Rheumatoid factors in subacute bacterial endocarditis--bacterium, duration of disease or genetic predisposition?
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During summer Mediterranean spotted fever (MSF) is prevalent in the subcostal part of Croatia (North Dalmatia) as well as in other areas of the Mediterranean coast. We compared the specificity and sensitivity of complement fixation (CF), latex agglutination (Latex-R. conorii), microimmunofluorescence (micro-IF) and enzyme-linked immuno assay (ELISA) for detection and measuring antibodies against Rickettsia conorii in 78 sera from 46 patients with/or suspected Mediterranean spotted fever. The seroreactivity with SFG antigens containing the Rickettsia conorii-antigen(s) as a common determinant, was positive in all four serological tests suggesting that Rickettsia conorii was the probable causative agent of infection in our patients.
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AIMS: To compare the novel Serofast latex agglutination test (International Mycoplasma, Toulon-Cedex, France) with the complement fixation test and enzyme immunoassay (EIA) for diagnosing acute Mycoplasma pneumoniae infection. METHODS: Paired sera from 60 patients with respiratory infection who had tested positive for M pneumoniae by complement fixation test were analysed with Serofast and indirect EIA for specific IgG and IgM antibodies. RESULTS: Serofast was less sensitive than the two other tests. Only 30 (50%) out of 60 paired sera which showed a diagnostic seroconversion or had high positive, unchanged antibody titres by complement fixation test or EIA, or both, tested positive with Serofast. Positive test results with Serofast were associated with the presence of a complement fixation test titre of > or = 512 and high positive IgM antibody titres measurable by EIA; virtually all patients with a complement fixation test titre of < 256 or those responding primarily in the IgG class tested negative with Serofast. Based on analysis of sera taken at the acute phase of infection, 10 (17%) of the 60 patients tested positive by complement fixation test, 10 (17%) by EIA, and only four (7%) by Serofast. CONCLUSIONS: Serofast was less sensitive than complement fixation test and EIA and it cannot be recommended as a replacement for either test in routine diagnostic use. It might prove useful in laboratories where non-specific tests, such as the determination of cold agglutinins, are still used for the diagnosis of M pneumoniae infection. Testing paired sera is, however, a prerequisite for obtaining acceptable sensitivity by Serofast as well as other serological methods currently available.
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A reverse-phase passive haemagglutination (RPHA) test was developed and standardised after coupling glutaraldehyde- and tannic acid-treated sheep erythrocytes with the soluble goat pox virus (GPV) antigens for the detection of GPV antibody in goat sera. The RPHA test was as sensitive as the latex agglutination (LA) test, and more sensitive than precipitation tests viz. agar gel precipitation and counter immunoelectrophoresis. Nevertheless, the LA test was practically the most useful.
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Volumes of agglutinates produced by the microtiter latex antiglobulin test (LAGT) were measured by an electronic data processing (EDP) method using a particle volume distribution analyzer. This method proved highly sensitive for quantitating weak antibodies, such as anti-digoxin and anti-DNP. EDP measurement of the microtiter latex antiglobulin-inhibition test (LAGIT) is also a suitable method for quantitating HCG, digoxin and DNP.
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A sol-particle immunoassay (SPIA) was developed for determination of anti-rubella antibodies. The test is based on antibody-coated gold sol particles, which may agglutinate in the presence of rubella haemagglutinin antigen. The agglutination which gives a decrease in optical density can be inhibited by specific antibodies present in sera incubated with the immunochemical reagents. The test is performed in microtitration plates and results can be read in a plate-reader. Clinical validation studies were performed comparing the anti-rubella SPIA with the haemagglutination inhibition test and with the latex agglutination test. The sensitivity of the SPIA was calculated to be 99%; the specificity of the test was at least 99.5%. The anti-rubella SPIA is highly suitable for large-scale screening to determine the rubella immune-status.
Latex agglutination (LA), passive hemagglutination (PHA), immunoelectrophoresis (IEP) and specific IgE, IgM, IgG enzyme-linked immunosorbent assay (ELISA) tests for diagnosis and postoperative follow-up of 79 patients with surgically confirmed pulmonary hydatidosis were evaluated. Specific IgG ELISA was the most sensitive test (83.5%) and the least sensitive tests were specific IgE ELISA (44.3%) and IEP (50.6%). The specificity obtained for all the serologic test was above 97% in all cases. The greatest number of false positives in all tests (except IEP) occurred in patients with Taenia saginata and Taenia solium cysticerci infestations and in patients with lymphoma and leukemia. Specific IgG ELISA demonstrated the highest negative predictive value (93.8%). No statistically significant differences (p > 0.050) were found in the sensitivity of the tests when patients with only one cyst and patients with various cysts were compared. Considering only the patients without relapse, the percentage of seropositive patients increased in all tests at 1 and 3 months after surgery. After that time the percentage of seropositive patients decreased. At 48 months after surgery all patients without relapse became negative in IEP, specific IgE ELISA, and specific IgM ELISA. The antibody titers in all seropositive patients increased during the 3 months after surgery. From these 3 months onward, antibody levels decreased in all serologic tests studied in the group of patients without relapse. The patients who had relapses during the first year after surgery presented persistently elevated antibody titers in all postoperative sera. The antibody titers of the patients who relapsed between the third and fourth years after surgery decreased progressively the third month after surgery, and increased in the serum obtained at the moment of relapse diagnosis. Our results show that persistence of elevated antibody titers in patients with pulmonary hydatidosis in the year after surgery or titer increase after a progressive decrease are indicative of relapse or reinfection.