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Phenotypic analysis of cerebrospinal fluid cells over the course of Lyme meningoradiculitis
1Department of Neurology, Ruhr University, Kliniken Bergmannsheil, Bochum, Germany.
Abstract:
Cytologic cerebrospinal fluid abnormalities that most distinctly point to the diagnosis of Lyme meningoradiculitis are pronounced mononuclear pleocytosis composed mainly of T lymphocytes, large amounts of plasma cells and IgM-positive B cells. In this study, repeat examinations revealed decreasing cell numbers and almost normal cell counts 100-130 days after the onset. B cells persisted over the whole observation period in five of six patients and were not related to any clinical symptoms or signs indicative of persistent meningitis or central nervous system involvement. The CD4/CD8 ratio of the helper/inducer and suppressor/cytotoxic lymphocyte subsets declined in all the patients after antibiotic treatment. It might be useful as a marker of the disease activity.
Insights
Cerebrospinal fluid analysis for Lyme meningoradiculitis shows T lymphocytes, plasma cells, and B cells. Cell counts normalize post-treatment, but B cells may persist, and the CD4/CD8 ratio may indicate disease activity.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Background:
- Lyme meningoradiculitis is a neurological manifestation of Lyme disease.
- Cerebrospinal fluid (CSF) analysis is crucial for diagnosing central nervous system involvement.
- Specific cytologic abnormalities in CSF can aid in diagnosis and monitoring.
Purpose of the Study:
- To characterize cytologic abnormalities in CSF of patients with Lyme meningoradiculitis.
- To evaluate changes in CSF cell counts and subsets during and after antibiotic treatment.
- To identify potential CSF markers for disease activity and persistence.
Main Methods:
- CSF samples were analyzed cytologically.
- Cell counts, differential counts (T lymphocytes, B cells), and CD4/CD8 ratios were assessed.
- Repeat examinations were performed 100-130 days after disease onset.
- Patients received antibiotic treatment.
Main Results:
- Pronounced mononuclear pleocytosis with T lymphocytes, plasma cells, and IgM-positive B cells was observed.
- CSF cell counts decreased significantly, nearing normal levels 100-130 days post-onset.
- B cells persisted in most patients throughout the observation period.
- A decline in the CD4/CD8 ratio was noted in all patients after antibiotic treatment.
Conclusions:
- CSF cytology reveals distinct abnormalities in Lyme meningoradiculitis, including specific lymphocyte and plasma cell populations.
- While cell counts normalize, persistent B cells may not correlate with ongoing CNS inflammation.
- The CD4/CD8 ratio may serve as a valuable marker for assessing Lyme meningoradiculitis activity post-treatment.