tailieunhanh - Tropical Neurology - part 6

Tăng bạch cầu ái toan nhẹ, thường là dưới 10%, huyết học bất thường phổ biến nhất ở những bệnh nhân với NCC và có thể được tìm thấy trong 6-37% của Một số bệnh nhân cũng có tăng bạch cầu vừa phải (lên đến mỗi mm3) cũng như lắng đọng trầm tích hồng cầu tỷ lệ trên 30 mm | 264 Tropical Neurology Laboratory Findings Hematological Abnormalities Mild eosinophilia usually below 10 is the most common hematological abnormality in patients with NCC and may be found in 6-37 of Some patients also have moderate leukocytosis up to 17 000 per mm3 as well as an erythrocyte sedimentation rate above 30 mm. These findings appear to be more common in patients with massive cysticercal infestation. Stool Examination for Taenia solium Eggs Eggs of T solium are detected in the stool of 3-27 patients with NCC. It is more important to search for T solium carriers in the patients close environment than to determine the prevalence of Recognition of Taenia eggs is not easy and many patients may remain undiagnosed if a single sample study is performed. Serial stool specimens therefore must be examined before the patient is considered negative. Two recent advances have been made for the diagnosis of human taeniasis ELISA for coproantigen detection and DNA hybridization for egg identification. These new tests will greatly improve the screening for T. solium carriers among healthy individuals in the endemic areas. Cytochemical Analysis of CSF CSF abnormalities have been reported in about 80 of patients with NCC Table . These abnormalities correlate with the activity of the disease and subarachnoid location of the 10 A normal CSF examination therefore does not rule out the diagnosis of NCC. The most consistent CSF finding is a moderate mononuclear pleocytosis with an increase in the number of eosinophils. The cell count rarely exceeds 300 per mm3 however in severe cysticercus meningitis CSF cell count may rise up to 5000 mm3. CSF glucose levels are usually within the normal range despite active meningeal disease. Hypoglycorrhachia 40 mg dl has been associated with poor prognosis. Elevated CSF protein is common in patients with pleocytosis. Protein usually ranges from 50 to 300 mg dl although it may be as high as 1 600 mg dl. 15