Effect of Aging on Coagulation and Fibrinolysis(Special Issue in Hornor of the Retirement of Professor Toshiko Takemiya at the Department of Neurology, Tokyo Women's Medical University)

Abstract

I tried to detect herpes simplex virus (HSV)-DNA from cerebrospinal fluid (CSF) obtained from herpes simplex encephalitis (HSE) patients by polymerase chain reaction (PCR) to evaluate the utility of PCR in the HSE diagnosis. Patients in whom the diagnosis of meningoencephalitis was established or suspected based on clinical symptoms, brain MRI and CT findings, HSV antibody titer determined by enzyme linked immunosorbent assay, and the results of CSF examinations were divided into the following four groups, and HSV-DNA in CSF was semi-quantitatively determined by PCR in each patient: group A; eight patients in whom the diagnosis of HSE has been clinically established (patients 1～8), group B; twenty eight patients with meningoencephalitis due to an unknown causative organism, or with aseptic meningitis (patients 9～36), group C; eleven patients in whom the diagnosis of meningoencephalitis other than HSE has been confirmed (patients 37～47), group D; six patients with the disease except meningoencephalitis (patients 48～53). In group A, HSV-DNA was detected in the CSF of all eight patients compared to nine of twenty eight patients in group B, one of eleven in C group and none in group D. HSV-DNA in CSF was detected by PCR at an early stage of the disease onset and was not found in the recovery stage. The HSV-DNA amount reflected the clinical severity and state of the disease. In group B, a positive reaction was thought to indicate the presence of meningoencephalitis caused by HSV. These findings suggest that PCR is highly sensitive as an auxiliary diagnostic method. In conclusion, the detection of HSV-DNA in CSF by PCR gives very disease-specific results and is useful for the diagnosing HSE