Utility of ELISA Optical Density Values and Clinical Scores for the Diagnosis of and Thrombosis Prediction in Heparin-induced Thrombocytopenia / 대한진단검사의학회지

BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction caused by antibodies to the heparin/platelet factor 4 (PF4) complex, resulting in thrombocytopenia and prothrombotic state. HIT diagnosis is challenging and depends on clinical presentation and laboratory tests. We investigated the usefulness of clinical scores and heparin/PF4 ELISA optical density (OD) as a diagnostic marker and thrombosis predictor in HIT. METHODS: We analyzed 92 patients with suspected HIT. The heparin/PF4 antibody was measured using a commercial ELISA kit (GTI, USA). For each patient, the 4 T's score and Chong's score were calculated. RESULTS: Of the 92 patients, 28 were anti-heparin/PF4-seropositive. The 4 T's score and Chong's score showed good correlation (r=0.874). The 4 T's score and OD values showed good performance for diagnosis of the definite and unlikely HIT groups; however, OD levels showed better sensitivity (93.8%) than the 4 T's score used alone (62.5%). Of the 92 patients, 26 developed thrombosis. The OD values were significantly higher in patients with thrombosis than in those without thrombosis (0.52 vs. 0.22, P0.4) had an increased risk of thrombosis (adjusted odds ratio 9.44 [3.35-26.6], P<0.001) and a shorter 250-day thrombosis-free survival (32.1% vs. 54.7%, P=0.012). CONCLUSIONS: ELISA OD values in combination with clinical scoring can improve the diagnosis of and thrombosis prediction in HIT. More attention should be paid to the use of clinical scores and OD values as thrombosis predictors in HIT.

Perfil sorológico dos anticorpos colostrais para Neospora caninum em bezerros livres da infecção / Serological profile of colostral antibodies to Neospora caninum in infection free calves

Neospora caninum é considerado a principal causa de aborto bovino mundial. O diagnóstico laboratorial correto é muito importante para identificar os animais infectados e para aplicar medidas de controle. O objetivo deste trabalho foi mostrar o declínio de anticorpos colostral em bezerros. Este estudo empregou oito bezerros holandeses, recém-nascidos, machos, descendentes de vacas soronegativas para N caninum. Amostra de sangue pré-colostral foram colhidas destes bezerros e todos estavam soronegativos pra N. caninum. Estes bezerros foram alimentados com dois litros de um pool de colostro de vacas soropositivas dentro de duas horas após o nascimento. Amostras de sangue dos bezerros foram colhidas semanalmente até os animais soroconverterem negativo. As amostras foram testadas para anticorpos de N. caninum usando teste de imunofluorescência indireta nos títulos de 1:50; 1: 100 e 1:200. Os resultados mostraram que 3 dos 8 bezerros não soroconverteram e foram excluídos do estudo. Os restantes cinco bezerros soroconverteram em todos os títulos no quinto dia após a inoculação. No título 1:50, um bezerro permaneceu positivo por 21 semanas, dois por 20 semanas e um por 13 semanas. No título 1:100, um bezerro foi positivo por 15 semanas e o restante quatro bezerros por 13 semanas. No título 1:200, cada bezerro foi positivo por 1; 7; 12; 12 e 13 semanas, respectivamente. Estes resultados demonstram que o anticorpo colostral para N. caninum pode permanecer até 21 semanas após o nascimento nos bezerros e é muito importante excluir os bezerros até quatro meses de idade nos estudos de soroprevalência para impedir os resultados falso-positivos.

Neospora caninum is considered the main cause of bovine abortion worldwide. The correct laboratorial diagnose is very important to identify the infected animals and to apply control measure. The objetive of this study was to show the persistence period of colostral antibodies in calves. Eight newborn Holstein Friesan calves, males, were selected from N. caninum soronegative dams. Pre-colostral blood samples were collected of these calves and all of them were seronegative to N. caninum. They were fed with two liters of pooled colostrum from seropositive cows within two hours after birth. Blood samples were collected and tested weekly until the animals turned negative. Serum samples were tested for antibodies to N. caninum using indirect fluorescence antibody test at 1:50; 1: 100 and 1:200 dilutions. Antibodies were not detected from three out of eight calves and they were excluded from the study. The remaining 5 calves seroconverted in all dilutions at the fifth day after colostrums ingestion. At 1:50 dilution, one calf remained positive for 21 weeks, two for 20 weeks and one for 13 weeks. At 1:100, one calf was positive for 15 weeks and the remaining 4 calves for 13 weeks. At 1:200, each calf was positive for 1, 7, 12, 12 and 13 weeks, respectively. These results demonstrate that the colostral antibody to N. caninum may persist until 21 weeks after birth in calves and it?s very important to exclud the calves at the first month of age in the seroprevalence studies to avoid the false-positive results.

Anemia hemolítica autoinmune por anticuerpos calientes: reporte de un caso pediátrico / Autoimmune hemolytic anemia, warm antibody: a case report pediatric

Las anemias hemolíticas autoinmunitarias se caracterizan por la presencia de inmunoglobulinas en la superficie eritrocitaria dirigidas contra los determinantes antigénicos de los hematíes. La anemia hemolítica autoinmune por anticuerpos calientes se caracteriza porque los autoanticuerpos actúan a la temperatura del organismo (37°C), son de clase IgG y la hemólisis es predominantemente extravascular, siendo el tipo más frecuente de anemia hemolítica autoinmune en los niños de 2-12 años de edad. Sus manifestaciones clínicas son postración, palidez, ictericia, fiebre y hemoglobinuria. El diagnóstico de las AHAI se establece con la prueba de Coombs. La administración de corticoesteroides constituye el tratamiento inicial de elección. Se presenta el caso de una preescolar femenina de tres años de edad procedente del medio rural, quien exhibe las características clínicas, paraclínica y epidemiológicas de anemia hemolítica autoinmune por anticuerpos calientes, con respuesta satisfactoria a la terapia con esteroides.

[Correlation between in vitro fertilization with the level of antisperm antibody in seminal plasma measured by flow cytometry]

Antisperm antibodies [ASA] are present in%8-21 of infertile men. In vitro Fertilization [IVF] has been recommended as an effective procedure in couples with immunological male factor. Although this procedure has been found to bypass the inhibitory effect of antisperm antibodies on fertilizing ability of spermatozoa but the fertilization rate is reduced about%40 for ASA positive samples. The goal of present study was to investigate the correlation between anti-sperm antibodies measured by indirect flow cytometry and fertilization rate in infertile couples undergoing in vitro Fertilization [IVF]. Semen samples were collected from 80 infertile men undergoing IVF cycle in Isfahan fertility and infertility center. Couples were classified based on fertilization rate into high and low groups. 52 couples had high [>50%] and 28 couples had low fertilization rate [

Anticuerpos anticitoplasmáticos de neutrófilos (ANCA): un estudio sobre su presencia en patologías no asociadas con arteritis / Antineutrophil cytoplasmatic antibodies (ANCA): study on its presence in pathologies not associated with artheritis

En la presente investigación, se ha estudiado la presencia de anticuerpos anticitoplasmáticos de neutrófilos (ANCA) en 101 pacientes con diferentes patologías: Artritis reumatoide, lupus eritematoso sistémico, neutropenia idiopática, síndrome de Down, glomerulonefritis aguda postes-treptocóccica, síndrome nefrótico con cambios mínimos, periodontitis del adulto, calcinosis tumoral, lipodistrofia y monoartritis. Inmunofluorescencia indirecta e inmunoensayo enzimático indirecto(ELISA) fueron las técnicas utilizadas para la detección de estos autoanticuerpos. Nuestros resultados muestran el patrón de distribución de ANCA en estas enfermedades y por primera vez se describe la presencia de estos autoanticuerpos en enfermedades como síndrome de Down, glomerulonefritis aguda postestreptococcica y periodontitis del adulto. El alto grado de positividad para ésta última enfermedad, plantea la posibilidad de que un número de casos positivos para ANCA reportados para ciertas enfermedades sistémicas, correspondan verdaderamente a otra enfermedad concurrente no detectada

Anemias hemoliticas autoinmunes por anticuerpos calientes. Anemias hemoliticas por drogas / Hemolytic autoimmune anemia caused by hot antibodi. Hemolytic anemia by drugs

Entre las anemias hemolíticas adquiridas destacan por sus características especiales, las originadas por procesos inmunológicos, es decir la resultante de la interacción de un anticuerpo contra su antígeno. A efectos de reunir las diferentes formas clínicas que constituyen este grupo, se han propuesto varias clasificaciones, y entre ellas hemos adoptado la que se muestra en las tablas incluidas en el trabajo