Eosinophil-associated inflammation and elaboration of eosinophil-derived proteins in 2 children with raccoon roundworm (Baylisascaris procyonis) encephalitis.

Abstract

OBJECTIVE:

Eosinophil-associated proteins, especially eosinophil-derived neurotoxin, may be important contributors to the neurologic pathology and symptoms caused by Baylisascaris procyonis infection.

METHODS:

Two cases of severe B procyonis encephalitis with evidence of marked eosinophil degranulation in the central nervous system are presented. Serial cerebrospinal fluid (CSF) specimens were collected from each patient during the course of their illness. Antibodies against B procyonis were measured in the patients' serum and CSF. Levels of the eosinophilopoietin interleukin-5 (IL-5) and 2 important eosinophil proteins, eosinophil-derived neurotoxin and major basic protein, were assayed in the CSF.

RESULTS:

Both patients had rapidly progressive central nervous system disease with evidence of eosinophilic meningoencephalitis. Both tested positive for antibodies to B procyonis in serum and CSF and had progressively worsening deep white matter changes on magnetic resonance images of the brain. CSF levels of IL-5, eosinophil-derived neurotoxin, and major basic protein were markedly elevated over controls.

CONCLUSIONS:

This is the first report of the measurement of IL-5, eosinophil-derived neurotoxin, and major basic protein in human CSF. In addition to traumatic damage and necrosis caused by migrating larvae, eosinophil-derived neurotoxin from associated eosinophilic inflammation may be an important contributory factor in the pathogenesis of B procyonis encephalitis. parasite, eosinophil-derived-neurotoxin, major basic protein, eosinophilia, hypereosinophilia, interleukin-5, encephalitis, child.

• Authors: C L Moertel, K R Kazacos, J H Butterfield, H Kita, J Watterson, G J Gleich
• Journal: Pediatrics (Pediatrics) Vol. 108 Issue 5 Pg. E93 (Nov 2001) ISSN: 1098-4275 [Electronic] United States
• PMID: 11694677 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Biomarkers
• Blood Proteins
• Eosinophil Granule Proteins
• Eosinophil-Derived Neurotoxin
• Ribonucleases

Topics

• Animals
• Ascaridida Infections (cerebrospinal fluid, complications, drug therapy)
• Ascaridoidea
• Biomarkers (cerebrospinal fluid)
• Blood Proteins (cerebrospinal fluid)
• Encephalitis (cerebrospinal fluid, drug therapy, parasitology)
• Eosinophil Granule Proteins
• Eosinophil-Derived Neurotoxin
• Eosinophilia (cerebrospinal fluid, complications)
• Fatal Outcome
• Humans
• Infant
• Male
• Raccoons (parasitology)
• Ribonucleases (cerebrospinal fluid)