DIAGNOSIS OF ENTEROVIRUS BRAIN DISEASE IN HYPOGAMMAGLOBULINEMIC PATIENTS BY POLYMERASE CHAIN-REACTION

CSF samples taken from three patients with primary hypogammaglobulinem ia and chronic brain disease were positive for enterovirus RNA by use of a technique based on the polymerase chain reaction (PCR) to amplify viral genomic sequences. Repeated attempts to culture viruses from th e CSF from these patients were unsuccessful, possibly because the pati ents were treated regularly with intravenous immunoglobulin, which may have contained enough specific antibody to partially neutralize the v iruses. Our data suggest that enteroviruses are responsible for divers e CNS features in patients with primary hypogammaglobulinemia and that for these patients the diagnosis should be pursued using PCR technolo gy.