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False-positive results in serologic tests for Rocky Mountain spotted fever during pregnancy.

The data from this study demonstrate that false-positive results from tests for Rocky Mountain spotted fever increase with the duration of pregnancy. The sera of 4.0% (2/50) of women in their first trimester of pregnancy, 10.9% (5/46) in their second trimester, and 12.1% (12/99) in their third trimester yielded false-positive results from latex agglutination assays for Rickettsia rickettsii infections. The cause of these false-positive results was not determined by this study. These false-positive titers were not associated with clinical findings or other laboratory abnormalities. Even though these sera did not contain antibodies to R rickettsii detectable by indirect fluorescent antibody testing, such false-positive results from serologic tests for Rocky Mountain spotted fever can obscure the patient's correct diagnosis. This may lead to the unnecessary use of potentially toxic antibodies and prevent initiation of appropriate therapy.

Adolescent↗

Comparison of four serological tests in the diagnosis of caprine brucellosis.

Results from four serological tests for diagnosing brucellosis--serum tube agglutination (SAT), agar gel immunodiffusion (AGIT), Rose Bengal plate (RBPT) and complement fixation (CFT)--were compared using sera from goats from farms infected with Brucella melitensis. Ninety-two goats were negative and 29 positive to all four tests. The remaining 85 reacted to one or more tests. The RBPT was the most sensitive test and the AGIT the most specific, when compared with the CFT. The results suggest that the SAT adds little information when used with other tests but that RBPT and AGIT are useful for testing caprine brucellosis where facilities for the CFT are not available.

Agglutination Tests↗

Nocardia species as an etiologic agent in Parkinson's disease: serological testing in a case-control study.

To test the hypothesis that Nocardia spp. may be an etiologic factor in Parkinson's disease (PD), we used a serodiagnostic panel to determine if PD patients had antibodies specific for Nocardia spp. To validate the serological test panel, sera from healthy volunteers and from patients with culture-proven nocardiosis (n = 307) were compared in part 1 of the study. The sensitivity of the panel was 88% for detection of culture-proven nocardial infections, and specificity was 85% (excluding cross-reactive leprosy cases). In part 2, no difference in seropositivity was found when PD patients were compared with their age- and gender-matched controls (n = 140). We found a high exposure rate of humans to nocardial antigens, especially among men and older individuals. Our results offer no support to the hypothesis that Nocardia spp. are causative in PD; however, it is possible that serological testing may not be optimal for detection of nocardial central nervous system infection.

Antibodies, Bacterial↗

[Validation and clinical and epidemiological use of a serologic test recommended in the diagnosis of Helicobacter pylori infection].

A commercial serologic test using purified antigens of Helicobacter pylori has been evaluated in the diagnosis of this infection. In a series of 250 patients undergoing endoscopy with antral biopsies for cytology, histology and culture, serology was positive in 68 of 71 patients with a positive culture (sensitivity: 96%) and negative in 67 of 69 patients with a normal mucosa and no microorganisms on biopsy (specificity: 97%). In the entire series, serology was positive in 33 patients with no infection on biopsies (13%). In a group of 205 blood donors, we confirmed an increasing prevalence with age, ranging from 13% in subjects less than 30 years old to 38% in subjects more than 60 years old.

Adult↗

Problems in the use of serologic tests for the diagnosis of Lyme disease.

Lyme disease can be reliably diagnosed in the presence of erythema migrans. When erythema migrans is absent, serologic tests are often used to confirm the diagnosis. To choose a test for our Lyme disease diagnostic center, serum samples were obtained from 34 patients and tested for antibodies to Borrelia burgdorferi. We evaluated five enzyme-linked immunosorbent assays from Stony Brook (NY) University Hospital, Cambridge Bioscience (Worcester, Mass), Hillcrest Biologicals (Cypress, Calif), Sigma Diagnostics (St Louis, Mo), and Zeus-Wampole Scientific Inc (Raritan, NJ) and two fluorescent antibody tests (3M [Diagnostic Systems Inc, Santa Clara, Calif] and FIAX [Whittaker M.A. Bioproducts Inc, Walkersville, Md]). A positive sample by any test was further analyzed by Western blot. Using the Centers for Disease Control (Atlanta, Ga) epidemiologic case definitions, patients were classified into those with clinical Lyme disease, patients not meeting the Centers for Disease Control definitions, and asymptomatic patients. Sensitivities of Lyme serologies varied from 13% to 73%, with Hillcrest showing the highest value and Sigma the lowest value. False-positive test results were found in 0% to 27% of patients. Western blot analysis was positive in six of 15 patients with clinical Lyme disease. These results emphasize the need for better serologic testing for Lyme disease and underline their usefulness only as adjuncts in the clinical diagnosis of Lyme disease.

Blotting, Western↗

Skin and serologic testing in the diagnosis of latex allergy.

BACKGROUND: Latex hypersensitivity is associated with occupational allergy, contact urticaria, rhinitis, asthma, and anaphylaxis. However, standardized sensitive and specific latex extract for skin prick or serologic testing is not available in the United States. METHODS: We investigated the reliability of two latex extracts in 118 consecutive skin tests in patients with spina bifida, health care workers, and other patients with symptoms of latex allergy, and 10 control subjects. RESULTS: Forty-two of 86 patients with spina bifida, 11 of 15 health care workers with symptoms of latex allergy, 6 of 7 patients with symptoms of latex allergy, and 0 of 10 control subjects had demonstrable immediate wheal and flare responses to latex prick testing. In addition, 95 patients and 10 control subjects were tested concurrently for latex-specific IgE by ELISA. Of 55 patients with positive skin prick test results, 48 were reactive as determined by ELISA for IgE-specific latex antibody (sensitivity = 87%). Latex ELISA titers were significantly higher in patients with positive skin prick test results with a history of anaphylaxis to latex and in individuals without symptoms of latex allergy who had positive skin prick test results when compared with patients with negative skin prick test results. During the skin test procedure, nine patients had adverse reactions, including anaphylactic reactions in four. CONCLUSIONS: Skin prick and serum testing are reliable methods of diagnosing latex allergy. Serologic evaluation may be more desirable until allergen standardization is available.

Adult↗

Analysis of a large pedigree with elliptocytosis, multiple lipomatosis, and biological false-positive serological test for syphilis.

Elliptocytosis, multiple lipomatosis, and biological false-postive serological test for syphilis (BFPSTS) were found in a single individual. One hundred eighty relatives were tested for the three diseases: 74 were typed for seven blood group antigens, and 58 were typed for four electrophoretic enzyme markers. Likelihood analysis of the pedigree data confirmed independent dominant inheritance for elliptocytosis and lipomatosis. BFPSTS appears dominant, but the analysis was inconclusive. No linkages were found between any disease gene and any marker gene. Two female pedigree members with BFPSTS developed systemic lupus erythematosus, a finding in agreement with the previously described association. The analysis did not lead to any conclusions about the causal relationship between the two traits.

Adult↗

Strategies for detection of transfusion-transmitted viruses eluding identification by conventional serologic tests. I. Radioimmunoassay for picogram quantities of DNA.

The unavailability of serological tests for detection of several not yet characterized infectious agents transmitted by blood transfusion or by blood products prompted the development of alternative tests based on utilization of labeled nucleic acid probes specific for genomes of each of these agents. The prerequisite for the preparation of such probes is the demonstration in human plasma of nucleic acid sequences distinct from those present in host DNA or in genes of already characterized viruses occurring in plasma of infected individuals. To accomplish this, ultrasensitive tests for nucleic acids not dependent on their base sequence are needed. We describe here a radioimmunoassay (RIA) for picogram quantities of DNA. Plasma (serum) specimens are treated with proteinase K in the presence of sodium dodecyl sulfate and extracted with phenol. Nucleic acids are precipitated with ethanol in the presence of dextran (mol. wt. approximately equal to 5 X 10(5)) as carrier. Subsequently, DNA from the redissolved samples is adsorbed onto polylysine-coated wells of microtiter plates and detected by a double-antibody RIA using anti-DNA autoantibodies from NZB/NZW mice and 125I-labeled antibodies to mouse immunoglobulins. DNA which did not hybridize with human DNA was detected by this method in sera containing hepatitis B virus used as a model system.

Blood Transfusion↗

Interpretation and clinical correlation of serological tests in paracoccidioidomycosis.

In order to correlate the findings of two serological tests, double immunodiffusion (IDD) and immunoblotting (IB), with the clinical diagnosis and follow-up of paracoccidioidomycosis (PCM), 325 serum samples from PCM patients were tested at the beginning of specific therapy and after its completion. Group I included 245 PCM patients at the onset of symptoms without treatment. In 221 cases (90.2%) the IDD showed positive reactions and in 24 (9.8%) the results were negative. Of the 24 IDD negative samples, 23 were investigated by IB and were positive. Group II included 80 PCM patients under follow-up after treatment. There were four cases of relapse in which the IDD and IB tests were positive (100%). Among the 76 cases with inactive mycotic infection, the IDD was negative in 71.2% and positive in 28.8%; the IB was positive in all cases (100%). The control group (Group III) included 27 samples from patients with other mycoses, tuberculosis and from healthy individuals. All showed negative IDD tests but positive reactions with IB, which could be abolished by serum dilutions without altering the PCM reactivity. Therefore, the utilization of the IB, an immunoenzymatic method for the diagnosis of PCM, raised the sensitivity to 100%.

Adolescent↗

The biological false positive reaction to serological tests for syphilis.

Acute and chronic biological false positive reactions to serological tests for syphilis are discussed. Three cases are presented, one showing an acute and one a chronic reaction, and one in which it was not possible to determine if the reaction was acute or chronic. Once a biological false positive reaction is found, serum from the patient should be tested at intervals for at least six months to determine if the reaction is acute or chronic. If a chronic reaction is found the patient should then be investigated to find the underlying cause. Problem sera from 753 patients are reviewed. Biological false positive reactions were shown by 47 sera and 257 sera gave results indicating they came from patients infected with syphilis. The reactive sera were divided into four groups: sera from blood donors, antenatal patients, cases of recent vaccination, and a miscellaneous group. It was found that in the first three groups the number of sera from patients showing biological false positive reactions was equalled or exceeded by the number showing syphilitic reactions. Biological false positive reactions in sera from cases of lepromatous leprosy and in sera from the inhabitants of the Okapa region of New Guinea are also discussed. It is concluded that sera which give reactive results to reagin detection tests for syphilis and come from patients known to have conditions which cause acute or chronic biological false positive reactions should never be dismissed as such. Experience has shown that a number of these sera will give reactive Treponema pallidum immobilization test results, that is, they come from patients who have or have had syphilis.

Adult↗

[Evaluation of the impact of vector control of Chagas disease through serological testing in Mambaí/Buritinópolis, Goiás State].

In 1999, we performed serological and entomological surveys to evaluate the impact of vectorial control measures against transmission of Chagas' disease in the endemic area of Mambaí and Buritinópolis (GO). A census was undertaken of the population, after which the entomological survey was performed regarding the dwelling units and serological evaluation of the human population. Blood samples were collected by digital puncture in filter paper. The first serologic test performed to detect antibodies against Trypanosoma cruzi was the indirect immunofluorescence test (IFI) with (1/2)0 positive dilution as cut-off point and, positive samples were further evaluated with indirect hemagglutination reaction (HAI). The prevalence of positive IFI reactions was 12.3% (95%CL: 11.5-13.2). Triatoma infestans was not found within the dwellings. The absence of infection among individuals younger than 14 years and, the absence of T. infestans during the last entomological survey demonstrates the success of the control program of Chagas' disease in the studied area where the vectorial transmission can be considered to have been interrupted.

Adolescent↗

Development of a rapid equine serological test (REST) by modified agar-gel immunodiffusion.

A rapid equine serological test (REST) has been developed for detection of horse meat in a wide variety of raw meat products. The test is an adaptation of previously developed field screening immunodiffusion tests for beef, poultry, pork, and sheep detection. Results show that the REST test was specific, sensitive, and accurate in the analysis of 101 samples.

Animals↗

Interpreting serologic tests for syphilis.

Since syphilis is most often diagnosed by serologic studies, the correct interpretation of these tests is critical. Serologic tests are classified as nontreponemal of treponemal, according to the antigen employed. Flocculation tests are generally used for routine screening because of their simplicity. The treponemal procedures are more specific, but false-positive results may still occur. Results vary with the procedure, stage of disease and treatment. Significant difficulties remain with the serologic diagnosis of neurosyphilis and congenital syphilis.

Complement Fixation Tests↗

A quantitative comparison of the sensitivity of serological test for bovine brucellosis to different antibody classes.

Brucella-specific antibodies of different immunoglobulin classes were quantitatively evaluated with respect to their efficiency in serological tests for bovine brucellosis. IgM reacted more efficiently than IgG1 and IgG2 in both the Rose Bengal plate test and serum agglutination test. The complement fixation test was found to be slightly more sensitive to IgM than to IgG1 and did not react to IgG2. IgM was, however, partly inactivated when heated at 60 degrees C. in the presence of serum.

Agglutination Tests↗

Evaluation of a serologic test for gonorrhea in a low-risk female population.

This is a report of an evaluation of a new serologic test for gonorrhea--the Gonosticon Dri-Dot Test--as compared to the standard Thayer-Martin culturing technics in a low-risk female population. The Gonosticon Dri-Dot Test detected only 50% of the gonorrhea cases discovered by the conventional culture method. Furthermore, the serologic technic accounted for 17% false-positives, indicating that a reactive Gonosticon test is not necessarily consistent with active gonococcal infection. The efficacy of the Thayer-Martin culture plate diagnostic procedure for uncomplicated gonorrhea in women was reaffirmed by this study.

Cervix Uteri↗

Summary of serological test results on the monoclonal antibodies to non-specific erythrocytes antigens.

Monoclonal antibodies from the 2D3 Section (Other Non-specific Erythrocyte Antigens) of the Third International Workshop & Symposium on Monoclonal Antibodies Against Human Red Blood Cell and Related Antigens were tested using standard serological tube methods. Each antibody was tested to determine the presence of prozoning. A selected panel of red blood cells was tested against each antibody at different phases. Anti-CD44 specificities were weaker or non-reactive with Lu(a-b-) InLu cells and 2 sources (2D3-1 and 2D3-2) were slightly decreased with Ko cells. Anti-CD47 and antibodies to Rh related molecules showed decreased or no reactivity with Rh null cells. Anti-CD99 showed weak or no reactivity with Gy-, LW:-3 and cord blood cells.

Antibodies, Monoclonal↗

Specific syphilis serological tests may become negative in HIV infection.

The diagnosis of syphilis is frequently dependent upon the results of serological tests, but the reliability of syphilis serology in patients with HIV-1 infection has been questioned. We examined specific antibody to Treponema pallidum (TP) using the TP haemagglutination (TPHA) and fluorescent treponemal antibody-absorption (FTA-ABS) tests in AIDS patients and HIV-antibody-negative controls with a history of syphilis. Tests were carried out on two sera separated by an interval of at least 3 years from each patient. Twelve out of 29 AIDS patients compared with four out of 29 controls showed significant falls in titres of specific antibody as measured by the TPHA, FTA-ABS, or by both the TPHA and FTA-ABS (P = 0.02). Furthermore, in three out of 29 (10%) of the AIDS patients with past syphilis infections both the TPHA and FTA-ABS became non-reactive. We conclude that negative specific serology does not exclude a past syphilis infection in patients with AIDS.

Acquired Immunodeficiency Syndrome↗