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PEDIATRICS Vol. 102 No. 4 October 1998, pp. 986-989

EXPERIENCE AND REASON:
Pertussis Encephalopathy With High Cerebrospinal Fluid Antibody Titers to Pertussis Toxin and Filamentous Hemagglutinin

Received Dec 30, 1997; accepted Apr 3, 1998.

Cameron C. Grant

Department of Paediatrics Faculty of Medicine and Health Sciences University of Auckland Starship Children's Hospital Auckland Healthcare Limited Auckland, New Zealand

E. John McKay, and Dr Med Sci

Department of Virology/Immunology Auckland Healthcare Limited Auckland, New Zealand

Alan Simpson, and David Buckley

Starship Children's Hospital Auckland Healthcare Limited Auckland, New Zealand

A 7-year-old unimmunized girl with pertussis presented with respiratory failure and electroencephalographic evidence of an encephalopathy. The cerebrospinal fluid (CSF)/serum ratio of antibodies to pertussis toxin and filamentous hemagglutinin were 11- and ninefold higher than the CSF/serum ratio of total immunoglobulin G. The CSF/serum ratio of albumin was normal. These findings indicate production of antibodies in the central nervous system to Bordetella pertussis antigens and imply, therefore, that the pertussis encephalopathy in this girl was associated with the entry of pertussis antigens into the central nervous system.

 Key words:  pertussis encephalopathy, pertussis toxin, filamentous hemagglutinin, cerebrospinal fluid antibodies.




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