Arq. NeuroPsiquiatr. vol.63 número3B

898 Arq Neuropsiquiat r 2005;63(3-B)

NEUROLOGICAL M ANIFESTATIONS OF DENGUE INFECTION: CLINICAL CHARACTERISTICS AND

CERE-BROSPINAL FLUID ANALYSIS (ABSTRACT)* .

DISSERTATION. NITEROI, 2005.

CRISTIANE NASCIMENTO SOARES**

Introduction. Neurological manif est at ion is

consid-ered a rare complicat ion of dengue inf ect ion.

Encepha-lit is, myeEncepha-litis, Guillain Barré syndrome (GBS), cranial

ner-ve palsies haner-ve been recognized as clinical consequences

of dengue inf ect ion.

Objective. To det ermine and correlate t he neuro l o g

i-cal and cere b rospinal f luid (CSF) charact eristics of patient s

w it h dengue inf ect ion and t o evaluat e t he use of t w o

dengue enzyme-linked immunosorbent assays (ELISA) kit s

in t he CSF.

Method. We report 17 IgM seroposit ive pat ient s f or

dengue w ho present ed diff e rent neurological manif

es-t aes-t ions in es-t he course of es-t he acues-t e inf eces-t ion. Wies-t h es-t hese

manif est at ions, pat ient s w ere divided in f our groups:

headache, encephalit is, myelit is and GBS. Tot al and dif

-f e rent ial cyt ology count , prot ein and glucose levels and

ELISA f or IgM and IgG dengue ant ibodies w ere

exam-ined in t he CSF samples f rom all 17 patient s. In six of t hem

(myelit is and GBS pat ient s), t he albumin and IgG

con-cent rat ions w ere det ermined in serum and CSF. CSF and

serum f rom Brazilian and German pat ient s w it h ot her

neurological diseases w ere used as cont rols f or IgG and

IgM dengue t est s.

Result. We had seven pat ient s w it h encephalit is, t wo

with myelitis, four with GBS and four with headache

asso-ciat ed w it h acut e dengue inf ect ion. The CSF w as

nor-mal in t he cases of headache and in 42.8 % of t he

ence-phalit is cases. GBS show ed a CSF-blood barrier dysf

unc-t ion and unc-t he unc-typical prounc-t ein-cyunc-t ology dissociaunc-tion. Paunc-tienunc-t s

w it h myelitis show ed specific ant ibodies int rat hecal

syn-t hesis. IgM dengue ansyn-t ibodies in CSF w ere obsyn-t ained in

47% of t he 17 cases but w it h a high specif icit y of 97 %

f or Brazilian cont rols and 100% f or German cont rols.

Ot herw ise, IgG dengue t est s revealed a low specif icit y

w hen Brazilians cont rols w ere used, det ect ing previous

cont act w it h t he virus in our populat ion.

Conclusion: In endemic regions, dengue inf ect ion

should be alw ays invest igat ed as t he et iological agent

in cases of encephalit is, GBS and myelit is. A normal CSF

analysis does not exclude t he diagnosis of encephalit is

and headache caused by dengue inf ect ion. On t he ot

h-er hand, int rat hecal synt hesis of ant ibodies may suggest

t he virus presence in t he cent ral nervous syst em (CNS).

Our f indings, based on t he det ect ion of IgM dengue in

CSF w ere an import ant t ool t o conf irm dengue infect ion

in t he CNS but it s absence does not exclude t he

diag-nosis. Furt her, t he high posit ivit y t o IgG dengue ELISA

in t he CSF of our Brazilin cont rols ref lect s previous

con-t accon-t w icon-t h con-t he virus in our populacon-t ion.

KEY WORDS:

dengue inf ect ion, cerebrospinal f

lu-id, neurological manifest at ions, viral encephalitis,

myeli-t is, Guillain Barré syndrome.

* M anif est ações neurológicas da dengue: aspect os clínicos e análise do líquido cef alorraqueano. Dissertação de M est rado, Universidade Federal Fluminense, (Área: Neurologia). Orient adores: M arzia Puccioni e M arcos R G de Freit as.

**Address: Rua Aureliano Coutinho 81/605, 25625-000 Petrópolis RJ, Brasil. E–mail: crist_nsoares@yahoo.com.br

IM M UNOHISTOCHEM ICAL STUDY OF THE M OLECULAR ALT E R ATIONS IN THE ASTROCYTIC TUM ORS:

TUMORIGENIC PAT H WAYS AND RESISTANCE M ARKERS (ABSTRACT)* .

D I S S E RTATION. FORTA L E Z A ,

2005.

MÁRIO HENRIQUE GIRÃO FARIA**

The present st udy aimed t o evaluat e t he expression

of genes involved in t he t umorigenic process and in t he

chemoresist ance mechanisms of t he ast rocyt ic t umors.

A clinical and epidemiological analysis, hist opat

ho-logical evaluation and immunohist ochemical st udy of the

p roteins Ki-67, c-M yc, GFA P, p53, p21

_{, p27}

_,

Bcl-2, Bax, EGFR, erbB-Bcl-2, p21

_{, MGM T, GST}

_π

_{, TS and To p o I I}

_α

using st re p t o a v i d i n - b i o t i n - p e roxidase met hod w ere

per-f o rmed in 55 diper-fper-f e ren t graduat ions oper-f astro c y t o m a s

(WHO) (13 grade I, 14 grade II, 7 grade III, 21 grade IV)

and 05 samples of non-t umoral t issue (cont rol group).

The dist ribution by age, sex and t umoral localizat ion

of ast rocyt omas pat ient s in Fort aleza reproduced, in a

general w ay, t he w orldw ide t rends.

The hist opat hological f indings evaluat ed w it h

semi-quant it at ive crit eria conf irmed t he classif icat ion

param-et ers f or ast rocyt omas est ablished by WHO.

The st ain f or Ki-67 ant igen increased as according t o

ast rocyt ic t umors pro g ression; its det ect ion in more t han

8.0% of t he t umoral cells dist inguished Ast rocyt omas

Grade IV, labeled index bet w een 1.5 and 8.0% dif f

er-ent iat ed Ast rocyt omas Grade III and values below 1.5%

discriminat ed low -grade t umors (I and II).