Anakinra is safe and effective in controlling hyperimmunoglobulinaemia D syndrome-associated febrile crisis.

Hyper-IgD and periodic fever syndrome (HIDS) is a hereditary autoinflammatory syndrome, characterized by recurrent inflammatory attacks. Treatment of HIDS is difficult. Recently, the IL-1ra analogue anakinra was reported to be successful in aborting the IgD inflammatory attacks in a vaccination model. We report a clinical case of spectacular reduction of febrile attacks in a severe HIDS patient.

[Neonatal screening of glucose-6-phosphate dehydrogenase deficiency in umbilical cord blood]. / Dépistage néonatal du déficit en glucose-6-phosphate déshydrogénase (G6PD) sur sang de cordon.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most frequent enzyme deficiency. It is a sex-linked genetic disease concerning mostly african, mediterranean and far-eastern populations. The main clinical expression is a hemolytic anemia which can be acute or chronic. During the neonatal period the disease may manifest as neonatal jaundice. We have been asked by the neonate department to set up a blood screening test for this deficiency. We have therefore developed a test using umbilical cord blood. The assay of G6PD has been automatised and red blood cell aspartate-amino-transferase (ASAT) chosen as a reference enzyme to evaluate the age of red blood cells. Normal values of G6PD, ASAT and G6PD/ASAT ratio have been calculated from 235 cord samples. Genetic frequency of this deficiency in 2002 was 6% in male and 1% in female newborns.

[Multicenter study of commercial kits for the determination of human IgG subclasses, using the ELISA technique]. / Etude multicentrique des trousses commercialisées pour le dosage des sous-classes d'IgG humaines par technique ELISA.

We evaluated two commercially available sandwich type Elisa procedures for the measurement of IgG subclasses in human serum. Assay kits from The Binding Site and the Central Laboratory of the Netherlands Red Cross Blood Transfusion Service were tested in six laboratories. The performance of spectrophotometers, pipettes and dilutors were assessed at each center. Within-run precision was estimated according to the Valtec method (Société Française de Biologie Clinique). The overall coefficient of variation ranged from 4 to 50% depending on subclass and kit. We also evaluated the IgG2 and IgG4 specificity using four sera containing a monoclonal IgG2 or IgG4 (kappa or lambda type). Using total IgG and immunoelectrophoresis as a comparative technique, IgG2 kappa and IgG4 kappa were both underestimated, IgG2 lambda was overestimated while IgG4 lambda compared favorably. Polyclonal IgG subclasses were frequently overestimated in these sera suggesting cross-reactions with either monoclonal IgG or other polyclonal IgG. Antigen excess was investigated and not encountered with either kit. Our results demonstrate that these procedures are insufficiently accurate or precise for routine clinical use.

[Sero-immunologic diagnosis of human African trypanosomiasis: cross reactions of various parasitoses and hyperglobulinemias]. / Le diagnostic séro-immunologique de la trypanosomose africaine humaine: réactions croisées au cours de diverses parasitoses et hyperglobulinémies.

The immunological test: latex agglutination, counter immuno-electrophoresis, ELISA, and immunoperoxydase test, have been applied on the serodiagnosis of african sleeping sickness, and have been compared with each other, with special reference to the cross-reactions in parasitic diseases and hyperglobulinemia. In addition to malaria and leishmaniasis well known interferences, this study gives clear indication of the importance of false positive reactions in active toxoplasma infection. Any how, the serodiagnostic can be worked out from the analysis of responses to various specific antigens, which are always more positive with the homologous antigen.

[Blood proteins in African trypanosomiasis: variations and statistical interpretations]. / Les protéines sériques dams la trypamosomose africaine humaine: variations et interprétation statistique.

The estimation of blood orosomucoid, haptoglobin, C-reactive protein and immunoglobulins levels, has enable us to prove a specific proteic profile in the human african trypanosomiasis, as compared with other that of parasitic diseases, and with an healthy african reference group. Data processing informatique by principal components analysis, provide a valuable pool for epidemiological surveys.

[Use of multidimensional technics of analysis in the study of specific immunoglobulins in human African trypanosomiasis]. / Utilisation des techniques d'analyse multidimensionnelle dans l'étude des immunoglobulines spécifiques au cours de la trypanosomose africaine humaine.

In human african trypanosomiasis, the quantitative studies of specific immunoglobulins (IgG, IgA, IgM) complement fixing antibody, and multivariate analysis methods (discriminant analysis allocation of cases with a Jacknife procedure) enable to assert the immunological profiles evolution through the different stages of the disease.

[Comparative study of immunoenzyme technics, ELISA and on formed antigens, in the immunologic diagnosis of African trypanosomiasis]. / Etude comparative des techniques immunoenzymatiques, ELISA et sur antigène figuré, dans le diagnostic immunologique des trypanosomoses africaines.

The enzyme linked immunosorbent assay (ELISA) for the serodiagnosis of human african trypanosomiasis is described, comparatively with the immunoperoxidase technique using blood streamforms of Trypanosoma brucei as antigen. Practical aspects for measuring the amount of antibody in serum samples from infected rabbits and from patients with african sleeping sickness are discussed. ELISA does offer important advantages over the other method used namely: -- quantitative estimates are possible, -- it bends itself readily to large scale series, owing the fact that it can be fully automatic. These qualities will be turned to full account when the different classes of antibodies present in trypanosomiasis suffers can be examined by means of specific antigenic fractions.

[Comparative value of immunofluorescence and immunoenzymology on figured antigen in the immunological diagnosis of African trypanosomiasis]. / Valeur comparée de l'immunofluorescence et de l'immunoenzymologie sur antigène figuré dans le diagnostic immunologique des trypanosomoses africaines.

Indirect immunoperoxydase method is compared with indirect immunofluorescence using immunized animal and human sera, and negative control sera. The obtained results show a good statisticly established concord and allow to propose the indirect immunoperoxydase method being used in the biological diagnostic of african Trypanosomiasis because its easy carrying out and its examin with an ordinary microscope.

[Electrosyneresis in the diagnosis of African trypanosomiasis]. / Les possibilités de l'électrosynérése dans le diagnostic des trypanosomoses africaines

Comparative studies were carried out on serums from rabbits inoculated with several Trypanosoma strains and 50 serums from sleeping sickness cases. The techniques used were antigen-antibody reaction in gel according to Ouchterlony, and electrosynerese for which directions are outlined. Electrosynerese has been shown to be a much faster and more sensitive method of detecting precipitating antibodies in trypanosomiasis.

[Preparation of a standardized antigenic extract from several strains of African trypansomes]. / Préparation d'un extrait antigénique standardisé à partir de diverses souches de trypansomes africains

The preparation of a soluble antigen from african trypanosomes is described below. It is important to observe the following steps: --minimal dose of the phytohemagglutinin must be placed in rapid contact with the trypanosomes; --the standard speed of the different centrifugations must be strictly observed; --a thorough washing of the trypanosomes must be carried out to eliminate the hetero-antigens, but caution should be excercised, as over washing is harmful to the Trypanosomes.