CORRELATION OF ANA IMMUNOFLUOROSCENT TITRE AND PATTERN DISTRIBUTION WITH CLINICAL FEATURES: JOURNEY BEYOND SLE

This is a Retrospective study conducted at Pathology department Bombay Hospital Indore. 300 patients were tested for presence of ANA antibody using indirect immunofluorescent test (IMMUNOSHOP AESKU SLIDES) over the period of one year. ANA testing by IIF is a highly valuable and time tested technique for diagnosis of autoimmune disorder. Results should be interpretated in the light of clinical and biochemical findings as normal individuals have positive results on traditional ANA testing. The most definitive result from ANA testing is a negative test. This result, especially when coupled with negative tests on an ANA profile, suggests strongly that ANA associated diseases are unlikely to be present. This imparts a high NPV to ANA IIF tests. Apart from the usually described clinical features this study highlights few of the uncommon isolated clinical features like cytopenias, myopathies and Pyrexia of unknown origin and utility of ANA IIF in establishing diagnosis. We at our centre perform ANA profile of patients to further classify the disease which is beyond the scope of this article. Keywords: ANA, Immunofluoroscent, Titre & SLE

Feline bartonellosis· A review

Bartonella infection is caused by Gram negative bacteria commonly isolated from domestic cats. Cats are the major reservoir of Bartonella henselae, B. clarridgeiae and B. koehlerae which are transmitted to humans, while they are accidental host of B, quintana. Β, bovis και Β, vìmonìi subsp. berkhoffìi. The pathogen is transmitted among cats mainlyby fleas while other vectors are also suspicious for transmission since the bacteria have been isolated from ticks and flies.The bacterial pathogenicity may be emphasized by the strain of the bacterium and the immune status of the infected host. Most of the infected eats remain asymptomatic. In the natural occurring cases of feline bartonellosis uveitis, chronic gingivostomatitis and endocarditis have been reported. Mild anemia and leucocitosi s in the early phase of the infection has been also reported. Diagnosis is based on the detection of the specific anti-bartoneila antibodies by the inderict immunofluorescent test, ELISA and Western blot assays. Molecular biology techniques mainly PCR, cytology, histopathology and blood culture have also been employed for the direct detection of the pathogen. Prolonged antimicrobial therapy results to the reduction of bacterial burden without total elimination of the pathogen.Bartonella henselae is the causative agent of cat scratch disease, a human infection usually characterized by persistent regional lymphadenopathy and less frequently fever while angiomatosis or hepatic peliosis have been reported mainly in immunocompromised patients. It is transmitted to humans by cat scratches or bites. The most effective means of protection is regular flea control Additionally, commonsense precautions and hygiene such as washing hands after handling pets and clean any cats and bites or scratches promptly are recommended especially in population at great risk.

Results of Detection Antibodies against Rickettsiae in the Blood Sera at the Omsk Region of Russia and the West-Kazakhstan Region of Republic Kazakhstan

Previously, we found high species- and antigenic heterogeneity of spotted fever group rickettsiae circulating in the territories of the Russian Federation. This paper presents the results of the detection of antibodies to R. sibirica and R. conorii by using of complement fixation test and indirect immunofluorescent test (IFT) in the sera of patients after tick bites in tick-borne rickettsioses foci in border areas of Russia and Kazakhstan. The results of the study allow us to recommend carrying out the serological study of the blood sera of patients after tick’s bites using IFT with antigens of Rickettsia species, which circulation is proved or suspected in the area.

Unusual case of lethal tick-borne encephalitis in patient vaccinated with vaccines produced from different viruses strains (the Chelyabinsk Region)

Lethal cases of tick-borne encephalitis in previously vaccinated patients have not been described. Modern inactivated vaccines against Tick-borne encephalitis (TBE) are high effective. The TBE cases, preference unfocal forms, are developed in persons with incomplete irregular vaccination. First case of lethal TBE after plural vaccination was described in the Kurgan region, the second case - in the Chelyabinsk region. These very rare unusual cases were studied. Being dominant the Siberian subtype of TBE virus is related with lethal TBE cases in the Chelyabinsk region. Unusual TBE case was developed in patient who had been vaccinated 8 limes with vaccines produced from strains of Far-Eastern TBE subtype («Virion», Tomsk, Chumakov institute, Moscow) and European TBE subtype (Encepur; FSME-Immun). Two years after the last vaccination a focal form of TBE was developed with lethal outcome at 9 th day. Specific antibodies IgM and IgG seroconversion were detected. The TBE virus antigen was detected in brain neurons by immunofluorescent test. Destructed neurons and gliocyles were shown by hystological study in cerebral hemispheres and cerebellum. The Purkinje cells were destructed. Possible reasons of surmounting vaccinal immunity including a genetic difference of vaccine and infection virus strains are discussed.

Antibody levels to hantavirus in inhabitants of western Santa Catarina State, Brazil

Hantavirus cardiopulmonary syndrome (HCPS) is an infectious disease caused by hantaviruses of the family Bunyaviridae, and is transmitted by aerosols of excreta of infected rodents. The aim of the present study was to determine antibody levels to hantavirus in the population that lives at frontier of Brazil and Argentina. Participated of the study 405 individuals living in the municipalities of Bandeirante, Santa Helena, Princesa and Tunapolis, state of Santa Catarina, Brazil. IgG antibodies to hantavirus were analyzed in sera by an ELISA that uses a recombinant N protein of Araraquara hantavirus as antigen. The results were also confirmed by immunofluorescent test. Eight individuals showed antibodies to hantavirus (1.97% positivity), with serum titers ranging from 100 to 800. Six seropositives were males, older than 30 years and farmers. Our results reinforce previous data on hantavirus circulation and human infections in the southern border of Brazil with Argentina.

Rabies diagnosis and serology in bats from the State of São Paulo, Brazil

INTRODUCTION: Bats are one of the most important reservoirs and vectors of the rabies virus in the world. METHODS: From 1988 to 2003, the Zoonosis Control Center in São Paulo City performed rabies diagnosis on 5,670 bats by direct immunofluorescent test and mouse inoculation test. Blood samples were collected from 1,618 bats and the sera were analyzed using the rapid fluorescent focus inhibition test to confirm rabies antibodies. RESULTS: Forty-four (0.8%) bats were positive for rabies. The prevalence of rabies antibodies was 5.9% using 0.5IU/ml as a cutoff. Insectivorous bats (69.8%) and bats of the species Molossus molossus (51.8%) constituted the majority of the sample; however, the highest prevalence of antibodies were observed in Glossophaga soricina (14/133), Histiotus velatus (16/60), Desmodus rotundus (8/66), Artibeus lituratus (5/54), Nyctinomops macrotis (3/23), Tadarida brasiliensis (3/48), Carollia perspicillata (3/9), Eumops auripendulus (2/30), Nyctinomops laticaudatus (2/16), Sturnira lilium (2/17) and Eumops perotis (1/13). The prevalence of rabies antibodies was analyzed by species, food preference and sex. CONCLUSIONS: The expressive levels of antibodies associated with the low virus positivity verified in these bats indicate that rabies virus circulates actively among them.

Pathohistological changes in diffuse coronary atherosclerosis and chronic infection caused by Chlamydia pneumonia.

BACKGROUND AND PURPOSE: To investigate the histopathologic characteristics of atherosclerotic lessions in diffuse coronary artery disease and to evaluate the possible inflammatory role of chronic infection with Chlamydia pneumoniae (CP).MATERIALS AND METHODS: For 10 patients (males, mean age 61 years) who were surgically treated for grave diffuse coronary artery disease, histomorphological analyses of endarterectomized segments of the coronary arteries were performed. Serological analyses for the detection of CP antibodies in peripheral blood were done, preoperatively.RESULTS AND CONCLUSIONS: Diffuse and concentric atherosclerotic changes from VI to VIII stage according to the Stary classification were found. Immunohistochemical methods revealed infiltrates of T-lymphocytes (80% of cases), B-lymphocytes (40% of cases) and macrophages (80%). Using the nuclear marker for proliferation activity MIB-1, single MIB-1 positive cells were found in 40% of cases. Features of arteriologenesis and vasculitis of newly formed arterioles (as well as thickening of the wall of newly formed arterioles) were found in the vessel wall of 8 patients, 7 of them had chronic infection with CP (preoperative micro-immunofluorescent test results: 1:32<IgG ≥1:512 and IgA≥32), one had passed CP infection (1:32 ≤IgG<1:512, IgA negative). These features were absent in 2 patients, both recovered from CP infection and had not the chronic CP infection at the time of surgery. DNA of Chlamydia pneumoniae was detected using the polymerase chain reaction (PCR) method in the vessel wall of 3 patients who were chosen randomly for this method. This study suggests an inflammatory and proatherogenic role of CP in a high grade atherosclerotic coronary artery wall in diffuse coronary artery disease.