Specific humoral immunity in mumps meningitis in children

The pathogenesis of mumps meningitis remains unclear. The aim of this study was to assess the relation between IgM and IgG levels in blood and their relationship with the picture of CSF.

We tested 40 children of both sexes aged 2-14 years. CSF was examined at admission (I) and after 12-14 days (II). Antibodies were measured four times: at admission (I), and after 2 (II), 4 (III), and 8 weeks (IV) by EIA (Behring). The results were expressed as delta absorbency.

The mean IgM level was respectively 0.403; 0.424; 0.317; 0.220. Significant differences were demonstrated between tests I and III and between III and IV. The mean IgG level was respectively 0.923; 1.322; 1.381 and 1.257. Significant differences were noted between tests I and II and between III and IV. We observed significant positive correlations between the IgM levels in tests I and II, II and III, and III and IV. The IgG concentrations significantly correlated in tests I and II, II and III, and II and IV. Significant negative correlations were noted between the IgG levels at test I and the IgM levels at test II. A negative correlation also appeared between the IgM level and CFS pleocytosis at admission, and between the IgM concentration and CSF pleocytosis after two weeks. A positive correlation was found between the IgG level at test I and the CSF glucose level in test II. In this study a high IgG level probably resulted in a lower IgM level at the next test. The IgM concentration at week 8 weeks was about 50% lower than its highest concentration (week 2), while the IgG level decreased simultaneously. The IgM concentration at hospital admission and two weeks later influenced CSF pleocytosis during these periods (higher IgM level - lower pleocytosis). A high IgG level at admission resulted in a lower CSF glucose concentration at the second examination.