Cerebrospinal fluid parameters of horses with West Nile virus neuroinvasive disease

Kutasi, Orsolya and Joó, Kinga and Moravszki, Letícia and Bódai, Emese and Balogh, Nándor and Szenci, Ottó and Sárdi, Sára (2015) Cerebrospinal fluid parameters of horses with West Nile virus neuroinvasive disease. Journal of the American Veterinary Medical Association. ISSN 0003-1488 (Submitted)

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Abstract

Objective: To compare biochemical and cytological findings of cerebrospinal fluid (CSF) samples in horses with acute neuroinvasive West Nile virus (WNV) infections with those of control healthy horses. Design: Retrospective case-control study. Samples: Fifteen CSF samples from horses with acute WNV neuroinvaisve disease (WNVND)and twenty from healthy horses. Procedures: WNVND was diagnosed based on acute neurologic symptoms and positive IgM ELISA results. CSF samples were collected either from the atlanto-occipital or the lumbosacral sites. Results: CSF results of the WNV affected group did not follow normal distribution. Protein,creatine-kinase, aspartate-aminotransferase, lactate-dehydrogenase, alkaline-phosphatase,magnesium, glucose, and lactate concentrations showed abnormal levels in a number of WNV cases. None of the 6 horses with elevated glucose concentrations survived (<=0.36, modified Wald method). Opposite to previous equine studies we have found neutrophilic pleocytosis in 54% of cases. Measured data also indicates that CSF neutrophilia is more likely to be found parallel with high protein content (Fisher exact test, p = 0.1026). Conclusions and clinical relevance: The CSF findings with WNVND are nonspecific and variable. Neutrophils likely play a role in the development of inflammatory response and brain damage. Increased enzyme activities and changes in the electrolyte concentrations reflect CNS cellular injury rather than blood-brain barrier leakage. Although elevated glucose levels reliably predicted outcome, these results might be the consequences of increased plasma levels and reflectgeneral stress rather than any CNS pathophysiology. Examination of CSF is most useful when the results are correlated with history, clinical findings and ancillary laboratory studies.

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