Factor VIII-related antigen in cerebrospinal fluid.

ABSTRACT

A hundred and one samples of cerebrospinal fluid (CSF) were obtained from patients with bacterial meningitis (18), viral meningitis (9), lymphoproliferative disorders (33), 15 with meningeal infiltrations, multiple sclerosis (8), stroke (8) and 25 subjects with normal CSF. All samples were studied for VIIIRAg with specific and sensitive immunoradiometric assay (IRMA) and Laurell's technique. Prothrombin and factor IX antigenic activities were investigated by Laurell's technique. Simultaneously, plasma specimens from ten patients with bacterial meningitis were evaluated. Only a selective increase of VIIIRAg was demonstrated in CSF from bacterial meningitis whereas prothrombin and factor IX were not detected. VIIIRAg plasma and CSF levels were uncorrelated. Similarly, no relationship could be established between the degree of elevation of VIIRAg in the CSF and their protein concentration. These findings suggest that VIIIRAg elevation in CSF has diagnostic value for bacterial meningitis and that disruption of the blood-brain barrier is not responsible for their elevated levels. Accordingly, the presence of VIIIRAg in CSF may be an indication of endothelial damage in the choroid plexi.