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. 1997 Jun;73(3):181–183. doi: 10.1136/sti.73.3.181

Cerebrospinal fluid ferritin in HIV infected patients with acute neurological episodes.

F Deisenhammer 1, R F Miller 1, N S Brink 1, M J Harrison 1, E J Thompson 1
PMCID: PMC1195817  PMID: 9306897

Abstract

OBJECTIVES: To measure cerebrospinal fluid (CSF) ferritin in HIV infected patients with acute neurological episodes and to correlate the findings with the type and severity of neurological disease. METHODS: CSF ferritin and the ratio of CSF to serum albumin (QAlb) were prospectively measured in 27 consecutive HIV infected patients admitted to a specialist unit for investigation of acute neurological episodes; the results were compared with their clinical diagnoses. RESULTS: Ten patients had HIV associated dementia complex, six had cryptococcal meningitis, two had primary CNS lymphoma and nine had miscellaneous conditions including herpes simplex virus encephalitis, cytomegalovirus encephalitis, cerebral toxoplasmosis and mononeuritis multiplex. Overall, 16 (59%) patients had raised CSF ferritin levels, ranging from 13.0 to 50.2 micrograms/l, (median = 16.1 micrograms/l: normal range = 1.0-12.0 micrograms/l). Thirteen of the 16 also had normal QAlb values, implying an intact CSF-blood barrier, and thus that local synthesis of ferritin had occurred. Elevated ferritin levels were not associated with particular neurological diagnoses. In those with HIV associated dementia complex there was no correlation between CSF ferritin levels and the severity of clinical cognitive deficit or the extent of magnetic resonance imaging abnormalities. CONCLUSIONS: An elevated CSF ferritin level is a non-specific finding in HIV infected patients presenting with acute neurological episodes.

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Selected References

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  1. Aurelius E., Johansson B., Sköldenberg B., Forsgren M. Encephalitis in immunocompetent patients due to herpes simplex virus type 1 or 2 as determined by type-specific polymerase chain reaction and antibody assays of cerebrospinal fluid. J Med Virol. 1993 Mar;39(3):179–186. doi: 10.1002/jmv.1890390302. [DOI] [PubMed] [Google Scholar]
  2. Campbell D. R., Skikne B. S., Cook J. D. Cerebrospinal fluid ferritin levels in screening for meningism. Arch Neurol. 1986 Dec;43(12):1257–1260. doi: 10.1001/archneur.1986.00520120041014. [DOI] [PubMed] [Google Scholar]
  3. Fox J. D., Brink N. S., Zuckerman M. A., Neild P., Gazzard B. G., Tedder R. S., Miller R. F. Detection of herpesvirus DNA by nested polymerase chain reaction in cerebrospinal fluid of human immunodeficiency virus-infected persons with neurologic disease: a prospective evaluation. J Infect Dis. 1995 Oct;172(4):1087–1090. doi: 10.1093/infdis/172.4.1087. [DOI] [PubMed] [Google Scholar]
  4. Grant A. D., Fox J. D., Brink N. S., Miller R. F. Detection of varicella-zoster virus DNA using the polymerase chain reaction in an immunocompromised patient with transverse myelitis secondary to herpes zoster. Genitourin Med. 1993 Aug;69(4):273–275. doi: 10.1136/sti.69.4.273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Keir G., Tasdemir N., Thompson E. J. Cerebrospinal fluid ferritin in brain necrosis: evidence for local synthesis. Clin Chim Acta. 1993 Jul 16;216(1-2):153–166. doi: 10.1016/0009-8981(93)90148-w. [DOI] [PubMed] [Google Scholar]
  6. Mitchell S. M., Fox J. D., Tedder R. S., Gazzard B. G., Lightman S. Vitreous fluid sampling and viral genome detection for the diagnosis of viral retinitis in patients with AIDS. J Med Virol. 1994 Aug;43(4):336–340. doi: 10.1002/jmv.1890430404. [DOI] [PubMed] [Google Scholar]
  7. Nomenclature and research case definitions for neurologic manifestations of human immunodeficiency virus-type 1 (HIV-1) infection. Report of a Working Group of the American Academy of Neurology AIDS Task Force. Neurology. 1991 Jun;41(6):778–785. doi: 10.1212/wnl.41.6.778. [DOI] [PubMed] [Google Scholar]
  8. Paley M. N., Chong W. K., Wilkinson I. D., Shepherd J. K., Clews A. M., Sweeney B. J., Hall-Craggs M. A., Kendall B. E., Newman S. P., Harrison M. J. Cerebrospinal fluid-intracranial volume ratio measurements in patients with HIV infection: CLASS image analysis technique. Radiology. 1994 Mar;190(3):879–886. doi: 10.1148/radiology.190.3.8115644. [DOI] [PubMed] [Google Scholar]
  9. Price R. W., Brew B. J. The AIDS dementia complex. J Infect Dis. 1988 Nov;158(5):1079–1083. doi: 10.1093/infdis/158.5.1079. [DOI] [PubMed] [Google Scholar]
  10. Pulliam L., Herndier B. G., Tang N. M., McGrath M. S. Human immunodeficiency virus-infected macrophages produce soluble factors that cause histological and neurochemical alterations in cultured human brains. J Clin Invest. 1991 Feb;87(2):503–512. doi: 10.1172/JCI115024. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Reiber H., Felgenhauer K. Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system. Clin Chim Acta. 1987 Mar 30;163(3):319–328. doi: 10.1016/0009-8981(87)90250-6. [DOI] [PubMed] [Google Scholar]
  12. Sindic C. J., Collet-Cassart D., Cambiaso C. L., Masson P. L., Laterre E. C. The clinical relevance of ferritin concentration in the cerebrospinal fluid. J Neurol Neurosurg Psychiatry. 1981 Apr;44(4):329–333. doi: 10.1136/jnnp.44.4.329. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Wick M., Fink W., Pfister W., Einhäupl K., Huber M., Fateh-Moghadam A. Ferritin in cerebrospinal fluid differentiation between central nervous system haemorrhage and traumatic spinal puncture. J Clin Pathol. 1988 Jul;41(7):809–809. doi: 10.1136/jcp.41.7.809-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Worwood M., Aherne W., Dawkins S., Jacobs A. The characteristics of ferritin from human tissues, serum and blood cells. Clin Sci Mol Med. 1975 May;48(5):441–451. doi: 10.1042/cs0480441. [DOI] [PubMed] [Google Scholar]
  15. Zappone E., Bellotti V., Cazzola M., Ceroni M., Meloni F., Pedrazzoli P., Perfetti V. Cerebrospinal fluid ferritin in human disease. Haematologica. 1986 Mar-Apr;71(2):103–107. [PubMed] [Google Scholar]

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