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PubMed1982

[Clinical experience in systemic lupus erythematosus (author's transl)].

Thirty-four cases of SLE treated during the past seven years (1974-1981) in Taipei Municipal Jen-Ai Hospital are reported and analyzed. Diagnosis of SLE was based on ARA preliminary criteria and Hahn's preliminary criteria. There were 32 females (94.2%) and 2 males (5.8%). The mean age at diagnosis was 28.5 years (range 14-51). Clinical manifestations were as follows: facial erythema 24 cases (70.6%), Raynaud's phenomenon 4 cases (11.4%), oral or nasopharyngeal ulceration 7 cases (20.6%), arthritis without deformity 22 cases (64.7%), proteinuria 21 cases (61.8%), pleural or pericardial effusions 13 cases (38.2%), psychosis or convulsions 9 cases (26.5%), hematological abnormalities 25 cases (73.5%). Laboratory findings were as follows: positive ANA test 33/34 (97.0%), hypocomplementemia 10/13 (76.9%), direct Coombs' test 4/18 (22.2%), indirect Coombs' test 1/13 (7.6%), LE cell 19/34 (55.9%), RA Latex 7/17 (41.7%), polyclonal gammopathy 15/17 (88.2%), anemia 25/34 (73.5%), leukopenia 12/34 (35.3%), thrombocytopenia 10/34 (29.4%). Three cases were complicated by herpes zoster, one by hyperthyroidism, and one by autoimmune thyroiditis. Ten cases died, including 4 renal failure, 2 heart failure, 2 cases of committed suicide and 1 case of CNS involvement.

Adolescent↗
PubMed1976

Vaccination against bovine brucellosis with a low dose of strain 19 administered by the conjunctival route.

Eighteen 25 month old cows were vaccinated once either with 10(6) to 10(10) living bacteria of Brucella abortus B 19 by the conjunctival route, or with 2.5 to 5 X 10(10) formalin-killed bacteria of the same strain by subcutaneous injection. Fifteen days post-vaccination, low but definite agglutination titers were present in sera of cattle receiving 10(10) living bacteria by the conjunctival route, whereas high titers were observed in the control group given subcutaneous injection of killed bacteria (table I). Agglutination reactions were negative in sera from all cattle receiving less than 10(10) bacteria, and complement fixation tests were negative with all sera. Seventy-one 4 month old claves were vaccinated by the conjunctival route with different doses (10(6) to 10(10)) of living bacteria, either freshly prepared or lyophilized. At autopsy about 15 or about 30 days later, the parotid, submaxillary and retropharyngeal lymph nodes were removed and cultured on Brucella selective medium. Blood samples were taken at autopsy for testing by agglutination, complement fixation, Coombs test and (for some samples) by the Rose Bengal plate test. Colonization of at least one lymph node was observed in 26 of 34 calves given 10(9) bacteria, in all 9 calves given 5 X 10(9) bacteria and in all 12 calves given 10(10) bacteria. Serological responses were demonstrated rarely, and then only in agglutination and Coombs tests. The 5 X 10(9) dose, wich following conjunctival inoculation consistently colonized the regional lymph nodes without inducing significant serological response, would be the most suitable dose for the vaccination of calves and cows.

Animals↗
PubMed1976

Antibody-dependent cell-mediated destruction of human erythrocytes sensitized in ABO and rhesus fetal-maternal incompatibilities.

Antibody-dependent cell-mediated cytotoxicity (ADCMC) was measured in a 51Cr-release assay with antibody-sensitized human red blood cells (RBC) as target cells and nonimmune isologous or autologous mononuclear peripheral blood leukocytes (MPBL) as effector cells. ADCMC was readily demonstrable within 6 hr and was independent of exogenous complement (C'). The specificity of the ADCMC reaction was determined by the antiserum employed. Anti-A, anti-B, anti-D, and anti-c sera were all active in ADCMC; the specific lysis was between 35 and 50% with antiserum dilution of 1/1,000, using 10(5) target cells and 10(6) MPBL. Anti-C, anti-E, and anti-e sera had no detectable activity. Sephadex column separation suggested that this activity was by antibodies of the IgG class. Cord RBC from infants with RhD fetal-maternal incompatibility were lysed by autologous or isologous MPBL in the absence of exogenous antiserum. ADCMC was between 22% and42% in cases with high direct Coombs' test, but was negative with low direct Coombs' test as in five cases of ABO incompatibility.

ABO Blood-Group System↗
PubMed1994

Bilirubin production in healthy term infants as measured by carbon monoxide in breath.

To describe total bilirubin production in healthy term infants, we measured the end-tidal breath CO, corrected for ambient CO (ETCOc), with an automated sampler and electrochemical (EC) CO instrument. For infants of mothers with a negative Coombs' test, the ETCOc was 1.3 +/- 0.7 microL/L (n = 397) and the serum bilirubin on day 3 postpartum was 73 +/- 35 mg/L (n = 381). In contrast, the ETCOc for infants with ABO or Rh incompatibility, a positive direct Coombs' test, and bilirubin > 130 mg/L (n = 9) was significantly higher, 1.8 +/- 0.8 microL/L, than for those who had a positive Coombs' test result but whose bilirubin was < or = 130 mg/L (n = 12), 1.0 +/- 0.5 microL/L (P < 0.05). At 2 to 8 h postpartum seven term babies from mothers with insulin-dependent diabetes had ETCOc of 1.8 +/- 0.7 microL/L, significantly higher than that in the other term infants [1.3 +/- 0.7 microL/L (n = 390), P < 0.04]. Their bilirubin concentration at 72 +/- 12 h was also higher: 121 +/- 45 mg/L (n = 7) vs 73 +/- 34 mg/L (n = 374; P = 0.03). We conclude that ETCOc measurements may be helpful in understanding the mechanisms of jaundice in healthy term infants in a variety of conditions.

Asian↗
PubMed1976

Correlation between serological and immunofluorescence results in the investigation of brucellosis in veterinary surgeons.

Four serological tests and three immunofluorescence tests for IgG, IgM, and IgA were compared for value in the investigation of brucellosis in veterinary surgeons. No one serological test stood out over the others, and the immunofluorescence tests did not appear to have advantages over the serological tests. If a laboratory is limited in time and resources then the saline agglutination or the complement fixation test would be reasonably satisfactory. The 2-mercaptoethanol test and the antihuman globulin (Coombs' test) have no advantages over the other two and could be dropped. Immunofluorescence tests are not recommended for routine testing of brucellosis sera. The results and these recommendations apply to the 'vet' sera tested; it is reasonable to suppose that what applies to 'vet' sera will also apply to sera of those who work with or are in repeated contact with cattle and who will have had previous experience of brucella antigen, that is, dairy farmers, herdsmen, or slaughter house employees.

Agglutination Tests↗
PubMed1995

Anti-Nform antibody in hemodialysis patients.

The anti-Nform antibody is produced by dialysis patients following reuse of dialyzers sterilized with formaldehyde and it has been implicated as a cause of hemolytic anemia. Formaldehyde is one of the common disinfectants used for reprocessing capillary hemodialyzers. The safety of formaldehyde and the clinical significance of anti-Nform antibody need further evaluation. Amongst 45 patients practising dialyzer reuse, anti-Nform antibody was detected in 5 (11.1%), but not amongst 111 patients not reusing their dialyzer (p < 0.005). The presence of anti-Nform was not related to the sex, or duration of dialysis with positive anti-Nform antibody. Direct Coombs' test was positive amongst 80% of all tested patients with anti-Nform antibody, and in 38% of patients reusing dialyzers but without anti-Nform antibody. No tests of hemolysis (including direct Coombs' test) discriminated between anti-Nform antibody-positive and -negative patients, nor between anti-Nform antibody patients with and without overt hemolysis. The best diagnostic test for hemolysis in anti-Nform antibody-positive patients was hematocrit rise after cessation of dialyzer reuse. It appears that despite the induction of anti-Nform antibody, hemolysis is rarely a serious consequence of dialyzer reuse.

Adult↗
PubMed1996

[Hemophagocytosis in a child with paroxysmal cold hemoglobinuria].

A 2-year and 5-month-old boy was admitted to Okaya municipal hospital because of low grade fever and reddish-brown urine soon after an outside walk in November, 1994. Direct Coombs test was negative, but indirect Coombs test positive. Both sugar water test and Ham test were negative. A diagnosis of paroxysmal cold hemoglobinuria (PCH) was made by Donath-Landsteiner (D-L) test which showed the presence of a high amount of anti-P specific IgG and IgM of D-L antibody. Serological tests for syphilis were negative. Cold agglutinin titer and mycoplasma antibody titer was X 128 and X 80, respectively. A bone marrow specimen exhibited pronounced hemophagocytosis. Serum INF-gamma and M-CSF level were normal (less than 5 pg/ml and 1007 units/ml, respectively). These results suggest that hemophagocytosis in this case is not due to hemophagocytic syndrome.

Bone Marrow↗
PubMed1989

[Blood type and screen for crossmatch].

To reduce work and effectively use blood for transfusion, a type and screening system (T & S) has been adopted in many hospitals. A questionnaire survey on the system and tests for a transfusion was carried out on our hospital and 381 other hospitals. For 3 years in our hospital, 0.73% of the samples tested revealed the presence of antibodies to red cells which were 30% of the antibodies in Rh system, 30% in Le system, 38% in P1 M and N, and 3% of the other system such as Fyb, Jka and S. Forty percent of the positive samples were subjected to a crossmatch test. The tests were done in a laboratory for serum test in approximately half of the hospitals. A pharmaceutical division controlled the reservation of blood and blood components in 56% of the hospitals. In 45% of the hospitals, a crossmatch test was done using the methods of saline, enzyme treatment and Coombs test. In 10% of the hospitals. Coombs test was used for the test in the transfusion of red cells, platelets, and frozen plasma, and tests were done in 100, 67, and 52% of the hospitals, respectively. When the T & S system is adopted. Staff must have sufficient knowledge on blood transfusion and the system must be efficient to avoid transfusion troubles.

Blood Group Antigens↗
PubMed1998

Anti-phosphatidylcholine antibodies in patients with brucellosis.

An indirect ELISA was adapted to measure individual classes of anti-phosphatidylcholine (PC) antibodies in patients with brucellosis; a comparison was made with patients with other infectious diseases and healthy human controls. Immunoconjugates of alpha, gamma or mu chain specificity were used. The results were compared with those of conventional tests for brucella antibodies, Rose Bengal, microagglutination (MAT) and Coombs tests, as well as with VDRL. The results indicated that although all sera from patients with brucellosis were VDRL negative, 97% of them (30 of 31) had higher levels of IgA or IgG anti-PC antibodies than the healthy control group. The IgM anti-PC antibodies isotype was not discriminatory between both groups. Seven sera (19%) from patients with other infections had values of IgG anti-PC higher than those of the healthy group; three of them were VDRL positive. The mean ELISA values of IgG and IgA anti-PC (serum diluted 1 in 1600) in the brucellosis and healthy groups were: IgG, 0.80 SEM 0.17 versus 0.23 SEM 0.10; and IgA, 0.86 SEM 0.26 versus 0.35 SEM 0.15. The sensitivity and specificity for the ELISA-PC were: IgG, 96.8% and 96.5%, respectively; IgA, 90.3% and 89.7%, respectively. Only one of 14 individuals clinically cured from brucellosis had significant IgG anti-PC antibodies. In contrast, all of these patients gave positive values in the conventional test for brucellosis. No correlation was found between the serum levels of IgA, IgG anti-PC by ELISA-PC and the results of the MAT or Coombs tests.

Agglutination Tests↗
PubMed2006

Utility of an immunocapture-agglutination test and an enzyme-linked immunosorbent assay test against cytosolic proteins from Brucella melitensis B115 in the diagnosis and follow-up of human acute brucellosis.

The utility of an immunocapture-agglutination (Brucellacapt, Vircell SL, Granada, Spain) test and an enzyme-linked immunosorbent assay IgG, IgA, and IgM (ELISA-IgG, ELISA-IgA, ELISA-IgM) against cytosolic proteins from Brucella melitensis B115 (R) was compared with ELISA-IgG, ELISA-IgA, and ELISA-IgM against smooth lipopolysaccharide (S-LPS) from B. melitensis 16M (S), serum agglutination test (SAT), and Coombs test in the diagnosis and follow-up for 10 months of 51 patients with acute brucellosis. The sensitivities of ELISA tests against cytosolic proteins varied from 49.0 % for ELISA-IgG to 64.7% for ELISA-IgM and were lower than the sensitivities showed by ELISA S-LPS (from 88.2% to 92.2%), SAT (88.2%), Coombs (96.1%), and Brucellacapt (98.0%) tests. Specificity was over 93% in all cases. The evolutionary behavior of the SAT, Coombs, and Brucellacapt tests was similar. There was a decrease of between 20% and 40% in antibody titer in the 10th month of evolution after treatment. The evolutional curves of IgG, IgA, and IgM against cytosolic protein increased slightly till the eighth month. The specific IgM and IgA antibodies against protein fractions began to show a drop from the eighth month on, showing levels slightly lower than the initial sera values by the end of the 10th month. In this month, titers of specific IgG against proteins fractions remained higher than the titers showed by the initial sera.

Acute Disease↗
PubMed1978

[Use of Groupamatic in surveying fetomaternal alloimmunizations].

The A.V.I.S. Blood Transfusion Center of Turin performs the screening of foetomaternal allo-immunizations for the S. Anna Hospital of Turin. This hospital includes 3 hospital departments and 3 obstetrical and gynaecological university departments. The number of births in one year is roughly 13.000, i.e. 50 mother-baby couples, are tested every day. The identification system and the sampling process are described. The program used on the Groupamatic system includes: 1.) First run: Blood typing of mother blood with screening of alloantibodies. Second run: Blood typing control, screening of immune anti-A and anti-B antibodies, syphilis screening. 2.) Washing of cord blood red blood cells: First run: Washed red blood cells ABO and Rhesus typing, direct Coombs test. Second run: Blood typing control. Automatic screening of maternal irregular alloantibodies and automatic indirect Coombs test on washed cordblood red cells are simultaneously controlled with standard manual techniques. Sampling and testing are processed within 24 hours after birth. The set of results concerning mother-baby couples are grouped on one card and sent to the hospital department for a quick MHNN prophylaxy. Results of tests performed on 6.351 pregnancies studied until birth are presented. The automated direct Coombs test was positive with: 1--95% of new borns from mother who have a high immune allo antibody anti-A/B titer (IgG after treatment with two Mercapto etanol greater than I/64). 2--100% of new borns from mother who have irregular allo antibodies in Rh, Kell, Duffy or Kidd systems.

ABO Blood-Group System↗
PubMed1995

Anticardiolipin antibodies in systemic lupus erythematosus: clinical and laboratory correlations.

PURPOSE: To examine the link between anticardiolipin antibodies and the features of antiphospholipid syndrome in patients with systemic lupus erythematosus (SLE). PATIENTS AND METHODS: In this prospective cohort study conducted in a single center, 390 SLE patients were followed up between June 1991 and 1994. At each assessment, a complete history, physical examination, and laboratory evaluation (including measurement of anticardiolipin antibodies) were performed according to a standard protocol. RESULTS: Forty-seven percent of the patients had an elevated level of anticardiolipin antibodies. In the univariate analysis, elevated anticardiolipin antibody levels were found to correlate with thrombocytopenia (P = 0.006), prolonged activated partial thromboplastin time (aPTT) (P = 0.003), and positive direct and indirect Coombs' test result's (P < 0.001). No correlation was identified with any of the clinical features of antiphospholipid syndrome. In the multivariate analysis, anticardiolipin antibodies remained highly associated with thrombocytopenia (odds ratio [OR] 4.05, P = 0.02), positive direct Coombs' test (OR 2.31, P < 0.001), and prolonged aPTT (OR 1.73, P = 0.03). In the multivariate model using venous/arterial thrombosis as the outcome variable, only prolonged aPTT was associated with venous/arterial thrombosis (OR 7.9, P < 0.001). None of the laboratory variables were found to correlate with fetal loss. CONCLUSIONS: The presence of anticardiolipin antibodies in patients with SLE is associated with prolonged aPTT, thrombocytopenia, and positive Coombs' test result, but not with antiphospholipid syndrome. Prolonged aPTT is strongly associated with venous/arterial thrombosis.

Adolescent↗
PubMed2000

Evaluation of an immunocapture-agglutination test (Brucellacapt) for serodiagnosis of human brucellosis.

We evaluated the validity and the usefulness of a new test for the diagnosis of human brucellosis based on an immunocapture-agglutination technique. A total of 315 sera from 82 patients with a diagnosis of brucellosis, 157 sera from patients in whom brucellosis was suspected but not confirmed, and 412 sera from people living in rural areas with endemic brucellosis were studied. The seroagglutination test (SAT), Coombs anti-Brucella test, and Brucellacapt test were evaluated. All the initial sera from the 82 patients proved to be positive in Brucellacapt and Coombs tests, while only 75 (91.4%) were positive in the SAT. If a >/=1/160 diagnostic threshold titer was defined for the Brucellacapt test, Coombs test, and SAT, the sensitivities were 95.1, 91.5, and 65.8%, respectively. Taking the same diagnostic threshold titer for the 157 sera from the unconfirmed but suspected patients, the specificities of the Brucellacapt, Coombs, and SAT were 81.5, 96.2, and 100%, respectively; for the 412 control sera, the specificities were 99.0, 99.8, and 100%. The diagnostic efficiency (area below the receiver operating characteristic curve) of Brucellacapt was 0.987852 (95% confidence interval [CI], 0.95109 to 0.99286), very similar to the diagnostic efficiency of the Coombs test (0.97611; 95% CI, 0.94781 to 0.99146) and higher than that of SAT (0.91013; 95% CI, 0.86649 to 0.94317). The results of the Brucellacapt test were compared with those of the Coombs test (correlation coefficient, 0.956; P = 0.000) and SAT (correlation coefficient, 0.866; P = 0.000). The study shows very good correlation between the Brucellacapt and Coombs tests, with a high concordance between titers obtained in the two tests. Nevertheless, lower correlation and concordance were found between the Brucellacapt and Coombs tests when the results for titers of >/=1/160 were compared (0.692; P = 0.000). In acute brucellosis, the Brucellacapt and Coombs tests render positive titers of >/=1/160. When the titers are lower, they increase significantly in the following 30 days, despite the evolution of SAT titers. In contrast, Brucellacapt and Coombs titers are always high (>/=1/640) in brucellosis with long evolution, whether SAT titers are higher or lower than 1/160.

Adolescent↗
PubMed2005

A pregnant woman with anti-Gregory antigen: case report.

Negative Gregory antigen (Gy(a-)) remains an extremely uncommon blood phenotype. We describe a 32-year-old pregnant woman with (Gy(a-)) and anti-Gregory antigen (anti-Gy(a)). There was no evidence of consanguineous mating in her family. Blood typing study revealed that only her father was Gy(a-) among the family. Anti-Gy(a) had a titer of 16 before pregnancy, but increased to 1024 at 33 weeks of gestation with a titer of 512 at 34 weeks. Her own blood stores were collected starting at 14 weeks, amounting to 1800 g totally. She underwent an emergency cesarean section at 35 weeks due to a non-reassuring fetal status. Blood loss was approximately 1090 g. Cord blood type was found to be Gy(a-). The indirect Coombs test of cord blood was positive, while the direct Coombs test was negative. No neonatal hemorrhagic disease developed. The storage of a sufficient amount of crossmatch-compatible Gy(a-) blood during pregnancy is important in case of possible need of blood transfusion at delivery for women with anti-Gy(a).

Adult↗