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Vasculitides
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Ivy M. Obonyo, Virginia A. Jones, Kayla A. Clark, Maria M. Tsoukas
Laboratory studies: Cryoglobulins precipitate when cooled below core body temperature and dissolve when brought back to 37°F and can be used as a diagnostic tool in the context of cryoglobulinemic vasculitis. Immunoblotting is the most sensitive and specific test, but immunofixation and immunoelectrophoresis have also been used. Cryoglobulins may be measured indirectly by assessing levels of serum complement, monoclonal immunoglobulin, or rheumatoid factor.
Immunological Tests for Diagnosis of Disease and Identification of Molecules
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Immunoelectrophoresis (IEP) is a separation of antigens by their electrophoretic mobility as well as by diffusion in a gel. Other procedures which are modifications of the precipitation reaction include two-dimensional IEP, crossed IEP, and counter IEP. These are all qualitative procedures. As immunoelectrophoresis is a method that combines the technique of agarose gel electrophoresis with the highly specific antigen antibody reaction, it gives in one procedure information on the electro-phoretic mobility of antigen molecules being tested and on their antigenic nature.
B Cells and Humoral Immunity
Published in Constantin A. Bona, Francisco A. Bonilla, Textbook of Immunology, 2019
Constantin A. Bona, Francisco A. Bonilla
This gammopathy results from proliferation in the bone marrow of IgM-secreting plasmacytoid cells. The clinical presentation is non-specific, most often generalized weakness, fatigue, and weight loss. Diagnosis is made by detecting the M component in immunoelectrophoresis. Common associated symptoms are anemia and hepatosplenomegaly. Bence-Jones proteinuria occurs in about 10% of patients. Osteolytic bone lesions are very rare. The disease is relatively indolent, and even though incidence is rarely before age 60, the mean survival after diagnosis is three to five years, and occasionally ten years or more. Death attributable to this disease is usually due to increased blood viscosity. This can lead to renal failure, hemorrhagic purpura of mucous membranes (paraproteinemia may interfere with coagulation), and occasionally congestive heart failure.
Syphilitic meningomyelitis misdiagnosed as spinal cord tumor: Case and review
Published in The Journal of Spinal Cord Medicine, 2021
Huiqing Dong, Zheng Liu, Yunyun Duan, Dawei Li, Zhandong Qiu, Yaou Liu, Jing Huang, Chaodong Wang
Laboratory tests revealed normal hepatic, renal, thyroid function. She had negative angiotensin-converting enzyme, antinuclear antibodies, antineutrophil cytoplasmic antibodies, anticardiolipin antibodies and rheumatic factor. Serum immunoelectrophoresis and immunoglobulin studies showed no abnormalities. Serum lyme and brucella antibodies were negative. She had positive serum Treponema pallidum Hemagglutinin Test (TPHA) and rapid plasma reagin test (RPR, 1:4). CSF examination revealed 20 × 106 cells/l, 54 mg/dl protein, 37 mg/dl glucose and 112 mg/dl chloride. The cerebral spinal fluid (CSF) was positive with TPHA but negative for RPR. CSF revealed positive oligoband (OB), which indicated intrathecal IgG synthesis. CSF India ink stains were negative for cryptococcus. Bacterial growth was negative both on the blood and on the chocolate culture media Serum and CSF AQP-4 antibody was both negative.
Therapeutic targets for the treatment of microsporidiosis in humans
Published in Expert Opinion on Therapeutic Targets, 2018
Serological techniques that have been reported for the detection of immune responses, both IgG and IgM, to microsporidiosis include: immunoblotting, enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence test (IFAT), counter-immunoelectrophoresis, and carbon immunoassay [91–97]. IFAT and ELISA are the most widely used tests and they correlate well with each other [98]. A limitation of serology is that it is difficult to distinguish when the infection has occurred as antibodies persist in the host for a long time following infection [99,100]. To this end, the utility of serology is not as good as molecular diagnostic methods [80]. However, serology can be used for epidemiology to examine infection prevalence and will identify that an animal has been infected [101,102]. Serological screening is used in laboratory research to eliminate potentially infected animals, particularly rabbits with Enc. cuniculi infection, to avoid infection related confounding effects on experimental results [103].
AL amyloidosis diagnosed using anti-IGLL5 antibody: a case report
Published in Amyloid, 2019
Takayuki Hiroi, Toshiki Mushino, Ken Tanaka, Yoshiaki Furuya, Yoshikazu Hori, Takehiro Oiwa, Hiroshi Kobata, Yusuke Yamashita, Hiroki Hosoi, Shogo Murata, Akinori Nishikawa, Shinobu Tamura, Suguru Takeuchi, Masaharu Nohgawa, Taro Yamashita, Yukio Ando, Hiroyuki Hata, Takashi Sonoki
A 56-year-old man with no past medical history visited our hospital with a complaint of fatigue and weight loss over the last 6 months. No abnormalities were found in the physical examination. Complete blood count and blood chemistry also showed no abnormalities. Serum immunoelectrophoresis revealed a weak positivity of IgG-λ and IgA-λ. The serum-free LC kappa, lambda and k/λ ratio were 14.5 mg/L (3.3–19.4), 31.7 mg/L (5.7–26.3) and 0.46 (0.26–1.65), respectively. 18F-FDG-PET CT scan revealed osteolytic and sclerotic changes and FDG-avidity in the sternum and left iliac bone. The right axillary and bilateral parasternal lymph nodes were enlarged up to 17 mm with avid FDG uptake. Furthermore, a calcified tumor was observed in the tracheal branches, para-abdominal aorta, pleura and thyroid. A biopsy of the right axillary lymph node was performed. Amyloid deposition was suspected in direct fast scarlet staining, but we could not classify disease types in detail. Bone marrow aspiration of the left iliac bone showed that plasma cells were only 2.0% of all nucleated cells. There was no abnormality in the κ/λ ratio in bone marrow plasma cells as detected by flow cytometry. The axillary lymph node specimen was negative for κ, λ, transthyretin and amyloid A. However, the anti-IGLL5 antibody reacted with some part of the amyloid deposition site (Figure 1). We finally diagnosed the patient with AL amyloidosis. The patient received a triplet chemotherapy regimen (bortezomib, cyclophosphamide and dexamethasone [VCD]). After four cycles of VCD, autologous peripheral blood stem cell transplantation was performed following high-dose melphalan conditioning.