Seropositividad de Chlamydia psittaci en trabajadores expuestos a aves y revisión de la literatura: evidencia de circulación en Antioquia / Chlamydia psittaci seropositivity in workers exposed to birds and review of the literature: Evidence of circulation in Antioquia

Introducción. La psitacosis es una enfermedad zoonótica causada por Chlamydia psittaci. Esta bacteria es catalogada como un agente con potencial bioterrorista y ha causado múltiples brotes en trabajadores con exposición laboral a aves en diferentes lugares del mundo. En Colombia, no se hace seguimiento epidemiológico de la infección y existe una gran brecha en el conocimiento. Objetivos. Determinar la frecuencia de anticuerpos contra C. psittaci en trabajadores con exposición laboral a aves y sus factores asociados. Además, revisar la literatura en relación con los estudios sobre el tema realizados en Colombia. Materiales y métodos. Se llevó a cabo un estudio descriptivo, transversal, con intención analítica, en trabajadores en contacto con aves y se revisó la literatura científica relacionada en Colombia. Se detectaron anticuerpos IgM e IgG contra C. psittaci en suero por microinmunofluorescencia. La descripción de las características sociodemográficas y de exposición se hizo con frecuencias y medidas de resumen. Se exploraron factores asociados por análisis bivariados y multivariados. La revisión de la literatura científica y gris se hizo con búsqueda estructurada. Resultados. Se analizaron 54 trabajadores en contacto con aves y se encontró una prevalencia de anticuerpos del 31,5 %. El ejercer funciones de sacrificio y faenado de las aves sin ser médico veterinario fue un factor de riesgo para la presencia de anticuerpos. Solo se encontraron cuatro estudios previos sobre C. psittaci hechos en Colombia. Conclusiones. Este estudio constituye la primera evidencia de la circulación de C. psittaci en trabajadores en contacto con aves en Antioquia y el segundo reporte en el país. Estos hallazgos aportan desde la salud pública a la estrategia One Health.

Introduction. Psittacosis is a zoonotic disease caused by Chlamydia psittaci, a bacterium classified as an agent with bioterrorist potential. It has caused multiple outbreaks in exposed poultry workers around the world. Colombia has no epidemiological follow-up of the infection and a big knowledge gap. Objectives. To determine the antibodies' frequency against C. psittaci in workers with occupational exposure to birds and to review the literature on studies conducted in Colombia. Materials and methods. We conducted a cross-sectional descriptive study with analytical intent on workers in contact with birds and reviewed the related literature in Colombia. IgM and IgG serum antibodies against C. psittaci were detected by microimmunofluorescence. The sociodemographic and exposure characteristics were expressed as frequencies and summary measures. Associated factors were explored by bivariate and multivariate analysis. The scientific and gray literature review was done with a structured search. Results. We analyzed 54 workers in contact with birds. Antibody prevalence was 31.5%. Slaughtering and evisceration by non-veterinarians was a risk factor for antibody presence. There are only four previous studies on C. psittaci in Colombia. Conclusions. Here, we present the first evidence of C. psittaci circulation among workers exposed to birds in Antioquia and the second report in the country. These findings contribute to the "One Health" public health strategy.

Determination of a cut-off value for the serological diagnosis of scrub typhus by detecting anti-Orientia tsutsugamushi immunoglobulin M

Background & objectives: The diagnosis of scrub typhus (ST) is usually done using enzyme-linked immunosorbent assay (ELISA) due to its ease of performance and reading objectivity. The cut-off value for ELISA needs to be calculated for each geographical location as it depends on zonal endemicity of the disease. This study was, therefore, undertaken to calculate the pan-India cut-off for anti-Orientia tsutsugamushi (OT) immunoglobulin M (IgM) by ELISA. Methods: Samples from cases (cases of ST) and controls (voluntary, consenting, healthy adults) were collected by a network of 29 laboratories across India and tested for anti-OT IgM by immunofluorescence assay (IFA), the considered gold standard test. These samples were retested by ELISA for anti-OT IgM and their optical densities (ODs) were used for cut-off estimation by receiver operating characteristic (ROC) curve. Results: Anti-OT IgM ELISA ODs from 273 controls and 136 cases were used for the cut-off estimation. The ODs of the anti-OT IgM ELISA on healthy individuals and those of confirmed ST cases ranged from 0.1 to 0.75 and 0.5 to 4.718, respectively. ROC curve-based cut-off for ELISA was calculated as 0.554 at a sensitivity of 95.2 per cent and specificity of 95.1 per cent. A value of >1 was noted to have a specificity of 100 per cent in diagnosing ST. Interpretation & conclusions: The cut-off calculated for India was similar to the previous cut-off that was used until now.

Systemic disease in leukocytoclastic vasculitis: a focus on direct immunofluorescence findings

Abstract Background Direct immunofluorescence (DIF) panels are usually ordered for clinically suspected cutaneous vasculitis, but their positivity rate is variable, and their prognostic significance is not clear to date. Objective The study aims to investigate the systemic involvement rate in leukocytoclastic vasculitis (LCV) patients and the potential clinical and laboratory associations with systemic involvement, including DIF findings. Methods A retrospective study of patients with histopathologically proven cutaneous LCV examined in the dermatology department between 2013 and 2017 was performed. Results Of the 81 patients (mean age, 50.6 years), 42 (52%) were male. The mean time between the appearance of skin lesions and biopsy was 23.1 days, ranging from 2 to 180 days. DIF showed overall positivity of 90.1%, and C3 was the most frequent immunoreactant (82.7%). Any kind of extracutaneous involvement was present in 47 (58%) of patients, with renal involvement being the most frequent (53.1%), followed by articular (18.5%) and gastrointestinal (11.1%) involvement. The presence of renal disease was associated with the detection of IgG in the lesional skin (p = 0.017), and with the absence of IgM in the lesional skin (p = 0.032). There was a significant association between C3 deposition and joint involvement (p = 0.05). Study limitations This is a single-center study with a retrospective design. Conclusion DIF seems to be a useful ancillary diagnostic tool in the evaluation of cutaneous vasculitis, but the relationship between DIF findings and systemic involvement needs to be further elucidated due to contradictory data in the current literature.

Detección de infección por Chlamydia trachomatis en mujeres sexualmente activas en Venezuela / Detection of Chlamydia trachomatis infection in sexually active women in Venezuela

Introducción. La infección genital por Chlamydia trachomatis es una de las más frecuentes en el mundo. Cada año se registran cerca de 85 millones de nuevos casos de esta enfermedad, que cursa con graves complicaciones en la mujer y recién nacido. Objetivo. Determinar las características clínico-epidemiológicas de la infección por C. trachomatis en mujeres venezolanas sexualmente activas. Materiales y métodos. Es un estudio descriptivo, transversal y de campo, sustentado en la historia clínica y el examen físico, la detección de infección con la prueba inmunoenzimática con anticuerpos policlonales anti-LPS y la confirmación de los resultados con la de biología molecular. La muestra estuvo conformada por 100 mujeres sexualmente activas mayores de 12 años de edad, del estado Carabobo, Venezuela. Resultados. La mayoría de las mujeres se encontraba entre los 20 y los 45 años de edad. En el 25 % de las mismas, se detectaron anticuerpos IgG anti-C. trachomatis y, en el 84 % de estas, se confirmó la infección mediante PCR; en ninguna de las mujeres se hallaron anticuerpos IgM anti-C. trachomatis. Conclusión. La infección crónica predomina en las mujeres entre los 20 y los 45 años de edad; la prueba inmunoenzimática arrojó falsos positivos corroborados por PCR.

Introduction: Genital Chlamydia trachomatis infection is one of the most frequent in the world; about 85 million new cases of this pathology are registered each year, which causes severe complications in women and newborns. Objective: To determine the clinical-epidemiological characteristics of C. trachomatis infection in sexually active Venezuelan women. Materials and methods: Descriptive, cross-sectional, and field study based on the clinical history and physical examination, detection of infection with immunoenzymatic assay with anti-LPS polyclonal antibody and confirmation of results with molecular biology test. The sample consisted of 100 sexually active women over 12 years of age from Carabobo state, Venezuela. Results: The women were mostly between 20 and 45 years old, in 25% of them IgG antibodies to C. trachomatis were detected and in 84% of these the infection was confirmed by PCR, in none of the women IgM antibodies to C. trachomatis were found. Conclusion: Chronic infection characterizes women between 20 and 45 years of age; the immunoenzymatic test yielded false positives corroborated by PCR.

Mieloma múltiple con IgM de superficie precedido por síndrome mielodisplásico en paciente anciana / Surface membrane IgM multiple myeloma preceded by myelodysplastic syndrome in an elderly patient

Introducción: El mieloma múltiple con expresión de inmunoglobulina M de superficie constituye una enfermedad rara cuya causa es desconocida y se caracteriza por una alta tasa de anormalidades genéticas en las células plasmáticas o sus precursores. Objetivo: Determinar las características clínicas y sus asociaciones con la expresión inmunofenotípica de inmunoglobulina M de superficie e inmunohistoquímica de CD20 en una paciente afectada de mieloma múltiple precedido por síndrome mielodisplásico. Presentación del caso: Paciente femenina, 68 años de edad. Admitida en el Servicio de Hematología Clínica. Al momento del diagnóstico presentó palidez, trombocitopenia, hipercalcemia y lesiones óseas. Inicialmente, mediante citometría de flujo se detectaron patrones aberrantes para granulocitos, neutrófilos, monocitos y serie eritroide, sugerentes de síndrome mielodisplásico. Posteriormente se observó aumento de las células plasmáticas del 18 % en el frotis de médula ósea, exhibiendo una morfología similar a linfocitos. Se reportó una población patológica de 6 % de la celularidad total, mostrando positividad para CD38, CD117 e inmunoglobulina M de superficie, negatividad para CD19 y CD45, fenotipo coherente con células plasmáticas anormales. Adicionalmente resultados de inmunohistoquímica relataron tinción difusa de CD20 en biopsia de médula ósea. La paciente logró recuperarse luego de un trasplante autólogo de células progenitoras hematopoyéticas. Conclusión: Los resultados resaltan la importancia de diagnosticar y monitorear casos únicos que permitan un tratamiento oportuno del paciente.

Introduction: Multiple Myeloma with expression of surface immunoglobulin M is a rare entity, whose cause is unknown, and is characterized by a high rate of genetic abnormalities in plasma cells or their precursors. Objective: To determining the clinical characteristics and their associations with the immunophenotypic expression of surface immunoglobulin M and CD20 immunohistochemistry in a patient affected by Multiple Myeloma preceded by Myelodysplastic syndrome. Case presentation: A 68-year-old female patient is admitted to the Clinical Hematology Service. At the time of diagnosis, she presented pallor, thrombocytopenia, hypercalcemia, and bone lesions. Initially, flow cytometry detected aberrant patterns for neutrophilic granulocytes, monocytes, and the erythroid series suggestive of myelodysplastic syndrome. Subsequently, an 18% increase in plasma cells was observed in the bone marrow smear, exhibiting a lymphocyte-like morphology. A pathological population of 6% of the total cellularity was reported, showing positivity for CD38, CD117 and surface immunoglobulin M, negativity for CD19 and CD45, a phenotype consistent with abnormal plasma cells. Additionally, immunohistochemical results reported diffuse CD20 staining in bone marrow biopsy. The patient managed to recover after an autologous hematopoietic stem cell transplant. Conclusion: The results found highlight the importance of diagnosing and monitoring single cases that allow timely treatment of the patient.

Prevalence of molecular and serological tests of the new coronavirus (SARS-CoV-2) in Carlos Chagas laboratory - Sabin group in Cuiabá

SUMMARY BACKGROUND: Coronavirus disease 2019, which is caused by the new severe acute respiratory syndrome coronavirus 2, became a pandemic in 2020 with a mortality rate of 2% and high transmissibility, thus making studies with an epidemiological profile essential. OBJECTIVES: The aim of this study was to characterize the population that performed the severe acute respiratory syndrome coronavirus 2 molecular and serological tests in Carlos Chagas Laboratory - Sabin Group in Cuiabá. METHODS: A retrospective cross-sectional study was carried out with all the samples collected from nasal swab tested by RT-PCR and serological for severe acute respiratory syndrome coronavirus 2 IgM/IgG from the population served between April and December 2020. FINDINGS: In the analysis period, 23,631 PCR-coronavirus disease 2019 examinations were registered. Of this total number of cases, 7,649 (32.37%) tested positive, while 15,982 (66.31%) did not detect viral RNA and 374 of the results as undetermined. The peak of positive RT-PCR performed in July (n=5,878), with 35.65% (n=2,096). A total of 8,884 tests were performed on serological test SOROVID-19, with a peak of 1,169 (57.16%) of the positive tests for severe acute respiratory syndrome coronavirus 2 in July. MAIN CONCLUSIONS: Molecular positivity and serological tests, both peaked in July 2020, were mostly present in women aged 20-59 years, characterizing Cuiabá as the epicenter of the Midwest region in this period due to the high rate of transmissibility of severe acute respiratory syndrome coronavirus 2.

Dynamic changes and clinical significance of COVID-19 specific antibodies in rehabilitated patients / 中国热带医学

@#Abstract: Objective To investigate the dynamic changes and clinical significance of specific antibodies in patients with coronavirus disease 2019 (COVID-19). Methods A retrospective study was conducted to collect 141 adult COVID-19 survivors who were followed up in the Eighth Hospital affiliated to Guangzhou Medical University from February 6, 2020, to March 24, 2021. The patients were divided into severe group (severe and critical) and non-severe group (light and ordinary) according to the diagnosis at discharge. The antibody changes of the two groups were compared and analyzed at 1 week, 2 weeks, 1 month, 3 months, 6 months and 1 year after discharge. Results After discharge from hospital, the positive rate of IgG in the severe group was 95.00% after 1 week and 100.00% in the following year, in the positive rate of IgG in the non-severe group was 59.50% after 1 week, 90.08% in 6 months and 76.03% in one year. The level of serum IgG in the severe group was significantly higher than that in non-severe group (Z=-2.441, P=0.015). One-year follow-up: the serum IgG in the severe group was significantly higher than that in the non-severe group (Z=-3.410, P=0.001). The serum IgM level of the severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant (Z=-2.259, P=0.024). The serum IgG and IgM level of the non-severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant (Z=-7.37, P<0.01; Z=3.850, P<0.01). Conclusion The level of serum protective antibody in COVID-19 patients remained high within 6 months after discharge, and remained stable within 1 year after discharge. The antibody titers in the severe group were significantly higher than those in the non-severe group and lasted for at least one year. COVID-19 survivors receive 1 year of natural immune protection, and patients with critical conditions receive immunity for longer periods of time.

Time-resolved fluorescence immunochromatographic assay for the detection of mycoplasma pneumoniae IgM and IgG / 中华核医学与分子影像杂志

Objective:To establish time-resolved fluorescence immunochromatographic assay (TFICA) for rapid and quantitative detection of mycoplasma pneumoniae (MP) immunoglobulin (Ig)M and IgG.Methods:Based on capillary effect and europium nanospheres, rapid TFICA for MP-IgM and IgG detections were developed with the optimized parameters (coupling rates of antigens or antibodies to microspheres, dilution of labeled nanospheres, fixture concentrations on test line and serum dilutions). The methodological performances were estimated such as sensitivity, specificity, stability. By testing 55 healthy control samples, the reference values of TFICA were obtained. The reliability was evaluated by Kappa test from detecting sera of 88 cases (33 patients and 55 healthy controls) using TFICA and commercial kits by chemiluminescence immunoassays (CLA). Results:After screening the assay conditions, the mass ratios of mouse anti-human IgG and MP antigen with nanospheres were 1∶20 and 1∶100 respectively; the work dilutions of nanobeads conjugated with anti-human IgG and MP antigen were 1∶200 and 1∶100 respectively; the spraying concentrations of MP antigen and goat anti-human IgM were 0.5 and 1.0 g/L on the test line respectively, and the working dilutions of serum sample were both 1∶300. In the MP-IgM and IgG detections, the linear working ranges were (0.78-70.00)×10 3 relative unit (RU)/L and (0.17-200.00)×10 3 RU/L, while the sensitivities of the assays were 0.78×10 3 and 0.17×10 3 RU/L, respectively. No cross reactions were found with antithyroid peroxidase antibody, anticardiolipin antibody or thyroglobulin antibody. In these MP-IgM and IgG assays, the relative standard deviations were 3.7%-14.8% and 2.9%-14.0%, the average reduction rates of fluorescence were 13.7% and 14.2% respectively after incubation at 37 ℃ for 5 d. The reference values of MP-IgM and IgG were 3.33×10 3 and 2.61×10 3 RU/L, while the Kappa values between TFICA and CLA were 0.79 and 0.76, respectively. Conclusion:TFICA is a simple, sensitive, specific and quantitative method for detecting MP-IgM and IgG antibodies, and may show great promise for future clinical use.

Clinical significance of combined detection of serum immunoglobulin and interleukin-18 in patients with viral hepatitis B / 中国基层医药

Objective:To detect serum immunoglobulin and interleukin-18 (IL-18) levels in patients with viral hepatitis B and investigate the clinical significance of combined detection of serum immunoglobulin and IL-18 levels.Methods:A total of 102 patients with viral hepatitis B who received treatment in Jinan 2 nd People's Hospital from September 2019 to September 2020 were included in the observation group. An additional 99 patients who concurrently underwent physical examination were included in the control group. Serum immunoglobulin and IL-18 levels were detected in each group and they were compared between the two groups. Changes in serum immunoglobulin and IL-18 levels detected after treatment relative to before treatment were analyzed in the observation group. Results:Serum levels of immunoglobulin A, immunoglobulin G, immunoglobulin M, and IL-18 in the observation group were (2.68 ± 0.74) g/L, (15.24 ± 4.17) g/L, (2.59 ± 1.03) g/L, (2.53 ± 0.21) ng/mL, respectively, which were significantly higher than those in the control group [(1.76 ± 0.63) g/L, (11.58 ± 3.46) g/L, (1.38 ± 0.49) g/L, (1.68 ± 0.34) g/L, respectively, t = 9.45, 6.74, 10.54, 21.36, all P < 0.01). In the observation group, serum levels of immunoglobulin A, immunoglobulin G, immunoglobulin M, and IL-18 were (2.03 ± 0.51) g/L, (13.12 ± 3.25) g/L, (1.93 ± 0.47) g/L, (1.74 ± 0.15) μg/L after treatment, which were significantly lower than those before the treatment [(2.68 ± 0.74) g/L, (15.24 ± 4.17) g/L, (2.59 ± 1.03) g/L, (2.53 ± 0.21) μg/L , t = 7.26, 4.02, 10.54, 5.87, all P < 0.01). Conclusion:Serum immunoglobulin and IL-18 levels in combination can reflect the condition of viral hepatitis B patients and provide scientific reference for clinical treatment. The research results are scientific and innovative and are worthy of promotion.

Nodal marginal zone lymphoma with elevated monoclonal IgM: report of 1 case and review of literature / 白血病·淋巴瘤

Objective:To investigate the clinicopathological features, diagnosis, differential diagnosis and treatment of nodal marginal zone lymphoma (NMZL) with elevated monoclonal IgM.Methods:The clinical data of one NMZL patient with elevated monoclonal IgM treated at Yancheng No.1 People's Hospital in July 2020 were retrospectively analyzed, and the related literature was analyzed.Results:The patient was a 57-year-old female and the main clinical manifestations were fatigue and bone pain in left rib. Serum immunofixation electrophoresis showed IgM-κ type M proteinemia, bone marrow cytology showed a few plasmacytoid lymphocytes, bone marrow biopsy and immunohistochemistry showed B-cell non-Hodgkin lymphoma, bone marrow genetic testing showed MYD88 L265p and CXCR4 were both negative, postoperative pathology result of retroperitoneal lymph node biopsy was marginal zone lymphoma (mature small B type, prone to NMZL),and immunohistochemistry results: CD3, CD5, CD138, κ, λ, CD10, Cyclin D1 were negative, CD20, Pax-5, CD23 (FDC), bcl-2 were positive; Ki-67 positive index < 5%. The final diagnosis was NMZL with elevated monoclonal IgM. Partial remission was achieved after 8 cycles of reduced-dose CHOP regimen; thalidomide was used in the maintenance treatment, the disease condition was stable until August in 2021 and the follow-up was continuing.Conclusions:NMZL with elevated monoclonal IgM is relatively rare. Its diagnosis should be differentiated from Waldenstr?m macroglobulinemia and other inert B-cell lymphomas. Currently, there is no standard treatment and following the principle of individualized treatment can improve the prognosis of patients.

Consistency analysis and clinical guiding significance of cytomegalovirus nucleic acid and antibody detections in patients with different clinical characteristics / 北京大学学报(医学版)

OBJECTIVE@#To investigate the consistency of cytomegalovirus deoxyribo nucleic acid (CMV-DNA) and immunoglobulin M (IgM) antibody detections in patients with different clinical characteristics and their guiding value for clinical practice.@*METHODS@#From December 2014 to November 2019, a total of 507 patients who were detected with both CMV-IgM and CMV-DNA were collected in Peking University International Hospital. Their general information, such as gender, age and clinical data, including the patient's diagnosis, medication, and outcome were also collected. The groups were stratified according to whether CMV-DNA was negative or positive, CMV-IgM was negative or positive, age, gender, and whether they received immunosuppressive therapy or not. The Pearson Chi-square test or Fisher's exact test was used for comparison of the rates between the groups. P < 0.05 means the difference is statisti-cally significant.@*RESULTS@#Of the 507 patients submitted for examination, 55 (10.85%) were positive for CMV-DNA, 74 (14.60%) were positive for CMV-IgM, and 20 (3.94%) were positive for both CMV-DNA and CMV-IgM. Of the 55 patients with CMV-DNA positive, 37 were male, accounting for 67.27%. In addition, 25 patients were older than 60 years, accounting for 45.45% and 33 patients received immunosuppressive therapy, accounting for 60%. The rates were higher than that of CMV-DNA negative group, 47.35% (P=0.005), 68.14% (P=0.043), 46.02% (P=0.050), respectively. Of the patients with both CMV-DNA and IgM positive, 45% received immunosuppressive threapy, which was lower than that of CMV-DNA positive but IgM negative patients (68.57%, P=0.086), and also lower than CMV-DNA negative but IgM positive patients (68.52%, P=0.064). In the patients with both CMV-DNA and IgM positive, 91.67% showed remission after receiving ganciclovir, whereas in the patients with CMV-DNA positive but IgM negative, the rate was only 60% (P=0.067).@*CONCLUSION@#CMV-IgM antibody detection is affected by age, gender, and immune status. It is not recommended to use CMV-IgM alone to determine CMV infection in patients with immunosuppressive status and those older than 60 years. CMV-DNA and CMV-IgM combined detection may help to predict patients' immune status and outcomes of antiviral therapy.

Value of baseline IgM level in predicting the treatment response of primary biliary cholangitis / 临床肝胆病杂志

Objective To investigate the association between baseline IgM level and treatment response to ursodeoxycholic acid (UDCA) in patients with primary biliary cholangitis (PBC). Methods A retrospective analysis was performed for the clinical data of 637 PBC patients who were diagnosed and treated with UDCA for the first time in The Fifth Medical Center of Chinese PLA General Hospital from January 2010 to January 2020. The PBC patients were divided into UDCA complete response group with 436 patients and UDCA poor response group with 201 patients, and baseline clinical data were compared between the two groups. According to the optimal cut-off value of IgM determined by the area under the ROC curve (AUC) of baseline indices in predicting the risk of poor treatment response, the patients were divided into IgM ≥1.5×ULN group and IgM < 1.5×ULN group, and baseline parameters, treatment response, and prognostic model score were compared between groups. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Cochran-Mantel-Haenszel test was used for subgroup analysis, and forest plots were plotted for related risk values. Results Compared with the UDCA complete response group, the UDCA poor response group had significantly higher proportion of patients with liver cirrhosis, levels of total bilirubin, aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bile acid, total cholesterol (TC), IgA, and IgM, and positive rate of anti-Gp210 antibody at baseline ( χ 2 =4.596, Z =-9.932, -8.931, -8.361, -7.836, -4.694, -3.242, and -2.115, χ 2 =15.931, all P < 0.05). The UDCA poor response group had significantly higher Mayo Risk Score, Globe score, and UK-PBC risk score than the UDCA complete response group ( t =4.092, Z =-10.910 and -11.646, all P < 0.001). Compared with the normal IgM group, the elevated IgM group had significantly higher levels of AST, ALP, TC, IgA, and IgG and a significantly higher positive rate of anti-Gp210 antibody ( Z =-3.774, -5.063, -4.344, -2.051, and -6.144, χ 2 =25.180, all P < 0.05). IgM had an AUC of 0.552 in predicting poor treatment response. Compared with the IgM < 1.5×ULN group, the IgM ≥1.5×ULN group had significantly higher levels of AST, ALP, TC, and IgG, a significantly higher positive rate of anti-Gp210 antibody, and a significantly higher poor UDCA response rate ( Z =-4.193, -5.044, -3.250, and -5.465, χ 2 =25.204 and 8.948, all P < 0.05). IgM ≥1.5×ULN had an odds ratio of 1.416 (95% confidence interval [ CI ]: 1.129-1.776, P =0.003) in predicting poor response. The subgroup analysis showed that for patients without liver cirrhosis, IgM ≥1.5×ULN had an odds ratio of 1.821 (95% CI : 1.224-2.711, P =0.003) in predicting poor response. Conclusion Baseline IgM level has an important value in predicting UDCA response. IgM level should be closely monitored during treatment in PBC patients with a high baseline IgM level, and second-line drugs should be given in time if the abnormality persists.

Nefropatía por inmunoglobulina M: características histopatológicas y clínicas. Serie de casos / Immunoglobulin M nephropathy: histopathological and clinical characteristics. Case series

La nefropatía por inmunoglobulina M (NIgM) es una glomerulopatía idiopática caracterizada por depósitos mesangiales globales y difusos de IgM. Se realizó un estudio retrospectivo de las características clínicas e histopatológicas de los pacientes con NIgM atendidos en nuestro servicio. De 241 biopsias renales, 21 correspondieron a NIgM (8,7 %). Se incluyeron 18 pacientes (14 de sexo femenino, mediana de edad: 3,08 años). Se excluyó a 1 paciente por enfermedad sistémica asociada y a 2 por seguimiento menor a 1 año. Catorce pacientes se manifestaron con síndrome nefrótico (SN) y 4 con proteinuria aislada o asociada a hematuria. En la microscopia óptica, 13 presentaron hiperplasia mesangial, y 5 esclerosis focal y segmentaria. De los pacientes con SN, 7 fueron corticorresistentes, 4 corticodependientes y 3 presentaban recaídas frecuentes. Todos los pacientes con SN y 1 con proteinuria-hematuria recibieron inmunosupresores; los 18 pacientes recibieron, además, antiproteinúricos. Luego de 5,2 años (2-17,5) de seguimiento, 6 pacientes evolucionaron a enfermedad renal crónica

Immunoglobulin M nephropathy (IgMN) is an idiopathic glomerulopathy characterized by diffuse global mesangial deposits of IgM. We retrospectively studied the clinical and histopathological characteristics of the patients with IgMN seen in our service. Of 241 renal biopsies, 21 corresponded to IgMN (8.7 %). One patient was excluded due to associated systemic disease and 2 due to follow-up less than 1 year, 18 were included (14 girls, median age 3.08 years). Fourteen manifested with nephrotic syndrome (NS) and the remaining with proteinuria (isolated or associated with hematuria). On light microscopy, 13 had hyperplasia with mesangial expansion and 5 had focal and segmental sclerosis. Of the patients with NS, 7 were steroid-resistant, 4 steroid-dependent, and 3 frequent relapsers. All patients with NS and 1 with proteinuria-hematuria received immunosuppressants; the 18 patients also received antiproteinuric drugs. After 5.2 years (2-17.5) of follow-up, 6 patients developed chronic kidney disease.

Changes of serum immunoglobulin level in healthy pregnant women and establishment of its reference interval / 中南大学学报(医学版)

OBJECTIVES@#Pregnant women in a special physiological period, the body's blood indicators will change to a certain extent. This study aims to explore the changes of serum immunoglobulin levels in healthy pregnant women and establish its reference interval (RI).@*METHODS@#A total of 369 healthy pregnant women, who underwent pregnancy examination in the Department of Obstetrics, Second Xiangya Hospital of Central South University from August 2019 to October 2019, were enrolled for this study. They were divided into an early pregnancy group, a middle pregnancy group, and a late pregnancy group according to the pregnancy period, and 123 healthy non-pregnant women were selected as the controls. The levels of immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA) were determined by immune transmission turbidities. The level of immunoglobulin E (IgE) was determined by electrochemiluminescence. The differences in immunoglobulin levels between pregnant women and non-pregnant women and among different gestational periods were analyzed, and the RI of serum immunoglobulin level during pregnancy was established.@*RESULTS@#Compared to the non-pregnant women, the levels of serum IgG, IgM, IgA, and IgE in pregnant women were significantly decreased (all @*CONCLUSIONS@#The levels of immunoglobulin in pregnant women are decreased significantly. The establishment of RIs of IgG, IgM, IgA and IgE in healthy pregnant women could provide scientific basis for clinical decision-making.

Long-Term Persistence of Serum-Specific Anti-Chikungunya IgM Antibody - A Case Series of Brazilian Patients

Abstract The persistence of serum-specific anti-chikungunya IgM antibodies (CHIKV-IgM) can vary after chikungunya fever (CHIK) infection. However, the factors related to its production are not yet known. We described a case series drawn up from data collected from 57 patients between 12 and 36 months after the acute phase of CHIK infection in Northeastern Brazil. CHIKV-IgM was detectable in 7/57 (12.3%) patients after 28.3 months of infection. No frequency differences in chronic musculoskeletal manifestations and underlying conditions were detected between patients with or without CHIKV-IgM. CHIKV-IgM was detected for up to 35 months in Brazilian patients after CHIK infection.

Neumonía atípica en niños: Detección serológica y molecular de Mycoplasma pneumoniae. Revisión Sistemática / Atypical pneumonia in children: serological and molecular detection of Mycoplasma pneumoniae. Systematic Review

M. pneumoniae es un agente etiológico importante para neumonía atípica en niños. Por sus características inmunogénicas, la presentación clínica no alcanza una certeza diagnóstica. Métodos comunes usados para cuadros de etiología diferente, no producen en este caso hallazgos facilitadores del diagnóstico que generen decisiones terapéuticas apropiadas. El objetivo de esta revisión es describir la utilidad del uso de la PCR y serología IgM para M. pneumoniae en niños, conociendo que son las técnicas más usadas. Método: Con la estrategia Pico se buscó material científico en bases de datos Pubmed, Embase, Chrocane; verificando términos Mesh y Decs. Criterios de exclusión: abstracts, otros microorganismos, población adulta, pruebas de laboratorio diferentes, reportes de caso y cartas al editor. Es importante detectar M. pneumoniae por la aparición de cepas resistentes al tratamiento con macrólidos; secundario a no tener pruebas confiables. La serología, no es altamente sensible en etapas iniciales; pero, mediante pruebas pareadas se confirma el diagnóstico. Para agilizar la detección proponen la PCR; dependiendo de ciertas condiciones, podría hacerse diagnóstico. Si no se logran los requerimientos necesarios, el uso de los dos test resulta confiable. En conclusión, No hay superioridad de un test específico; algunos autores sugieren las dos pruebas para un diagnóstico rápido y evitar la resistencia por uso indiscriminado de antibióticos

M. pneumoniae is an important etiologic agent for atypical pneumonia in children. Due to its immunogenic characteristics, the clinical signs do not reach diagnostic certainty. Common methods used for different etiology do not produce diagnostic facilitating findings for therapeutic decisions. The objective of this review is to describe the usefulness of PCR and IgM serology for M. pneumoniae in children, considering that these are the most used techniques. Making use of the Pico strategy, scientific material was searched in PubMed, Embase, Chrocane databases; verifying terms Mesh and Decs. Exclusion criteria: abstracts, other microorganisms, adult population, different laboratory tests, case reports and letters to the editor. It is important to detect M. pneumoniae by the appearance of resistant to macrolide treatment microorganisms; secondary to not having reliable labs. Serology is not highly sensitive, in early stages; but, with paired tests, it confirms the diagnosis. To expedite detection, some propose PCR; depending on certain conditions, it could make a diagnosis. If the necessary requirements are not achieved, the use of the two tests is reliable. In conclusion, there is no superiority of a specific test; some studies suggest both tests for a rapid diagnosis and avoid resistance by indiscriminate use of antibiotics

Neumonía atípica en niños: Detección serológica y molecular de Mycoplasma pneumoniae. Revisión Sistemática / Atypical pneumonia in children: serological and molecular detection of Mycoplasma pneumoniae. Systematic Review

M. pneumoniae es un agente etiológico importante para neumonía atípica en niños. Por sus características inmunogénicas, la presentación clínica no alcanza una certeza diagnóstica. Métodos comunes usados para cuadros de etiología diferente, no producen en este caso hallazgos facilitadores del diagnóstico que generen decisiones terapéuticas apropiadas. El objetivo de esta revisión es describir la utilidad del uso de la PCR y serología IgM para M. pneumoniae en niños, conociendo que son las técnicas más usadas. Método: Con la estrategia Pico se buscó material científico en bases de datos Pubmed, Embase, Chrocane; verificando términos Mesh y Decs. Criterios de exclusión: abstracts, otros microorganismos, población adulta, pruebas de laboratorio diferentes, reportes de caso y cartas al editor. Es importante detectar M. pneumoniae por la aparición de cepas resistentes al tratamiento con macrólidos; secundario a no tener pruebas confiables. La serología, no es altamente sensible en etapas iniciales; pero, mediante pruebas pareadas se confirma el diagnóstico. Para agilizar la detección proponen la PCR; dependiendo de ciertas condiciones, podría hacerse diagnóstico. Si no se logran los requerimientos necesarios, el uso de los dos test resulta confiable. En conclusión, No hay superioridad de un test específico; algunos autores sugieren las dos pruebas para un diagnóstico rápido y evitar la resistencia por uso indiscriminado de antibióticos

M. pneumoniae is an important etiologic agent for atypical pneumonia in children. Due to its immunogenic characteristics, the clinical signs do not reach diagnostic certainty. Common methods used for different etiology do not produce diagnostic facilitating findings for therapeutic decisions. The objective of this review is to describe the usefulness of PCR and IgM serology for M. pneumoniae in children, considering that these are the most used techniques. Making use of the Pico strategy, scientific material was searched in PubMed, Embase, Chrocane databases; verifying terms Mesh and Decs. Exclusion criteria: abstracts, other microorganisms, adult population, different laboratory tests, case reports and letters to the editor. It is important to detect M. pneumoniae by the appearance of resistant to macrolide treatment microorganisms; secondary to not having reliable labs. Serology is not highly sensitive, in early stages; but, with paired tests, it confirms the diagnosis. To expedite detection, some propose PCR; depending on certain conditions, it could make a diagnosis. If the necessary requirements are not achieved, the use of the two tests is reliable. In conclusion, there is no superiority of a specific test; some studies suggest both tests for a rapid diagnosis and avoid resistance by indiscriminate use of antibiotics

Evaluation of Toxoplasma, Rubella, and Cytomegalovirus serological results in women of childbearing age

SUMMARY OBJECTIVE This study aimed to determine the rates of IgG and IgM antibodies against cytomegalovirus, rubella, and Toxoplasma gondii (all of which may cause congenital infections) in women of childbearing age who were admitted to Bolu Abant İzzet Baysal University Training and Research Hospital. METHODS Between January 2015 and December 2017, Toxoplasma gondii, rubella, and cytomegalovirus IgM and IgG antibody levels were studied using the ELISA method (Architect i2000SR, Abbott, Germany) in patients aged 15 to 45 who attended the obstetrics and gynecology outpatient clinics. Toxoplasma gondii and cytomegalovirus IgG avidity levels were analyzed retrospectively. RESULTS A total of 13.470 tests were conducted in the laboratory. Seropositivity percentages of IgM antibodies were found to be 1.3%, 0.5%, and 1.6% for Toxoplasma (n = 3607), rubella (n = 3931), and cytomegalovirus (n = 3795), respectively. The seropositivity percentages of IgG antibodies were 22%, 94.2%, and 98.2% for Toxoplasma (n = 702), rubella (n = 693), and cytomegalovirus (n = 679), respectively. Primary infection (acute, recently acquired) was found in 7 (35%) patients with low Toxoplasma IgG avidity. One (3%) patient with low cytomegalovirus IgG avidity had a primary infection. CONCLUSION Toxoplasma gondii seronegativity was found to be high in the region. Therefore, screening women of childbearing age may be important for the prevention of congenital infections caused by Toxoplasma gondii.

RESUMO OBJETIVO O objetivo deste estudo foi determinar as taxas de anticorpos IgG e IgM contra citomegalovírus, rubéola e Toxoplasma gondii (todos os quais podem causar infecções congênitas) em mulheres em idade fértil que foram admitidas no Hospital de Pesquisa e Treinamento da Universidade Bolu Abant İzzet Baysal. MÉTODOS Entre janeiro de 2015 e dezembro de 2017, os níveis de anticorpos IgG e IgM para Toxoplasma gondii, rubéola e citomegalovírus foram estudados usando o método Elisa (Architect i2000SR, Abbott, Alemanha) em pacientes de 15 a 45 anos que compareceram a ambulatórios de obstetrícia e ginecologia. Os níveis de avidez de IgG para Toxoplasma gondii e citomegalovírus foram analisados retrospectivamente. RESULTADOS Um total de 13.470 testes foram realizados em laboratório. As porcentagens de soropositividade dos anticorpos IgM foram de 1,3%, 0,5% e 1,6% para Toxoplasma (n=3.607), rubéola (n=3.931) e citomegalovírus (n=3.795), respectivamente. As porcentagens de soropositividade dos anticorpos IgG foram 22%, 94,2% e 98,2% para Toxoplasma (n=702), rubéola (n=693) e citomegalovírus (n=679), respectivamente. Infecção primária (aguda, adquirida recentemente) foi encontrada em sete (35%) pacientes com baixa avidez para Toxoplasma IgG. Um (3%) paciente com baixa avidez para citomegalovírus IgG teve uma infecção primária. CONCLUSÃO A soronegatividade do Toxoplasma gondii foi alta na região. Portanto, testar mulheres em idade fértil pode ser importante para a prevenção de infecções congênitas causadas pelo Toxoplasma gondii.

La citometría de flujo como auxiliar en el diagnóstico de las inmunodeficiencias primarias humorales / Flow-cytometry as an auxiliary in the diagnosis of primary humoral immunodeficiencies

Resumen Antecedentes: Las deficiencias de anticuerpos abarcan un amplio espectro de patologías y constituyen aproximadamente 50 % de las inmunodeficiencias primarias; con la citometría es posible evaluar el estado inmunológico de forma rápida, efectiva y a bajo costo. Objetivo: Evaluar mediante citometría de flujo, las células de pacientes con tres tipos de inmunodeficiencias primarias humorales. Método: Mediante citometría de flujo se analizaron muestras de sangre de pacientes y sujetos sanos con distintos anticuerpos monoclonales. Resultados: Mediante diversas tinciones se demostró disminución severa de linfocitos B en pacientes con agammaglobulinemia ligada al cromosoma X, la falta de expresión de CD154 en pacientes con síndrome de hiperinmunoglobulina M y heterogeneidad de subpoblaciones de linfocitos B en pacientes con inmunodeficiencia común variable. Conclusión: Con la citometría de flujo es posible realizar el diagnóstico temprano de inmunodeficiencias primarias con un nivel de confianza elevado y, en muchos casos, identificar los genes implicados.

Abstract Background: Antibody deficiencies encompass a wide spectrum of pathologies and constitute approximately 50 % of primary immunodeficiencies; with cytometry, it is possible to evaluate the immune status rapidly, effectively and at low cost. Objective: To assess, by means of flow cytometry, the cells of patients with three types of primary humoral immunodeficiencies. Method: Using flow cytometry, blood samples from patients and healthy subjects were analyzed with different monoclonal antibodies. Results: Using various stains, a severe decrease in B lymphocytes was shown in patients with X-linked agammaglobulinemia, as well as a lack of CD154 expression in patients with hyper-immunoglobulin M syndrome, and heterogeneity of B lymphocyte subpopulations in patients with common variable immunodeficiency. Conclusion: Flow cytometry enables early diagnosis of primary immunodeficiencies with a high level of confidence and, in many cases, identification of the genes involved.

Respuesta anticlases mayores de anticuerpos humanos séricos en antisueros hiperinmunes obtenidos en carneros / Characterization of hyperimmune anti-human serum produced in sheep

Introducción: La inmunoelectroforesis es una técnica de precipitación que permite la caracterización de muestras biológicas complejas. En el Departamento de Inmunología del Instituto de Ciencias Básicas y Preclínicas Victoria de Girón se cuenta con un antisuero hiperinmune obtenido por inmunizaciones de carneros contra proteínas totales séricas humanas y con otro antisuero anti IgA de calostro humano. Objetivo: Identificar IgG, IgM e IgA en suero humano y determinar respuesta anti IgM humana en el antisuero anti IgA de calostro humano obtenido en carnero. Material y Métodos: Se realizó un estudio observacional, descriptivo y transversal desde noviembre de 2017 hasta junio de 2018. Se desarrolló una inmunoelectroforesis de suero humano normal empleando el antisuero hiperinmune. Resultados: Se identificaron IgG, IgM e IgA además de albúmina y otras fracciones proteicas y se determinó respuesta anti IgM humana en el antisuero anti IgA de calostro humano obtenido en carnero. Conclusiones: Este trabajo permitió identificar y determinar la respuesta anticlases mayores de inmunoglobulinas en la muestra de estudio(AU)

Introduction: Immunoelectrophoresis is a precipitation technique that allows the characterization of complex biological samples. The Immunology Department of the Institute of Basic and Pre-Clinical Sciences Victoria de Girón has a hyperimmune antiserum obtained by immunization of sheep against human serum total proteins and it also has an anti-human IgA antiserum obtained from human colostrum. Objective: The aim of this study was to identify IgG, IgM and IgA in human serum and to determine response to anti-human IgM in human colostral IgA with antiserum obtained in sheep. Material and Methods: An observational descriptive cross-sectional study was conducted from November 2017 to June 2018. Immunoelectrophoresis of normal human serum was performed using hyperimmune antiserum. Results: These procedures allowed to identify IgG, IgM and IgA in addition to albumin and other protein fractions and to determine response to anti-human IgM in human colostral IgA with antiserum obtained in sheep. Conclusions: This work allowed us to identify and determine significant anti-class responses of immunoglobulins in the sample studied(AU)