RU2570384C1 - Method of predicting development of postherpetic neuralgia in acute period of herpes zoster - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: concentration of serotonin is determined in patient's blood serum in acute period of herpes zoster, and if its value is lower than 100 ng/ml, high risk of development of postherpetic neuralgia is predicted.

EFFECT: increased accuracy of prediction.

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Description

The invention relates to medicine, in particular to neurology and infectious diseases, namely, laboratory diagnosis and prevention of postherpetic neuralgia, and can be used to objectively predict the development of postherpetic neuralgia (PHN) in patients in the acute period of herpes zoster (OH) and its effective prevention.

PHN is the most common complication of herpes virus infection, especially in the elderly (Gobel, 1997). The frequency of occurrence of PHN is 15–20%; in elderly people, according to some authors, it reaches 70%. Given the presence of intense neuropathic pain, PHN has a significant negative impact on the quality of life and functional status of patients. The search for forecasting opportunities and prevention of the development of postherpetic neuralgia are an important problem of modern medicine.

No methods have been found for predicting the development of PHN in patients in the acute period of GO in the patent sources we studied and in the scientific medical literature.

EFFECT: development of an affordable, accurate, objective method for predicting the development of postherpetic neuralgia in the acute period of herpes zoster (EX), with a view to its timely prevention through the use of reliable laboratory criteria. This is achieved by determining the concentration of serotonin in the patient’s blood serum in the acute period of herpes zoster and when it is below 100 ng / ml, a high risk of developing postherpetic neuralgia is predicted.

The method is as follows.

5.0 ml of blood is taken from a vein from a patient in a glass centrifuge tube in the morning on an empty stomach. Serum is obtained by centrifugation at 1000 rpm for 10 minutes. The separated serum can be stored for 3 hours at room temperature, up to 12 hours at 4-8 ° C and for a long period at -20 ° C and below.

Essential reagents: an enzyme immunoassay for the quantitative determination of serotonin in serum, plasma, platelets, urine, tissue homogenates and in supernatants of cell cultures ELISA.

Definition: preparation of samples for analysis, namely, derivatization of serotonin into N-acylserotonin, is combined with the dilution of the sample and produced by incubating the sample with an “Acylating reagent”. The determination procedure itself is based on the principles of competitive enzyme-linked immunosorbent assay (competitive ELISA). Biotinylated and non-biotinylated antigen compete for a limited number of binding sites for specific antibodies immobilized on the solid phase. The amount of biotinylated antigen is inversely proportional to the concentration of the analyte in the sample. After equilibration and washing of the unbound antigen, the remaining bound antigen is labeled with anti-biotin antibodies conjugated to alkaline phosphatase. Then, its amount is recorded photometrically at a wavelength of 405 after carrying out an enzymatic reaction with the substrate. Antigen concentration is calculated by extrapolating the data to a calibration graph constructed from the results of the analysis with a series of Standards and expressed in ng / ml.

The quantitative serotonin content in the blood serum is determined, with an indicator below 100 ng / ml, the development of PHN is predicted in the patient. The quantitative serotonin content in the blood serum of healthy individuals averaged 240 ng / ml. The method provides accuracy in predicting the development of PHN in the acute period of exhaust gas for its timely prevention.

This method was tested in the examination of 53 patients (15 men and 38 women aged 39-83 years) in the acute period of herpes zoster before treatment with antiviral drugs that were hospitalized in the infectious ward. The control group consisted of 15 healthy individuals.

Clinical example 1.

Patient K., 64 years old, was admitted to the infectious ward with complaints of intense burning, throbbing pains in the left thigh, multiple vesicular rashes on the outer surface of the left thigh.

From the anamnesis it is known that at first they appeared with pain in the left thigh area, which were not stopped by taking analgesics, the next day, bubble rashes appeared on the skin of the left thigh. Upon admission in neurological status: cranial nerves without pathology. Tendon reflexes are living, equal. Hypesthesia of pain sensitivity in the area of the L3 segment on the left. In the area of the outer surface of the thigh, flushing of the skin and profuse vesicular eruptions.

Diagnosis: Acute herpes infection, herpes zoster.

Patient K.'s serum serotonin content was 214.4 ng / ml.

The patient was examined again after 1, 3, 6 months, there was no postherpetic neuralgia.

Clinical example 2.

Patient S., 68 years old, was admitted to the infectious ward with complaints of intense burning pains in the left hand, left half of the chest, vesicle rashes on the skin of the left hand.

From the anamnesis it is known that at first the patient had pains in the left arm, then after 3 days the pain intensified and multiple skin rashes appeared. In the study of neurological status: cranial nerves without pathology, tendon reflexes are living, equal. Hypesthesia of pain sensitivity in the area of segments C4-D4 on the left, multiple vesicular eruptions in the area of these dermatomes.

Diagnosis: Acute herpes infection, herpes zoster.

The serum serotonin content was 70.62 ng / ml.

After 4 weeks, the patient developed postherpetic neuralgia, which lasted up to 5 months.

Clinical example 3.

Patient V., 36 years old, was admitted to the infectious ward with complaints of burning pains in the left half of the chest, vesicles on the skin of the chest and back on the left.

From the anamnesis it is known that at first pains appeared in the left half of the chest, then on the third day multiple vesicles were poured on the skin of the chest and back on the left. In the study of neurological status: cranial nerves without pathology, tendon reflexes are living, equal. Hypesthesia of pain sensitivity in the area of segments D4-D5 on the left, multiple vesicular eruptions in the area of these dermatomes.

Diagnosis: Acute herpes infection, herpes zoster.

Patient S.'s serotonin content was 87.7 ng / ml.

In the follow-up, patient V. after 5 weeks developed postherpetic neuralgia, which lasted 3 months.

Claims (1)

A method for predicting the development of postherpetic neuralgia in the acute period of herpes zoster (OH), characterized in that the concentration of serotonin is determined in the patient's blood serum in the acute period of herpes zoster and, with its value below 100 ng / ml, a high risk of developing postherpetic neuralgia is predicted.