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Biomedical subjects

B Evengård

Publications and source records attributed to B Evengård.

14 recordsLinked to original sources

Early antibody responses in human schistosomiasis.

Early diagnosis is important when handling patients with acute schistosomiasis. This state is usually more severe in travellers and tourists than in the immune, resident patients. With increased travelling to areas endemic for schistosomiasis, a tool is needed to solve the problem of differential diagnosis due to the non-specific symptoms of the early stages of the disease. Early appearance of antibodies against excretory/secretory antigens of the intestinal tract in the adult worm was seen in six individuals recently infected with Schistosoma mansoni, using an indirect immunofluorescence technique. The antibodies were of IgM, IgG and IgA classes, and of the IgG1, IgG3 and IgA1 subclasses as detected by ELISA using an antigen preparation of adult worm. On immunoblots, using a freeze-dried adult worm antigen, IgG1 and IgG3 antibodies recognized antigens of 32-35 kD. Antibodies against these antigens could thus be a marker of early infection in previously non exposed visitors to endemic areas.

Adult

Diagnostic and clinical aspects of schistosomiasis in 182 patients treated at a Swedish ward for tropical diseases during a 10-year period.

Patients treated for schistosomiasis during a 10-year period at a hospital for infectious diseases in Stockholm were investigated by a retrospective analysis in order to evaluate the diagnostic procedures. 80% of the 182 individuals originated from an endemic area and 78% were men. The mean age was 28 years for men and 27 for women. 137 had no other detectable parasites. 127 were asymptomatic. Haematuria was found in 6/15 patients with S. haematobium. 143 patients had infection with S. mansoni. Pathological findings during physical examinations were rare. 61% of the patients had eosinophilia. IgE was a sensitive marker among the patients with a chronic infection (84%). Analysis of antibodies directed against the somatic structure of the adult worm by use of immunofluorescence (IFL) technique had a sensitivity of 80% among the patients with a chronic infection. The detection of antibodies against the gut-associated antigens in IFL indicated an early infection. An enzyme-linked immunosorbent assay (ELISA), using a crude soluble egg antigen, had a sensitivity of 95% and specificity of 96% and is of important diagnostic value.

Adolescent

Acute schistosomiasis mansoni in Finnish hunters visiting Africa: need for appropriate diagnostic serology.

Three symptomatic and 3 asymptomatic patients with acute schistosomiasis mansoni are described. The index case presented with fever and eosinophilia 4-6 weeks after swimming in the Pipi River of the Central African Republic, suggesting acute schistosomiasis (Katayama fever). A fortunate early diagnosis led to early treatment of these schistosomiasis patients. Diagnosis was obtained based on the finding of one Schistosoma mansoni egg in the index case and positive serology in all cases. A commercially available passive haemagglutination test for serum bilharzia antibodies was negative in all cases prior to, and 2 weeks after treatment. However, antibodies against gut-associated antigens (GAA) of adult S. mansoni worms could be demonstrated using the indirect immunofluorescence technique. These cases illustrate the importance of using appropriate diagnostic assays for the early demonstration of infection by schistosomes in previously unexposed "nonimmune" patients with atypical symptoms and in asymptomatic individuals at risk even after brief exposure to schistosome-containing water in endemic countries. Careful (and repeated) stool examination and appropriate serological tests are the keys to prompt diagnosis of S. mansoni infection.

Adult

Effect of heat on extracted HIV viral infectivity and antibody activity using the filter paper technique of blood sampling.

The diagnostic potential of the standardized filter paper technique at an outpatient clinic was further evaluated for individuals infected with HIV; the inactivation of HIV in dried blood from filter paper was also investigated. Heat treatment at 56 degrees C or 70 degrees C for 1 h did not demonstrably affect antibody activity as measured by enzyme-linked immunosorbent assay and Western blot. Prolonged treatment up to 18 h reduced the activity to some extent. Drying at room temperature of filter papers which had been soaked with HIV was sufficient to inactivate low, but not high, amounts of infectious virus. After exposure of the filter paper discs to 56 degrees C or 70 degrees C for 1 h, HIV could not be isolated from the extracts. The obvious advantage of blood collection on filter paper for serological studies makes it an alternative to venipuncture, especially when the blood might be contagious for HIV.

AIDS Serodiagnosis

Standardization of a filter-paper technique for blood sampling.

Blood sampling on filter paper has many potential advantages compared to sampling by venepuncture. However, the method is poorly standardized, and some variables affecting its usefulness were therefore explored; different filter papers were compared and an optimal elution procedure was determined. The quantity of eluted IgG, IgM and IgA was determined by single radial diffusion, and antibody activity was determined in an enzyme immunoassay. Comparison to serum titres was facilitated by calculation of the dilution factor. Filter papers containing drops of whole blood from a Swedish patient with Schistosoma mansoni infection were stored at different temperatures over different periods of time. Antibodies of different classes could be extracted and antibody activity demonstrated after up to 30 weeks of storage. The reproducibility of the technique was good, and comparison to serum titres can easily be calculated.

Animals

Subclass distribution and IgE responses after treatment in human schistosomiasis.

The IgG and IgA subclass distribution of specific antibodies as well as the distribution of total and specific IgE in 15 patients with schistosomiasis was determined in consecutive samples before and after initiation of treatment. An adult worm antigen preparation and a soluble egg antigen preparation were used as antigens in the ELISA assays. After initiation of treatment a rise was noted in certain subclasses and a correlation was found for specific IgG1 and IgG4 serum levels in the egg-excreting patients against adult worm antigen and for specific IgG4 and IgE levels in sera from the eight patients with a chronic disease. They also had a rise of the specific IgA1 titre and six of them also of specific IgA2. Members of eosinophilic granulocytes reached a peak after 2 weeks in seven of the eight patients. The increase of eosinophils was an early event as opposed to the incidence of peak of the determined specific isotypes. The associated rise in IgG1, IgG4 and IgE antibody concentrations and eosinophils may suggest a causal relation possibly induced by common interleukins.

Adolescent

Suppurative Staphylococcus aureus thyroiditis.

Suppurative thyroiditis with septicaemia caused by Staphylococcus aureus in a 65-year-old male patient with diabetes mellitus was diagnosed by needle aspiration. Antibiotic treatment and surgical drainage cured the patient.

Aged