THE VALIDITY OF INTRATHECAL SECRETION FOR MULAS OF IGG IN THE FOLLOW-UP OR RESPONSE TO TREATMENT OF NEUROSYPHILIS

The different formulas on intrathecal secretion of IgG were evaluated in patients with active neurosyphillis (NS) who did not have HIV infec tion with the aim of knowing their usefulness and sensitivity in the f ollow up of response to treatment. Five HIV negative patients with def ined criteria of active NS were analyzed. The QAlb ratio (albumin LCR/ serum x 1,000) and Tourtellotte, Schuller and Reiber formulas of intra thecal secretion and the Link's index were studied prior to and at 15 days and three months following treatment with high intravenous doses of penicillin G over 12 days. A decrease in the QAlb ratio and all the formulas of intrathecal secretion of IgG was observed after treatment . The mean decrease was statistically significant on the third month a fter treatment for the Tourtellotte formula (116.6 +/- 44 mg/dl in bas al control, 60.7 +/- 38 mg/dl at 15 days and 46.5 +/- 59 mg/dl at thre e months) (p < 0.05). The same evolutive pattern was not observed with the Link's index 1.75 +/- 9 mg/dl in basal control, 1.16 +/- 5 mg/dl at 15 days and 1.79 +/- 1 mg/dl at 3 months) in this series. The formu las of intrathecal secretion of IgG are useful to evaluate the respons e to treatment of patients with active neurosyphillis. The Tourtellott e formula was shown to be better than the Link index in this evaluatio n.