Diagnosis of inflammatory diseases of the CNS in children by means of CSF-protein electrophoresis (author's transl)

Abstract

CSF-protein was analyzed by quantitative zone electrophoresis in agarose gel in 141 children and adolescents who suffered from acute and chronic inflammatory disease of the CNS. 67 patients without any CNS affection served as controls. The normal CSF-protein consists of 15 fractions: 2 prealbumin, albumin, 5 α- 3 β- and 4 γ-globulins. In case of aseptic and purulent meningitis the protein profile of blood-CSF-barrier disturbance was found in a varying degree. The relation of nearly all protein fractions had changed, prealbumin, γ- and γ4-globulin, typical of CSF, were decreased in different amounts. The results in 42 children with aseptic meningitis differed significantly not only from that in the control group but also in the 21 patients with purulent meningitis. 179 patients (further 49 children added) belonging to one of these diagnostic groups were correctly classified in about 90 % using discriminant analysis. 50 children and adolescents with chronic inflammatory diseases of the CNS showed the protein pattern of local immunoglobulin synthesis. 4/5 of 29 children with congenital infections (cytomegalic inclusion body disease, toxoplasmosis, rubella and syphilis) revealed a marked increase of the γ 3-globulin, in 1/3 of these patients oligoclonal γ-fraction appeared. All patients with multiple sclerosis (6 adolescents) and subacute sclerosing panencephalitis (15 children) revealed an oligoclonal γ-globulin pattern. In MS the oligoclonal γ-bands were distributed in a stepwise fashion, whereas in SSPE there were 2-4 markedly protruding fractions.