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[Comparable evaluation of serological diagnostic tests (ELISA, IFA and PA methods) for the detection of anti-Borrelia burgdorferi antibody].

We have evaluated the usefulness of the enzyme-linked immunosorbent assay (ELISA), indirect fluorescent antibody assay (IFA) and particle agglutination (PA) method as serological screening tests for Lyme-borreliosis. Serum samples obtained from two patients with Lyme-borreliosis showed marked high antibody titers for Borrelia burgdorferi when measured by these methods. Of the serum of 368 healthy members of the Self-Defense Force in north-eastern Japan screened for the antibody to B. burgdorferi, 8.4%, 3.7%, 4.6% were found positive by the ELISA, IFA, and PA method, respectively. However, Western blot analysis of these "positive" sera demonstrated no identical bands to those seen in the serum from the patients with Lyme-borreliosis. While 85% and 15% of Treponema pallidum hemagglutination test (TPHA)-positive sera (20 samples) showed a false-positive reaction by the ELISA and IFA method, respectively, no cross-reaction to the anti-B. burgdorferi antibody was observed in these sera by the PA method. The analysis of the serum of the patients with autoimmune diseases (rheumatoid arthritis; 11 cases, systemic lupus erythematosus; 46 cases) by the ELISA and PA methods resulted in a cross-reaction to some extent, which suggested that the antibodies produced by autoimmune mechanisms such as the anticardiolipin antibody can cause a cross-reaction to the anti-B. burgdorferi antibody. These findings indicate that the PA and ELISA rather than the IFA method should be recommended for rapid and conventional screening of Lyme-borreliosis and that serum "positive" for the anti-B. burgdorferi antibody determined by these tests should be confirmed by Western blot analysis to negate the cross-reactions.

Agglutination Tests

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

Establishment of a statistical base for use of ELISA in diagnostic serology for infectious bovine rhinotracheitis.

The critical statistical parameters of an enzyme-linked immunosorbent assay were determined to enable quantitation of antibody responses in cattle affected with infectious bovine rhinotracheitis. A system of controlling well-to-well variations in optical density reading across a microtitre plate was evolved and dose--response assays were carried out to determine the dilution of serum which gave the greatest discrimination between acute and convalescent sera from an infected animal. Use of a standard serum was studied in further assays. An increase in optical density value of 0.15 was set as a diagnostic criterion for a significantly rising antibody response. This compared well with the conventional criterion of a fourfold rise in virus neutralizing antibody titre.

Animals

[Serological diagnostic studies of the occurrence of coronavirus infections in cattle with respiratory diseases].

Of paired serum samples of 196 cattle with respiratory disease from 37 herds which were tested for hemagglutination inhibiting antibodies against coronavirus (BCV) 185 of the first specimens and 190 of the second ones gave positive results. This difference was due to five animals of five different farms showing seroconversions between the time of the blood collections. A significant rise in antibody titer (no less than 4-fold) was evident in 28 cattle from 3 of the above mentioned and 12 other farms. Altogether serological indication of acute coronavirus infections were gained in 33 (16.8%) of animals with respiratory diseases which derived from 17 of 37 herds. Most of these infections (about 35%) occurred in animals older than 6 months while calves up to 3 or 6 months were only affected in a ratio of ca. 10%, respectively.

Animals

[Hepatitis A foci in children's collectives studied by using clinico-biochemical, virological and serological diagnostic methods].

In 4 foci of hepatitis A (HA) at children's institutions in Moscow 218 children and 30 staff members were examined. Simultaneously with clinico-biochemical studies, specific IgM and IgG in the blood and hepatitis A virus (HAV) antigen in feces were determined by radioimmunoassay. Different forms of HA were detected in 29.1% of children in kindergartens, 19.4% of school children and 3.3% of adults, which was due to great differences in the size of the immune stratum among them (IgG to HAV was detected in 8-10% of children aged 3-6 years and in 83% of adults). In 2/3 of children with HA in the foci the disease was not accompanied by jaundice, 1/5 of them having the inapparent form of this infection. In 45% of the patients HAV antigen was detected in feces, irrespective of the form of HA, 5-14 days before the appearance of hyperfermentemia, and in 2/3 of them this antigen was also detected during the first 6 days after that. Simultaneously with an increase in aminotransferase activity, all of the HA patients showed the presence of specific IgM in their blood.

Adult

Detection of IgE antibodies specific for 1-phenyl-2,3-dimethyl-3-pyrazoline-5-one by RAST: a serological diagnostic method for sensitivity to pyrazoline drugs.

Certain adverse reactions to pyrazoline drugs resemble IgE-mediated hypersensitivity. However, convincing evidence of antigen-antibody interactions is not fully demonstrated. In this study, IgE antibodies specific for 1-phenyl-2,3-dimethyl-3-pyrazoline-5-one have been found in 17 out of 19 serum samples from individuals sensitive to pyrazoline drugs with 4-aminoantipyrine discs by Radio Allergo Sorbent Test (RAST). In contrast, we have not found any positive results from 10 normal donors without sensitivity to pyrazoline drugs after ingestion of metamizol 500 mg/day for 14 days. Therefore, our results provide further evidence in favor of an IgE-dependent mechanism in patients suffering from sensitivity to pyrazoline drugs. The determination of specific IgE antibodies could be used as a serodiagnostics method.

Adult

Evaluation of serological diagnostic indices for mucocutaneous leishmaniasis: immunofluorescence tests and enzyme-linked immunoassays for IgG, IgM and IgA antibodies.

The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of immunofluorescence (IF) and enzyme-linked immunoassays (ELISA) for IgG, IgM and IgA antibodies were assessed on sera from mucocutaneous leishmaniasis patients and controls. The sensitivity of the IgG-ELISA test was 93.3% with 95% confidence interval higher than what could be due to a random test not associated with the disease. The specificity of all tests, except the IgM-ELISA, gave indices that could not have been due to chance. The IgG-ELISA and IgG-IF had the highest positive predictive value and the kappa statistic showed that the strength of agreement between the disease and the test was strongest for IgG-ELISA. The IgG-ELISA had a negative predictive value with 95% confidence limits that were not due to chance alone. Efficiency was highest for IgG-ELISA and IgG-IF. These results were obtained using sera from patients with severe or long-standing disease and from controls in whom the disease was ruled out by a negative Montenegro skin test. In field surveys where the differences between cases and controls are less easy to define the diagnostic indices of these tests may vary with the disease prevalence.

Adolescent

[Use of an immunoenzymatic test in the serological diagnostics of toxoplasmosis (author's transl)].

Four hundred and thirty four human sera have been tested for antitoxoplasma antibodies using an immunoenzymatic test on slides. A corpuscolar antigen, a peroxidase-labelled antiglobulin and a modified peroxidase stain have been employed. Results are compared with those obtained by indrect immuno-fluorescence and passive haemoagglutination; a good corrispondence between immunoenzymatic test and indirect immunofluorescence is found.

Antibodies

Completion of hemagglutination inhibition test by solid-phase radioimmunoassay test in routine diagnostic rubella serology.

A solid-phase radioimmunoassay (RIA) test for rubella virus IgG and IgM class antibodies was used for completing the hemagglutination inhibition (HI) test in routine diagnostic serology. During a six-month period 80 serum specimens from 47 patients were tested by RIA because the HI test result was either unreliable or gave insufficient information. This was approximately 5% of the total number of serum specimens tested for rubella antibodies in our laboratory during the study period. The main indications for using the RIA test were improper timing in the taking of serum specimens, which accounted for IgM determination, and nonspecific agglutinins or nonspecific serum hemaglutination inhibitors, which disturbed the HI test. In all cases an unambiguous result was obtained by the RIA test, and five recent rubella infections, not diagnosably by the HI test, were detected. Based on these findings we consider the RIA test to be a good alternative among the methods proposed for diagnostic rubella serology.

Hemagglutination Inhibition Tests

[Results of monitoring pregnant patients exposed to rubella].

Report about the results of serologic diagnostics of rubella. In the years 1975 til 1984 we took care for 17,731 pregnant women. 455 of them had rubella contact. In 16.7 per cent (76 women) there was a titer of 1:16 or below. In 18 cases of them we had to guess the patients on artificial abortion, because there were hints at a rubella disease. Nevertheless out of 379 pregnant women with serologic immunity decided on abortion. Reasons have been discussed. We propose a serologic diagnostics in each case of rubella contact of a pregnant women for prevention of rubella embryopathy.

Adolescent

[Cross reactions of eight yeasts and their importance in serological Candida diagnostic (author's transl)].

While the antigen structure of yeast cell walls is well known, the immunological cross reactivity of these is often difficult to interpret. The cross reactions of eight yeasts were tested in rabbit hyperimmune sera by the indirect immunofluorescence test. Among the eight species examined were the medically important yeasts C. albicans, C. pseudotropicalis, C. krusei, C. parapsilosis, C. tropicalis, T. glabrata, and C. guilliermondii and the apathogenic yeast S. cerevisiae. It has been shown, that there is no correlation between the number of common antigens and the degree of cross reactivity which give identical titers. Therefore it appears, that the quantitative contributions of the single antigens have an important rule, i.e., some antigens are immunogenic in one species while having only hapten characteristics in another. Further the results show that in infections with C. krusei, C. pseudotropicalis, and C. guilliermondii homologous antigens have to be used for the serological diagnosis. The testing of human sera with the yeast antigens by the same methods showed that the strikingly distributions of the Candida titer and the Saccharomyces titer were similar. A larger number of sera of healthy people and patients were compared in the hemagglutination test. These results showed that pathological C. albicans titers cannot be caused by S, cerevisiae antibodies.

Antibodies, Fungal