Current possibilities of laboratory diagnostics of cerebral injury pattern and outcomes of Varicella encephalitis in children

Encephalitis caused by Varicella zoster virus is one of the unpredictable diseases that complicate both the course of chickenpox (Varicella (chickenpox) encephalitis) and herpes zoster (zoster-encephalitis) that develops as a result of viral reactivation. In the pathogenesis of encephalitis, the significance of the brain vessels, myelin, astroglia and neurons. Biochemical markers of central nervous system damage are astroglia-specific S-100B protein and neuron-specific enolase (NSE).

The aim is to determine the value of NSE and S-100B protein levels in blood serum and cerebrospinal fluid in the diagnosis of the severity of brain damage and the prognosis of neurological outcomes in chickenpox encephalitis in children.

Materials and methods. Clinical and laboratory examination of 35 children aged from 5 months to 18 years who were hospitalized to the clinic of Federal Scientific and Clinical Center of Infectious Diseases with the diagnosis of chickenpox encephalitis. The study was conducted in groups of patients differing in the severity of the disease, specific features of residual neurological deficit after discharge from the hospital. The levels of S-100B protein and NSE in the blood serum and cerebrospinal fluid were determined by enzymelinked immunosorbent assay.

Results. A significant increase in the S-100B protein level in cerebrospinal fluid was found in extremely severe cases of the disease. The effectiveness of determining the level of NSE in cerebrospinal fluid for predicting the duration of neurological deficit was revealed. Comparison of neurospecific proteins level with MRI parameters allowed us to establish a reliable increase in the blood serum of NSE and S-100B protein in cerebrospinal fluid in children with more evident structural and functional changes according to MRI.

Conclusion. Identification of the levels of neurospecific proteins in the blood serum and cerebrospinal fluid in children with varicella encephalitis has diagnostic and prognostic significance, which allows to identify risk groups for unfavorable disease outcomes with long-term neurological deficit, and thus can serve as a basis for immediate therapy correction and early medical rehabilitation.

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