T-Cell Subsets and Interleukin-6 Response in Rasmussen’s Encephalitis

• Published in: Pediatric neurology 2005-07, Vol.33 (1), p.39-45
• Main Authors: Tekgul, Hasan, Polat, Muzaffer, Kitis, Omer, Serdaroglu, Gul, Tosun, Ayse, Terlemez, Semiha, Kutukculer, Necil, Ersahin, Yusuf, Gökben, Sarenur
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; CD8-Positive T-Lymphocytes - metabolism; Child; Child, Preschool; Development. Senescence. Regeneration. Transplantation; Encephalitis - blood; Encephalitis - cerebrospinal fluid; Encephalitis - diagnosis; Female; Fundamental and applied biological sciences. Psychology; Human viral diseases; Humans; Infectious diseases; Interleukin-6 - blood; Interleukin-6 - cerebrospinal fluid; Male; Medical sciences; Neurology; T-Lymphocyte Subsets - metabolism; Vertebrates: nervous system and sense organs; Viral diseases; Viral diseases of the nervous system
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2005.01.007

To evaluate the immunopathogenesis in Rasmussen’s encephalitis, peripheral lymphocyte subsets and interleukin-6 analysis were performed in three patients. Magnetic resonance spectroscopy and diffusion-weighted magnetic resonance imaging were performed to assess neuronal injury in the affected hemisphere. Before initiation of immune therapy, percentage of cytotoxic T cells was found to be increased in peripheral blood obtained from patients compared with a group of age-matched normal control subjects. During follow-up, percentage of cytotoxic T cells returned to the normal ranges only in one patient who had an early functional hemispherectomy. All three patients had significantly increased interleukin-6 concentration in cerebrospinal fluid and serum compared with the mean values of patients with acute viral encephalitis. The magnitude of interleukin-6 response in the patients correlated with the neuronal loss and atrophy on magnetic resonance spectroscopy and diffusion-weighted magnetic resonance imaging studies. The patient, who had a fulminant course and an early hemispherectomy, had higher interleukin-6 concentration in cerebrospinal fluid and serum than those of the other two. Detection of an increased percentage of cytotoxic T cells in peripheral blood supports the presence of a T cell-mediated inflammatory pathogenesis in Rasmussen’s encephalitis. However, elevated interleukin-6 response might reflect the magnitude of the inflammatory process in the affected hemisphere.