CNS tissue is reflected by higher cell counts in the CSF. At onset of disease the presence of a low concentration of neutralizing antibodies in serum and a high cell count in the CSF might indicate an unfavorable course of TBE.
机译：the传播性脑炎病毒（TBEV）感染可导致各种神经系统并发症。目前，关于实验室发现的数据很少，可能有助于预测tick传性脑炎（TBE）的临床过程和预后。在本研究中，检查了100例TBE患者的各种实验室参数，这些参数可能是该疾病的特征，并预示了TBE的预后。在大多数患者中，常见的有淋巴细胞增多，血液CSF屏障受损和鞘内合成免疫球蛋白（IgM> IgG，IgA）。入院时，84％的患者在脑脊液中鞘内合成了TBEV特异性IgM和/或IgG抗体。随访时，首次检查后15天内，所有研究患者均证实鞘内合成TBEV特异性抗体，但脑脊液参数的变化与疾病的临床进程无关。与那些病程中等的患者相反，病程严重的TBE患者的脑脊液细胞计数较高，血清中和抗体的浓度较低，并且鞘内合成总IgG的频率更高。仅在三名先前，不完整的针对TBE的疫苗接种患者中证明了CSF中的TBE特异性寡克隆IgG抗体。患有TBE的个体患者的严重病程可能是由中和抗体产生缓慢或产生低水平引起的。在这些患者中，中枢神经系统中较高的细胞计数反映了中枢神经系统组织的更严重损伤。疾病发作时，血清中低浓度中和抗体的存在和脑脊液中高细胞计数的存在可能表明TBE病程不利。

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