Neuroschistosomiasis due to Schistosoma mansoni: a review of pathogenesis, clinical syndromes and diagnostic approaches
Tóm tắt
Neuroschistosomiasis (NS) is the second most common form of presentation of infection by the trematode, Schistosoma mansoni. Granulomatous inflammatory reaction occurs as a result of schistosome eggs being transmitted to spinal cord or brain via the vascular system, or by inadvertent adult worm migration to these organs. The two main clinical syndromes are spinal cord neuroschistosomiasis (acute or subacute myelopathy) and localized cerebral or cerebellar neuroschistosomiasis (focal CNS impairment, seizures, increased intracranial pressure). Presumptive diagnosis of NS requires confirming the presence of S. mansoni infection by stool microscopy or rectal biopsy for trematode eggs, and serologic testing of blood and spinal fluid. The localized lesions are identified by signs and symptoms, and confirmed by imaging techniques (contrast myelography, CT and MRI). Algorithms are presented to allow a stepwise approach to diagnosis.
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Tài liệu tham khảo
ANDRADE A.N., 1989, Esquistossomose mansônica cerebral, Arq. Neuropsiquiat., 47, 100, 10.1590/S0004-282X1989000100015
ANDRADE FILHO A.S., 1996, Neuroesquistossomose mansônica: Aspectos clínicos, laboratoriais e terapêuticos, Arq. Neuropsiquiat., 54, 232, 10.1590/S0004-282X1996000200010
ANDRADE Z.A., 1998, The situation of hepatosplenic schistosomiasis in Brazil today, Mem. Inst. Oswaldo Cruz, 93, 313, 10.1590/S0074-02761998000700062
ARAÚJO M.I., 1996, Evidence of a T helper type 2 activation in human schistosomiasis, Europ. J. Immunol., 26, 1399, 10.1002/eji.1830260633
BLECK T.P., 2000, Approach to the patient with central nervous system infection, 5, 950
BOROS D.L., 1989, Immunopathology of Schistosoma mansoni infection, Clin. Microbiol. Rev., 2, 250, 10.1128/CMR.2.3.250
BRAGA B.P., 2003, Magnetic resonance imaging of cerebellar schistosomiasis mansoni, Rev. Soc. bras. Med. trop., 36, 635, 10.1590/S0037-86822003000500018
CAROD ARTAL F.J., 2004, Myelopathy due to Schistosoma mansoni: A description of two cases and review of the literature, Rev. Neurol., 39, 137
CAROD ARTAL F.J., 2004, Schistosoma mansoni myelopathy: clinical and pathologic findings, Neurology, 63, 388, 10.1212/01.WNL.0000130190.67613.BE
1984, Acute schistosomiasis with transverse myelitis in American students returning from Kenya, M.M.W.R., 33(31, 446
COHEN-GADOL A.A., 2003, Spinal cord biopsy: a review of 38 cases, Neurosurgery, 52, 815
CORRÊA R.L.B., 1983, Comprometimento neurológico na esquistossomose mansônica, Rev. bras. Neurol., 19, 101
FERRARI T.C., 1999, Spinal cord schistosomiasis: a report of 2 cases and review emphasizing clinical aspects, Medicine (Baltimore), 78, 176, 10.1097/00005792-199905000-00004
FERRARI T.C., 1999, Estimation of the local synthesis of immunoglobulin G (IgG) in the central nervous system of patients with spinal cord schistosomiasis by the IgG index, Trans. roy. Soc. trop. Med. Hyg., 93, 558, 10.1016/S0035-9203(99)90381-4
FERRARI T.C., 1995, The value of an enzyme-linked immunosorbent assay for the diagnosis of schistosomiasis mansoni myeloradiculopathy, Trans. roy. Soc. trop. Med. Hyg., 89, 496, 10.1016/0035-9203(95)90083-7
FERRARI T.C., 2004, Involvement of central nervous system in the schistosomiasis, Mem. Inst. Oswaldo Cruz, 99, 59, 10.1590/S0074-02762004000900010
FERRARI T.C., 2004, Spinal cord schistosomiasis: a prospective study of 63 cases emphasizing clinical and therapeutic aspects, J. clin. Neurosci., 11, 246, 10.1016/j.jocn.2003.05.006
FERREIRA L.A., 1998, A tumoral form of encephalic schistosomiasis: report of a case submitted to surgical treatment, Rev. Soc. bras. Med. trop., 31, 89
FISHMAN R.A., 1992, Composition of the cerebrospinal fluid, 2, 183
HABEEBULLA S., 2003, A Brazilian immigrant with spinal schistosomiasis, Infect. Med., 20, 555
HARIBHAI H.C., 1991, Spinal cord schistosomiasis: a clinical, laboratory and radiologic study, with a note on therapeutic aspects, Brain, 114, 709, 10.1093/brain/114.2.709
HUGHES A.J., 2002, Parasitic worms of the central nervous system: an Australian perspective, Intern. Med. J., 32, 541, 10.1046/j.1445-5994.2002.00265.x
JOUBERT J., 1990, Schistosomiasis of the spinal cord - underdiagnosed in South Africa?, S. Afr. med. J., 77, 297
KATZ N., 1972, A simple device for quantitative stool thick-smear technique in schistosomiasis mansoni, Rev. Inst. Med. trop. S. Paulo, 14, 397
LAMBERTUCCI, J.R., 1987, Esquistossomose mansoni em Minas Gerais, Rev. Soc. bras. Med. trop., 20, 47, 10.1590/S0037-86821987000100010
LEITE C.C., 2000, Clinics in diagnostic imaging (52): Spinal cord schistosomiasis, Singapore med. J., 41, 417
LESPRIT P., 2001, Photo quiz: cerebral S. mansoni infection, Clin. infect. Dis., 32, 1347, 10.1086/319999
LIVRAMENTO J.A., 1985, Síndrome do líquido cefalorraqueano na neuroesquistossomose, Arq. Neuro-psiquiat., 43, 372, 10.1590/S0004-282X1985000400006
LIVRAMENTO J.A., 1986, Sinalização do líquido cefalorroqueano em doenças inflamatórias crônicas do sistema nervoso central, Arq. Neuropsiquiat., 44, 351, 10.1590/S0004-282X1986000400005
MACKENZIE I.R., 1998, Manson's schistosomiasis presenting as a brain tumor: Case report, J. Neurosurg., 89, 1052, 10.3171/jns.1998.89.6.1052
MAGALHÃES-SANTOS I.F., 2003, Antibodies to Schistosoma mansoni in human cerebrospinal fluid, Amer. J. trop. Med. Hyg., 68, 294, 10.4269/ajtmh.2003.68.294
MAHMOUD A.A.F., 2000, Trematodes (schistosomiasis) and other flukes, 5, 2950
MORENO-CARVALHO O.A., 2003, Clinical and cerebrospinal fluid (CSF) profile and CSF criteria for the diagnosis of spinal cord schistosomiasis, Arq. Neuropsiquiat., 61 (2B, 353, 10.1590/S0004-282X2003000300006
MWATHA J.K., 1998, High levels of TNF, soluble TNF receptors, soluble ICAM-1, and IFN-gamma, but low levels of IL-5, are associated with hepatosplenic disese in human schistosomiasis mansoni, J. Immunol., 160, 1992, 10.4049/jimmunol.160.4.1992
NASCIMENTO-CARVALHO C.M., 2004, Clinical and cerebrospinal fluid findings in patients less than 20 years old with a presumptive diagnosis of neuroschistosomiasis, J. trop. Pediat., 50, 98, 10.1093/tropej/50.2.98
NAUS C.W.A., 2003, The contribution made by Schistosoma infection to non-traumatic disorders of the spinal cord in Malawi, Ann. trop. Med. Parasit., 97, 711, 10.1179/000349803225002363
NOBRE V., 2001, Schistosomal myeloradiculopathy due to Schistosoma mansoni: report on 23 cases, Mem. Inst. Oswaldo Cruz, 96, 137, 10.1590/S0074-02762001000900020
PAMMENTER M.D., 1991, The value of immunological approaches to the diagnosis of schistosomal myelopathy, Amer. J. trop. Med. Hyg., 44, 329, 10.4269/ajtmh.1991.44.329
PEARCE E., 1991, Downregulation of Th1 cytokine production accompanies induction of Th2 responses by a parasitic helminth, Schistosoma mansoni, J. exp. Med., 173, 159, 10.1084/jem.173.1.159
PEREGRINO A.J.P., 1988, Meningomielorradiculite por Schistosoma mansoni, Arq. Neuro-psiquiat., 46, 49, 10.1590/S0004-282X1988000100009
PEREGRINO A.J.P., 2002, Diagnosis of schistosomiasis of the spinal cord: contribution of magnetic resonance imaging and electroneuromyography, Arq. Neuropsiquiat., 60, 597
PEREGRINO A.J.P., 2002, Esquistossomose medular: análise de 80 casos, Arq. Neuropsiquiat., 60, 603, 10.1590/S0004-282X2002000400016
PITTELLA J.E., 1981, Brain involvement in hepatoesplenic schistosomiasis mansoni, Brain, 104, 621, 10.1093/brain/104.3.621
PITTELLA J.E., 1996, Tumoral form of cerebral schistosomiasis mansoni: a report of cases and a review of the literature, Clin. Neurol. Neurosurg., 98, 15, 10.1016/0303-8467(95)00075-5
PITTELLA J.E., 1991, The relation between involvement of the central nervous system in schistosomiasis mansoni and the clinical forms of parasitosis: a review, J. trop. Med. Hyg., 94, 15
POLDERMAN A.M., 1994, A sedimentation-selective filtration method for the diagnosis of light infections with Schistosoma mansoni, Acta trop., 58, 221, 10.1016/0001-706X(94)90016-7
REIS J.B., 1980, Síndromes do LCR, 171
REIS J.B., 1980, Semiologia do LCR, 63
ROPPER A.H., 2001, A 31-year-old man with an apparent seizure and a mass in the right parietal lobe, New Engl. J. Med., 345, 126, 10.1056/NEJM200107123450208
SANELLI P.C., 2001, Unique linear and nodular MR enhancement pattern in schistosomiasis of the central nervous system: report of three patients, Amer. J. Roentgenol., 177, 1471, 10.2214/ajr.177.6.1771471
SANTOS E.C., 2001, Clinical profile and criteria for the diagnosis of schistosomal myeloradiculopathy, Arq. Neuropsiquiat., 59, 772
SCRIMGEOUR E.M., 1981, Non-traumatic paraplegia in northern Tanzania, Brit. med. J., 283, 975, 10.1136/bmj.283.6297.975
SCRIMGEOUR E.M., 1985, Involvement of the central nervous system in Schistosoma mansoni and S. haematobium infection: a review, Brain, 108, 1023, 10.1093/brain/108.4.1023
SILVA L.C.S., 2002, Cervical spinal cord schistosomiasis, Rev. Soc. bras. Med. trop., 35, 543, 10.1590/S0037-86822002000500023
SILVA L.C.S., 2004, Schistosomal myeloradiculopathy, Rev. Soc. bras. Med. trop., 37, 261
STADECKER M.J., 2001, The identification and characterization of new immunogenic egg components: implications for evaluation and control of the immunopathogenic T cell response in schistosomiasis, Mem. Inst. Oswaldo Cruz, 96, 29, 10.1590/S0074-02762001000900004
TSANG V.C., 1997, Immunodiagnosis of schistosomiasis, Immunol. Invest., 26, 175, 10.3109/08820139709048925
URBAN C.D., 1996, Acute schistosomiasis of the brain: case report, Arq. Neuropsiquiat., 54, 677
VAN LIESHOUT L., 1995, Analysis of worm burden variation in human Schistosoma mansoni infections by determination of serum levels of circulating anodic antigen and circulating cathodic antigen, J. infect. Dis., 172, 1336, 10.1093/infdis/172.5.1336
VAN LIESHOUT L., 2000, Immunodiagnosis of schistosomiasis by determination of the circulating antigens CAA and CCA, in particular in individuals with recent or light infections, Acta trop., 77, 69, 10.1016/S0001-706X(00)00115-7
1996, 1