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Serologic Tests (serologic + test)
Selected AbstractsAcute cardiorespiratory collapse from heparin: a consequence of heparin-induced thrombocytopeniaEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2004Martha P. Mims Abstract: Background:, Heparin has rarely been reported to cause acute cardiorespiratory reactions or collapse. Some reports relate this to underlying heparin-induced thrombocytopenia. Objective:, To confirm and increase awareness of acute life-threatening cardiopulmonary events when patients with heparin-induced thrombocytopenia are re-exposed to heparin. Design:, Retrospective observational case series. Patients/setting:, Four cardiovascular surgery patients were identified in two adjacent large urban hospitals over a 2-yr-period who experienced eight episodes of cardiorespiratory collapse immediately following heparin administration. All had underlying heparin-induced thrombocytopenia. Results:, Intravenous boluses of unfractionated heparin were given to four patients with known or previously unrecognized heparin-induced thrombocytopenia. Two patients experienced severe respiratory distress within 15 min for which they required endotracheal intubation. Two other patients experienced cardiac arrest or a lethal arrhythmia within minutes of receiving intravenous heparin. Serologic tests for heparin-induced antibodies were positive in all patients. In three cases, the platelet count was normal or near normal but fell dramatically (71%) immediately following the heparin bolus. Three cases had prior diagnoses of heparin-induced thrombocytopenia, but health care workers administered heparin either unaware of the diagnosis or ignorant of its significance. No patients died, but all required some form of cardiopulmonary resuscitation and subsequent intensive care. Conclusions:, Heparin administration to patients with heparin-induced antibodies can result in life-threatening pulmonary or cardiac events. Appreciation of this phenomenon can unmask cases of heparin-induced thrombocytopenia and strengthens the mandate to avoid any heparin exposure in affected patients. Recognition is crucial to avoiding disastrous outcomes. [source] Cutaneous manifestations of dengue viral infection in Punjab (north India)INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2007Emy Aby Thomas MBBS Background, Dengue infection is emerging as a public health problem in India. Despite numerous studies, there is a paucity of literature regarding the cutaneous manifestations of dengue. This study was performed to investigate the prevalence and type of cutaneous manifestations in dengue viral infection. Methods, Two hundred and fifty-six patients with febrile illness, admitted to the Christian Medical College and Hospital, Ludhiana, India, were studied. On the basis of the clinical criteria and laboratory tests, 124 patients were diagnosed with dengue viral infection, and these patients were investigated in detail. Serologic tests were attempted in only 84 patients, and all of these samples tested positive for anti-dengue immunoglobulin M (IgM) antibodies. Results, Of the 124 patients with dengue infection, 41 (23.1%) were classified with dengue fever (DF) and 83 (66.9%) with dengue hemorrhagic fever (DHF), four (3.2%) of whom had dengue shock syndrome (DSS). Cutaneous involvement was seen in 46.8% of patients, the most common symptom being maculopapular/morbilliform eruption (48.3%), followed by ecchymotic (27.6%), petechial (13.8%), and macular/scarlatiniform (10.3%) eruption. Maculopapular eruption was observed more in DF, whereas petechiae, ecchymosis, and mucosal involvement were seen more in DHF; 72.4% of patients with cutaneous manifestations were asymptomatic, and 27.6% had pruritus. Involvement was generalized in 48.3% of patients, with the limbs and trunk involved in 32.8% and 18.9% of patients, respectively. Mucosal involvement was seen in 29.8% of patients, with conjunctival involvement being the most common (20.9%), followed by the lips (4.8%), palate (2.4%), and tongue (1.6%). Conclusions, This study describes the variety of cutaneous features associated with dengue viral infection which may evolve during the course of the disease. As a significant proportion of patients showed cutaneous features, these manifestations, together with simple laboratory tests, will be helpful in the early diagnosis of dengue viral infection. [source] Canine Dal Blood Type: A Red Cell Antigen Lacking in Some DalmatiansJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 2 2007Marie-Claude Blais Background:Based upon alloantibodies produced after sensitizing dogs with transfused blood, more than a dozen blood group systems have been recognized thus far, and some have been classified as dog erythrocyte antigens (DEA). Hypothesis:A new canine red cell antigen was suspected, based on the development of specific alloantibodies in a Dalmatian previously sensitized by blood transfusions. Animals:Twenty-six Dalmatians (including 1 Dalmatian in need of blood compatibility studies); 55 canine blood donors. Methods:Serologic tests, including blood typing, crossmatching, and direct Coombs' test were performed by standard tube techniques and a novel gel column technology adapted from human blood banking. Results:By day 40 after transfusion of an anemic Dalmatian, all major crossmatch tests to 55 non-Dalmatian dogs were incompatible. The 2 initial donors, who were compatible before transfusion, were also now incompatible, suggesting the development of an alloantibody to a common red cell antigen. No siblings were available, but 4 of 25 unrelated Dalmatians were crossmatch compatible, suggesting that they were missing the same red cell antigen. The patient was blood typed DEA 1.1, 3, 4, and 5 positive, but DEA 7 negative. Further blood typing and crossmatching results did not support an association to any of these known blood types. The alloantibodies produced were determined to be of the immunoglobulin G class. Conclusions and Clinical Importance: Based upon the identification of an acquired alloantibody in a Dalmatian, a presumably new common blood type named Dal was identified. Dalmatians lacking the Dal antigen are likely at risk of delayed and acute hemolytic transfusion reactions. [source] A neuro-Behcet's lesion in oculomotor nerve nucleusACTA NEUROLOGICA SCANDINAVICA, Issue 2 2003M. D. Aydin Objective , Fascicular oculomotor nerve involvement is occasionally seen in Behcet's disease, but nuclear involvement is very rare. Case presentation , A 25-year-old woman presented with the Behcet's symptoms and the left eye problems. Physical examination revealed muco-cutaneous lesions, eyelid ptosis, mydriasis, upward and medial gaze palsy and lateral deviation on the left eye. Serologic tests were positive. An inflammatory lesion was detected in the left oculomotor nerve nucleus on magnetic resonance imaging. Neuro-Behcet's disease was considered the most likely diagnosis. Result , Dexamethasone treatment was ordered. Muco-cutaneal lesions, laboratory abnormalities were normalized after 1 year; but oculomotor nerve palsy persisted in spite of improvement in radiological findings. Conclusion , Clinical signs of oculomotor nerve palsy may persist despite the radiological improvement. [source] Cutaneous manifestations of Wegener's granulomatosis: a clinicopathologic study of 17 patients and correlation to antineutrophil cytoplasmic antibody statusJOURNAL OF CUTANEOUS PATHOLOGY, Issue 10 2007Nneka I. Comfere Background:, Wegener's granulomatosis (WG), a systemic vasculitis, can be associated with cutaneous signs and symptoms before, during or after the diagnosis of systemic disease. Methods:, We reviewed clinical and histologic features of cutaneous lesions from 17 patients with WG. The temporal relationship between development of cutaneous symptoms and onset of systemic disease was determined, and antineutrophil cytoplasmic antibody (ANCA) status of the patients was also established. Results:, In six patients, systemic and cutaneous disease developed concurrently. In eight patients, cutaneous disease developed after patients received the diagnosis of systemic disease. In three patients, cutaneous disease preceded systemic disease. Cytoplasmic ANCA or proteinase-3-ANCA [c-ANCA/proteinase 3 (PR3)-ANCA] serologic test results were negative for one patient when cutaneous disease developed, and one patient had c-ANCA/PR3-ANCA seroconversion a year before systemic disease developed. Histopathologic features of cutaneous WG were not limited to leukocytoclastic vasculitis; they also included acneiform perifollicular and dermal granulomatous inflammation and palisaded neutrophilic and granulomatous inflammation. Conclusions:, Patients with WG can present initially with cutaneous symptoms. Histopathologic patterns vary, but leukocytoclastic vasculitis is most commonly noted. Patients with WG and skin lesions are likely to have positive c-ANCA/PR3-ANCA serologic test results. [source] Occupational exposure of Brazilian neonatal intensive care workers to latex antigensALLERGY, Issue 1 2004R. A. M. Lopes Background:, Frequent exposure to latex causes various reactions such as respiratory symptoms and anaphylactic shock. In these cases, proteins found in natural latex are responsible for the serious systemic antilatex-mediated immediate hypersensitive reactions. Methods:, Cross-sectional descriptive survey focusing on 96 Brazilian health care workers (HCW) in the neonatal intensive care unit at CAISM, State University of Campinas UNICAMP, Brazil. All subjects were interviewed, donated blood samples for the latex-specific immunoglobulin E measurement and underwent the skin prick test (SPT) with an antigen extracted from latex gloves. Results:, The prevalence of latex positive SPT was 8%. There were eight SPT positive and only one serologic test was in agreement with the SPT. Overall, there was evidence of an association between the latex SPT and reported eczema (P = 0.01); food allergy (P = 0.009) with pineapple (P = 0.01). Conclusions:, These results suggest that the identification of reactions of immediate hypersensitivity mediated by antilatex antibodies in HCW should be encouraged to prevent occupational exposure to latex products. [source] Antibody response to Candida albicans cell wall antigensFEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY, Issue 3 2004José L López-Ribot Abstract The cell wall of Candida albicans is not only the structure where many essential biological functions reside but is also a significant source of candidal antigens. The major cell wall components that elicit a response from the host immune system are proteins and glycoproteins, the latter being predominantly mannoproteins. Both carbohydrate and protein moieties are able to trigger immune responses. Proteins and glycoproteins exposed at the most external layers of the wall structure are involved in several types of interactions of fungal cells with the exocellular environment. Thus, coating of fungal cells with host antibodies has the potential to profoundly influence the host,parasite interaction by affecting antibody-mediated functions such as opsonin-enhanced phagocytosis and blocking the binding activity of fungal adhesins to host ligands. In this review we examine various members of the protein and glycoprotein fraction of the C. albicans cell wall that elicit an antibody response in vivo. Some of the studies demonstrate that certain cell wall antigens and anti-cell wall antibodies may be the basis for developing specific and sensitive serologic tests for the diagnosis of candidiasis, particularly the disseminated form. In addition, recent studies have focused on the potential of antibodies against the cell wall protein determinants in protecting the host against infection. Hence, a better understanding of the humoral response triggered by the cell wall antigens of C. albicans may provide the basis for the development of (i) effective procedures for the serodiagnosis of disseminated candidiasis, and (ii) novel prophylactic (vaccination) and therapeutic strategies to control this type of infections. [source] Multiple condylomata lata: a case reportINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2008Haikang Hua MD An unusual form of secondary syphilis was reported, characterized by multiple papules involving the intertriginous areas. The skin biopsy was performed but was nondiagnostic. Later on, serologic tests confirmed the diagnosis. This patient is presented to emphasize the importance of considering syphilis in any patient with an at-risk sexual history and popular verrucous lesions of the skin folds. [source] Comparison of the Tzanck test and polymerase chain reaction in the diagnosis of cutaneous herpes simplex and varicella zoster virus infectionsINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2007Atilla Ozcan MD Background, Although the diagnosis of herpes simplex virus (HSV) and varicella zoster virus (VZV) infections is usually made clinically, the Tzanck test, electron microscopy, viral culture, polymerase chain reaction (PCR), and serologic tests can be utilized to verify the diagnosis. Methods, We conducted a study on a total of 98 patients (77 patients with recurrent herpes simplex and 21 patients with herpes zoster) to evaluate the reliability and reproducibility of the Tzanck test in comparison with PCR. Results, In herpes virus infections, the general positivity rates of the Tzanck test and PCR were 61.2% and 79.6%, respectively. The difference between the positivity rates of the two tests was statistically significant. The positivity rates of the tests differed according to the type and duration of the lesions. Conclusions, Although PCR was superior to the Tzanck test, the Tzanck test has also been proven to be a reliable diagnostic method, with a sensitivity of 76.9% and a specificity of 100%. We recommend the use of this easy, quick, reproducible, and inexpensive diagnostic test more often in dermatologic practice, especially in cutaneous herpes virus infections. [source] A case of erythema elevatum diutinum associated with breast carcinomaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2005Fikriye Yilmaz MD A 53-year-old woman diagnosed with invasive ductal-type breast carcinoma was referred to our clinic with red,purple lesions on the hands and legs. She had neither pruritus nor pain. The first lesion developed on the dorsal hand. In the following days, new lesions appeared on the extensor surface of the legs. The patient had been treated with modified radical mastectomy and three courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy. Dermatologic examination revealed reddish-violaceous papules and plaques ranging from a few millimeters to 2 cm in diameter, bilaterally located on the dorsal hands, especially over the metacarpophalangeal and interphalangeal joints (Fig. 1). Multiple red,purple, circumscribed papules and plaques of various diameters were observed bilaterally over the shins (Fig. 2). The largest of these plaques showed an annular configuration. The nails showed distal subungual keratosis and yellow discoloration. The rest of the physical examination was normal. Figure 1. Violaceous papules and plaques on the dorsal hands Figure 2. Red,purple, circumscribed, papules and plaques over the shins A biopsy taken from the medial side of the shin revealed a predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (Fig. 3). Figure 3. Predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (hematoxylin and eosin stain, ×100) Complete blood count, routine biochemical tests and fasting lipids, serologic tests of bacterial and viral agents, serum electrophoresis, and serologic profiles for autoimmune connective tissue diseases revealed normal results. Mycologic examination of nail clippings did not show any evidence of fungal infection. In the light of our clinical and histopathologic findings, a diagnosis of erythema elevatum diutinum was made, and the patient was given topical clobetasol propionate therapy. Complete clearance was achieved in 3 weeks (Fig. 4). After six courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy, and radiotherapy, no recurrence of erythema elevatum diutinum lesions was observed. Figure 4. Healed lesion 3 weeks after high-potency topical glucocorticoids [source] Early abdominal sonographic findings in patients with dengue feverJOURNAL OF CLINICAL ULTRASOUND, Issue 8 2004Keng-Liang Wu MD Abstract Purpose This study was conducted to evaluate the early sonographic findings in dengue hemorrhagic fever. Methods From July 2002 to September 2002, 86 patients were referred to our center with suspected dengue fever during an outbreak of the disease in Taiwan. All the patients underwent immediate abdominal sonography when they arrived at our emergency room. The diagnosis of dengue fever was subsequently confirmed by serology in 65 patients. Results All our patients had type 2 dengue fever, as confirmed by serologic tests. The sonographic features included a thickened gallbladder wall in 38 patients (59%), ascites in 24 patients (37%), splenomegaly in 22 patients (34%), and pleural effusion in 21 patients (32%); pleural effusion was either right-sided or bilateral. Conclusions Abdominal sonography can be used as a first-line imaging modality in patients with suspected dengue fever to detect early signs suggestive of the disease prior to obtaining serologic confirmation test results, especially in a dengue fever epidemic area. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:386,388, 2004 [source] Baculovirus expression of erythrovirus V9 capsids and screening by ELISA: Serologic cross-reactivity with erythrovirus B19JOURNAL OF MEDICAL VIROLOGY, Issue 2 2002Erik D. Heegaard Abstract Diagnosis of erythrovirus B19 (B19) relies on serology and the detection of viral DNA. Recently, a distinct erythrovirus isolate termed V9, markedly different from erythrovirus B19 (>,11% nucleotide disparity), was isolated. Standard B19 PCR assays were inconclusive and serologic tests failed to categorize V9 as an acute B19-like infection. Sequencing, combined with PCR studies, have since demonstrated the need for specific and differentiated techniques when examining samples for possible B19 or V9 viremia. The antigenic properties of the V9 capsid proteins have not been characterized previously. To address this question, V9 VP1 and VP2 open reading frames were cloned and expressed in insect cells using a baculovirus vector. Large quantities of purified recombinant V9 capsid protein were produced and electron micrographs revealed self-assembly of V9 VP1/VP2 and VP2 capsids into empty icosahedral erythrovirus-like particles with a diameter of ,23 nm. Screening of a panel of 270 clinical samples for the presence of V9 IgM and IgG antibodies in ELISA showed 100% serologic cross-reactivity between B19 and V9 when comparing V9 VP2 capsids to a commercial B19 VP2 assay. This suggests that both a V9 and a B19 antibody response may be diagnosed equally well by ELISA using either V9 or B19 recombinant capsids as antigen source. Retrospectively, translation of the V9 sequence indicates that despite a significant genetic variation on the DNA level, the majority of the discrepant DNA sequence represents silent mutations leading to an amino acid sequence very similar to the known B19 strains (96,97% homology). J. Med. Virol. 66:246,252, 2002. © 2002 Wiley-Liss, Inc. [source] 1242: Over-reliance on negative test resultsACTA OPHTHALMOLOGICA, Issue 2010V PURVIN Purpose This course focuses on areas of frequent diagnostic confusion in the field of neuro-ophthalmology. Methods The course uses a case-based method. Cases are presented as unknowns, each illustrating the specific clinical feature or features that should point to the correct diagnosis. Results Certain tests may provide misleading information, apparently "ruling out" a particular disorder, when in fact that is the correct diagnosis. Examples include serologic tests for ocular myasthenia, falsely negative temporal artery biopsy for giant cell arteritis and MRI scans in certain some disorders. Conclusion In order to interpret the results of ancillary testing we must know the clinical features of the disease in question and the limitations of the tests we use. [source] Recurrent herpes labialis in US children and youthCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 6 2004Jay D. Shulman Abstract , Objective:, This study reports data from the Third National Health and Nutrition Examination Study, 1988,1994 (NHANES III). Methods:, NHANES III was a complex, multistage sample of 33 994 civilian, non-institutional individuals from 19 528 households. Dentist examiners were trained to recognize, classify oral mucosal lesions to include recurrent herpes labialis (RHL). Subjects ,8 years of age were asked if they had cold sores in the past year and serologic tests for herpes virus type 1 (HSV-1) and type 2 (HSV-2) were performed on blood of youth >12 years of age. Results:, Examinations were performed on 10 032 individuals 2,17 years of age. Overall point prevalence was 1.42% (0.69,2.15); annual prevalence in individuals 8,17 years of age was 14.77% (12.74,16.80); and serologic prevalence of HSV-1 in youth 12,17 years of age was 43.18% (38.88,47.48). When the data were subset to youth 12,17, annual prevalence for seropositives was 24.13% (20.44,27.82) compared with 16.87 (14.16,19.57) for all subjects. Approximately 25% of the seropositive youth had at least one recurrence in the past year. Conclusion:, As RHL is a recurrent infection, prevalence in a population will be related to the proportion of the population that has been infected with herpes simplex virus. When lesion-specific prevalences are cited in the literature, they should be stratified by covariates known to be associated with them. Future studies should examine RHL prevalence in infected individuals. [source] | ||||||||||