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PubMed1984

Thrombotic and hemorrhagic complications in children with the lupus anticoagulant.

Endogenous circulating anticoagulants are unusual in children without a congenital factor deficiency. In particular, the lupus anticoagulant has only rarely been reported in children. Despite its functioning in vitro to prolong the partial thromboplastin time, patients more frequently have problems with thrombosis than bleeding, unless there is a coexistent prothrombin deficiency or thrombocytopenia. We report the cases of three children with the lupus anticoagulant. Two children had associated thromboses. One had a thrombosis of the iliofemoral system and the other had a partial Budd-Chiari syndrome, a thrombosis of the deep calf veins and ureteric obstruction. The third child had a concomitant prothrombin deficiency and bleeding after tooth extraction. Associated findings in these patients included a positive antinuclear antibody test in two, a positive anti-DNA antibody test in two, a false-positive VDRL test in two, and an antiphospholipid antibody test in two.

Adolescent↗
PubMed1976

Humoral immunity in experimental syphilis. II. The relationship of neutralizing factors in immune serum to acquired resistance.

Evidence for a humoral mechanism in immunity to experimental syphilis was provided by the demonstration of immune rabbit serum factor(s) capable of inactivating virulent Treponema pallidum, Nichols strain, in an in vitro-in vivo neutralization test. After intratesticular infection, rabbits were bled periodically and their resistance to reinfection was determined by challenge with T. pallidum. The results of challenge showed that resistance to reinfection begins to develop by 11 days after infection, becomes complete by 3 months, and persists for at least 2 years. In the neutralization test, a mixture of treponemal suspension and serum from the infected animals was incubated anaerobically at 34 degrees C and the virulence of the treponemes was determined by intradermal inoculation into normal rabbits. Complete inactivation of treponemes by immune serum required heat-stable and heat-labile (56 degrees C, 30 min) serum components and 16 hr of incubation, and was accelerated by pre-incubation of the treponemes for 4 hr with nonimmune serum but not by 100 mug/ml of added lysozyme. Serum-neutralizing activity, first demonstrable 1 month postinfection, was quantitated by a neutralizing endpoint (NEP). A relatively close quantitative correlation was shown between the development of resistance to symptomatic reinfection and the appearance and persistence of both TPI antibody and neutralizing serum factor(s). The nature of the serum factor(s), the mechanism of treponemal inactivation, and the application of the test in assessing the immune status are discussed.

Animals↗
PubMed1974

Comparison of three serological tests in gonococcal infection.

Three serological tests used in the diagnosis of gonococcal infection were compared with cultural techniques in 857 females attending the Prenatal and Gynaecology Clinics at the Winnipeg General Hospital. The tests evaluated were the microflocculation technique (MFT), the indirect fluorescent-antibody technique (IFAT), and the complement-fixation technique (CFT). One hundred six patients had positive cultures for Neisseria gonorrhoeae. In this population, the MFT was reactive in 80 patients (75.4%), the IFAT was reactive in 74 (69.8%), and the CFT was reactive in 33 (31.1%). In the 751 patients with negative cultures, the MFT was positive in 11.4%, the IFAT was positive in 17.4%, and the CFT was positive in 10.5%. Sera from 9 of 10 patients with gonococcal arthritis were positive with the MFT.

Adolescent↗
PubMed1983

Role of the Venereal Disease Research Laboratory test in the detection of syphilis.

Of 9733 consecutive serological samples received by Portsmouth and Southampton Public Health Laboratories (PHL) and tested for syphilis, 190 (140 from men and 50 from women) gave positive results. Thirty new cases of syphilis were identified. Most sera were tested initially by both a specific antibody test (the Treponema pallidum haemaglutination (TPHA) test) and a cardiolipin test (the Venereal Disease Research Laboratory (VDRL) test). Among the 14 patients whose sera gave VDRL-positive but TPHA-negative results, 12 sera gave false-positive results. The sera of 90 patients gave TPHA-positive but VDRL-negative results; sera from only seven of these patients gave false-positive results. The VDRL test is very unlikely to identify a new case of syphilis where a TPHA test has failed to do so. The results of the survey suggest that the VDRL test should be withdrawn from initial testing for syphilis except where early primary disease is suspected.

Antibodies, Bacterial↗