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Biomedical subjects

P Morgan-Capner

Publications and source records attributed to P Morgan-Capner.

At least 109 records · Page 6Linked to original sources
PubMed1984

Acute myocarditis. Role of histological and virological examination in the diagnosis and assessment of immunosuppressive treatment.

Twelve patients, who presented with congestive cardiac failure after a recent influenza like illness, had a clinical diagnosis of acute myocarditis confirmed histologically after endomyocardial biopsy. Eight were under 30 years of age. Serological testing suggested a viral aetiology in six patients. Nine patients were treated with immunosuppressive drugs (prednisolone and azathioprine in seven, prednisolone alone in two). At two months, seven patients showed clinical and haemodynamic improvement (ejection fraction rose from 26.8 to 49% and left ventricular end diastolic pressure fell from 26.4 to 16.2 mm Hg) with biopsy evidence of healed myocarditis. In two, activity persisted. At six months' follow up only four of these patients had maintained their improvement. One patient relapsed after stopping treatment, subsequently improving on its reinstatement. Two patients developed severe interstitial myocardial fibrosis with gradual deterioration. Virology and myocardial histology were complementary in the diagnosis of acute myocarditis in these young patients, whose response to immunosuppressive treatment was variable. An apparent early response could not be clearly separated from variables in the natural history of the condition. Serial endomyocardial biopsies showed a progression to congestive cardiomyopathy in two patients. Multicentre controlled trials will be necessary to assess fully the role of immunosuppressive treatment in this condition.

Acute Disease↗
PubMed1984

Evaluation of a commercial antibody capture enzyme immunoassay for the detection of rubella specific IgM.

A commercial M antibody capture ELISA kit ( Rubenz M) for the detection of rubella specific IgM was evaluated in comparison with M antibody capture radioimmunoassay. A total of 248 sera were evaluated, including sera from cases of primary postnatal rubella, congenital rubella, infectious mononucleosis, and sera which contained rheumatoid factor. No false positive results were obtained but two high positive sera gave Rubenz M values which were below the value recommended as indicative of a positive result. We therefore propose changes in the criteria used for assessing the significance of the results obtained. These changes improve the accuracy of the assay without loss of specificity.

Antibodies, Viral↗
PubMed1983

Importance of markers of hepatitis B virus in alcoholic liver disease.

To determine the importance of the presence of serological markers of hepatitis B virus infection in patients with alcohol related liver disease we compared cumulative alcohol intake and clinical and histological features in patients with markers of hepatitis B virus infection and in those without. Hepatitis B surface antigen (HBsAg) was detected in five (2%) out of 285 patients studied and antibody to HBsAg (anti-HBs) in 41 (14%); one patient had antibody to hepatitis B core antigen alone. The combined prevalence of markers of hepatitis B virus infection was similar in patients with alcoholic cirrhosis (18%) and precirrhotic liver disease (13%). Two patients positive for HBsAg had histological features of both alcoholic liver disease and chronic active hepatitis, with stainable HBsAg. Patients with anti-HBs were, however, histologically indistinguishable from patients without markers, and the mean cumulative alcohol intake of patients with anti-HBs was similar to or even higher than that of patients with liver disease of comparable severity who had no evidence of previous infection. The presence of markers of hepatitis B virus infection was related to former residence in countries with a high prevalence of the infection and to previous parenteral treatment and blood transfusions. Infection with hepatitis B virus does not enhance the development of chronic liver disease in heavy drinkers, except in the small number who remain positive for HBsAg.

Adult↗
PubMed1983

Rubella screening.

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Antibodies, Viral↗
PubMed1983

Antibody capture radioimmunoassay (MACRIA) for coxsackievirus B4 and B5-specific IgM.

An antibody capture radioimmunoassay was established for the detection of coxsackievirus B4 and B5-specific IgM. A significant feature of the assay was the use of an unrefined coxsackievirus B (CBV) antigen. The antigen was prepared by freeze thawing, ultrasonication and low speed centrifugation of infected Vero cells with no purification or concentration of the antigen being performed. Results of sera tested were expressed as a serum ratio (SR) by comparison with a low positive control serum. To establish an SR indicating positivity in the assays, 100 antenatal sera collected in late February were tested. The mean SR was calculated and the mean plus three standard deviations was taken as the minimum SR indicating positivity. Although resulting in a relatively insensitive assay, such a value was required to exclude sera giving a low level of reactivity which may be due to residual enterovirus-specific IgM resulting from a remote infection.The homologous CBV-IgM assay was positive in four cases of CBV4 infection and six cases of CBV5 infection. For the CBV4 IgM assay, ten of 20 (50%) sera from infections with CBV other than CBV4 were positive and nine of the 13 (69%) sera from infections with echoviruses or coxsackieviruses A were positive. Five of 18 (27%) sera with an elevated CBV neutralization titre were positive in the CBV4-IgM assay. For the CB5-IgM assay seven of 18 (39%) sera from infections with CBV other than CBV5 were positive and nine of 13 (69%) sera from infections with echoviruses or coxsackieviruses A were positive. The nine sera that were positive from this group in the CBV5-IgM assay were the same nine as were positive in the CBV4-IgM assay. Two of the 18 (11%) sera with an elevated CBV neutralization titre were positive in the CBV5-IgM assay. These two sera were also positive in the CBV4-IgM assay and had an elevated monotypic CBV4 neutralization titre. None of the sera giving positive results gave significant reactivity when tested with control antigen. Twelve rheumatoid factor containing sera and 46 sera from other infections were negative in both assays. Of 24 sera from confirmed CBV infection, seven gave a positive monotypic CBV4 or 5-IgM response, ten were positive in both assays and seven were negative in both assays. The positive results seen with sera from cases of heterologous enterovirus infection may result from an anamnestic IgM response or, more likely, IgM directed against enterovirus cross-reacting antigens. The absence of homologous neutralizing antibody at a dilution of 1:20 in nine of 20 sera that gave a positive CBV-IgM result and the presence of positive results for CBV4 and 5-IgM in a 14 month old infant who had echovirus 7 infection indicates that the IgM need not be directed against neutralizing antigens.Thus the CBV4 and 5-IgM assays developed appeared to be specific for an enterovirus infection but because of the cross-reactivity were not type-specific or group-specific.

Adolescent↗
PubMed1983

Rubella-specific IgM reactivity in sera from cases of infectious mononucleosis.

Eight sera from 125 cases of infectious mononucleosis (IM) were reactive for rubella-specific IgM in an M-antibody capture radioimmunoassay. The reactivity of individual sera varied depending upon the source of the rubella antigen used in the assay. One serum gave strongly positive results with some rubella haemagglutinating antigens but negative results with others and may have contained an IgM antibody which was capable of distinguishing between strains of rubella virus. If the diagnosis of rubella is based solely on detection in solid-phase immunoassay of rubella-specific IgM, IM should be excluded.

Adult↗
PubMed1983

Isolation of Chlamydia trachomatis from prostatic fluid in association with inflammatory joint or eye disease.

We describe two patients, one with peripheral arthritis, sacro-iliitis, positive HLA B27, and autoantibodies to smooth muscle and gastric parietal cell; the other with aphthoid ulcers, geographical tongue, conjunctivitis, anterior uveitis, peripheral arthralgia, and diarrhoea with distal proctocolitis. Neither patient would have been diagnosed as having urethritis on the basis of accepted microscopic criteria. In both patients, however, Chlamydia trachomatis was isolated from the prostatic fluid, but not the urethra.

Adult↗
PubMed1982

The detection of rubella-specific IgM by an immunosorbent assay with solid-phase attachment of red cells (SPARC).

An immunosorbent assay using solid-phase attachment of red cells (SPARC) was used for the detection of rubella-specific IgM. The method is described and the results compared with those obtained by the IgM antibody capture radioimmunoassay (MACRIA). One hundred and ninety-nine sera were investigated for the presence of rubella-specific IgM and only one discrepant result occurred, namely a false positive obtained by MACRIA in a patient with infectious mononucleosis. Rheumatoid factor, heterophile antibody, and rubella-specific IgG did not interfere with the results obtained by the SPARC technique. Advantages of the SPARC technique include the case and lack of expense of testing large numbers of sera, the small volume of sample required and the fact that pretreatment of serum is not necessary.

Antibodies, Viral↗
PubMed1982

Radial haemolysis for the detection of rubella antibody in acute postnatal rubella.

One hundred and forty-eight sera from 101 cases of acute postnatal rubella were examined by the radial haemolysis (RH) technique currently recommended by the Public Health Laboratory Service of the United Kingdom. In 75 cases the date of onset of rash was known. No sera were RH positive until the third day after the onset of rash and one serum was still negative at 9 days. By 10 days all sera gave a zone of at least 10 mm. The antibody response detected by RH appears later than that detected by haemagglutination inhibition (HI). Thirty-nine of the 101 cases could be diagnosed by seroconversion or a significant rise in titre using the HI test (diagnosis of the remainder depending upon rubella-specific IgM tests). Using the RH test this figure rises to 48 but in ten of these cases reliance on RH would have meant a delay in diagnosis. The results also indicate that many more sera would need to be tested for rubella-specific IgM if the RH test was used instead of the HI test for evaluating possible cases and contacts of rubella.

Acute Disease↗
PubMed1982

Chlamydial screening of pregnant women in a sexually transmitted diseases clinic.

Fifty-three consecutive pregnant women seen over six months were screened for chlamydial infection, syphilis, gonorrhoea, trichomoniasis, and candidosis. Chlamydia trachomatis was isolated in 20 (37.7%) patients, of whom six were sexual partners of known cases of non-gonococcal urethritis (NGU) (two had associated gonorrhoea or candidosis) and six had gonorrhoea (three had associated trichomoniasis and candidosis). If treatment is given to contacts of NGU 14 patients with other presenting conditions would not have been treated unless chlamydial cultures had been performed. This may lead to potentially serious complications of chlamydial infection in both mothers and neonates.

Adolescent↗