Clinical interpretation of detection of IgM anti-Brucella antibody in the absence of IgG and vice versa; a diagnostic challenge for clinicians

• Autorzy: Al Jindan R. , Saleem N. , Shafi A. , Amjad S.M.
• Języki publikacji: EN

Abstrakty

EN

Non-specific and often misleading clinical presentation of active brucellosis has made it a diagnostic puzzle for treating physicians. Clinicians rely greatly on the detection of IgG and IgM anti-Brucella antibodies by ELISA. Different patterns of positivity have been observed for IgG and IgM anti-Brucella antibodies in different cases, which further increases the risk of an erroneous diagnosis. Detailed herein is our two-years data with varied Brucella serology patterns and their clinical interpretation. Between January 2015 to December 2017, 1102 samples were processed in the Immunology Laboratory of KFHU for Brucella serology. 68 samples were positive for both IgG and IgM, 28 samples were positive for IgG and negative for IgM while 15 samples were positive for IgM and negative for IgG antibodies against Brucella. Electronic medical records, history of exposure, signs, symptoms, laboratory data, and the final diagnosis were recorded for all these patients. None of the patients with only positive IgM antibodies was finally diagnosed with brucellosis, while a diagnosis of brucellosis was established for only one patient with IgG antibodies positive in his serum. All the double-positive (IgG- and IgM-positive) serology patterns were diagnosed as having brucellosis.We concluded thatdetermination of single IgM or IgG anti-Brucella-antibodies by ELISA could both be considered as definite and should ideally be interpreted in the context of appropriate clinical scenario and confirmation by other laboratory assays.

• Wydawca: -
• Czasopismo: Polish Journal of Microbiology
• Rocznik: 2019
• Tom: 68
• Numer: 1
• Opis fizyczny: p.51-57,ref.

Twórcy

autor

Al Jindan R.

• Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

autor

Saleem N.

• Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

autor

Shafi A.

• Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

autor

Amjad S.M.

• Department of Nephrology, King Salman Center of Kidney Diseases, Riyadh, Saudi Arabia

Bibliografia

• Al Dahouk S, Nöckler K. Implications of laboratory diagnosis on brucellosis therapy. Expert Rev Anti Infect Ther. 2011;9(7):833–845.doi:10.1586/eri.11.55
• Aranís JC, Oporto CJ, Espinoza M, Riedel KI, Pérez CC, García CP. [Usefulness of the determination of IgG and IgM anti-bodies by ELISA and immunocapture in a clinical series of human brucellosis] (in Spanish). Rev Chilena Infectol. 2008;25(2):116–121.doi:10.4067/S0716-10182008000200006
• Asaad AM, Alqahtani JM. Serological and molecular diagnosis of human brucellosis in Najran, Southwestern Saudi Arabia. J Infect Public Health. 2012;5(2):189–194.doi:10.1016/j.jiph.2012.02.001 Medline
• Binnicker MJ, Theel ES, Larsen SM, Patel R. A high percentage of serum samples that test reactive by enzyme immunoassay for anti-Brucella antibodies are not confirmed by the standard tube agglutination test. Clin Vaccine Immunol. 2012;19(8):1332–1334.doi:10.1128/CVI.00197-12 Medline
• Corbel MJ. Recent advances in the study of Brucella antigens and their serological cross-reactions. Vet Bull. 1985;55:927–942.
• Fadeel MA, Hoffmaster AR, Shi J, Pimentel G, Stoddard RA.Comparison of four commercial IgM and IgG ELISA kits for diagnosing brucellosis. J Med Microbiol. 2011;60(12):1767–1773.doi:10.1099/jmm.0.033381-0 Medline
• Geresu MA, Kassa GM.A Review on diagnostic methods of bru-cellosis. J. Veterinar. Sci. Techno. 2016;7(1):323.
• Gómez MC, Nieto JA, Rosa C, Geijo P, Escribano MA, Muñoz A, López C. Evaluation of seven tests for diagnosis of human brucel-losis in an area where the disease is endemic. Clin Vaccine Immunol. 2008;15(6):1031–1033. doi:10.1128/CVI.00424-07 Medline
• ISCII. Spanish national records of notifiable diseases [Internet]. (in Spanish). 2018. Madrid (Spain): Carlos III Health Institute; [cited 2018 Aug 27]. Available from http://www.isciii.es/ISCIII/es/contenidos/fd-servicios-cientifico-tecnicos/fd-vigilancias-alertas/fd-enfermedades/enfermedades-declaracion-obligatoria-series-temporales.shtml
• Mantecón MÁ, Gutiérrez P, Zarzosa MP, Dueñas AI, Solera J, Fernández-Lago L, Vizcaíno N, Almaraz A, Bratos MA, Torres AR,et al. Utility of an immunocapture-agglutination test and an enzyme-linked immunosorbent assay test against cytosolic proteins from Brucella melitensis B115 in the diagnosis and followup of human acute brucellosis. Diagn Microbiol Infect Dis. 2006;55(1):27–35.doi:10.1016/j.diagmicrobio.2005.11.003 Medline
• Mantur B, Parande A, Amarnath S, Patil G, Walvekar R, Desai A, Parande M, Shinde R, Chandrashekar M, Patil S. ELISA versus conventional methods of diagnosing endemic brucellosis. Am J Trop Med Hyg. 2010;83(2):314–318.doi:10.4269/ajtmh.2010.09-0790 Medline
• Özdemir M, Feyzioğlu B, Kurtoğlu MG, Doğan M, Dağı HT, Yüksekkaya Ş, Keşli R, Baysal B. A comparison of immuncapture agglutination and ELISA methods in serological diagnosis of bru-cellosis. Int J Med Sci. 2011;8(5):428–432.doi:10.7150/ijms.8.428 Medline
• Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV.The new global map of human brucellosis. Lancet Infect Dis. 2006;6(2):91–99. doi:10.1016/S1473-3099(06)70382-6 Medline
• Poester FP, Nielsen K, Ernesto Samartino L, Ling Yu W.Diagnosis of Brucellosis. The Open Vet Sci J. 2010;4(1):46–60. doi:10.2174/1874318801004010046
• Sharma R, Chisnall C, Cooke RPD. Evaluation of in-house and commercial immunoassays for the sero-diagnosis of brucellosis ina non-endemic low prevalence population. J Infect. 2008;56(2):108–113. doi:10.1016/j.jinf.2007.10.010 Medline
• Varshochi M, Majidi J, Amini M, Ghabili K, Shoja MM. False positive seroreactivity to brucellosis in tuberculosis patients: a pre-valence study. Int J Gen Med. 2011;4:207–210. Medline
• Welch RJ, Litwin CM. A comparison of Brucella IgG and IgM ELISA assays with agglutination methodology. J Clin Lab Anal. 2010;24(3):160–162. doi:10.1002/jcla.20382 Medline

Identyfikatory

DOI

10.21307/pjm-2019-006