Cholangitis ; classification ; diagnosis ; etiology ; Cholangitis, Sclerosing ; diagnosis ; Diagnosis, Differential ; Humans ; Immunoglobulin G

OBJECTIVEThe development of recurrent respiratory tract infection (RRTI) is related to vitamin A deficiency and immune function abnormality in children. This study examined serum levels of IgG subclasses and vitamin A in children with recurrent respiratory tract infection.

METHODSSerum IgG subclasses levels (IgG1, IgG2, IgG3, IgG4) were detected using ELISA and serum vitamin A levels were detected using high performance liquid chromatography-Miller method in 80 children with RRTI (ranged from 2-10 years old). The values were compared with those from 80 aged-matched healthy children.

RESULTSSerum levels of IgG2 (1.52 +/- 0.18 g/L) and IgG4 (0.22 +/- 0.12 g/L) in children with RRTI were significantly lower than controls (IgG2: 2.23 +/- 0.08 g/L; IgG4: 0.28 +/- 0.01 g/L) (P < 0.05). Serum vitamin A levels in children with RRTI were also significantly lower than controls (1.16 +/- 0.22 micromol/L vs 1.56 +/- 0.12 micromol/L; P < 0.05). IgG2 and IgG4 deficiency (27%) was the most common in 22 RRTI children with vitamin A deficiency.

CONCLUSIONSSerum levels of IgG subclasses, IgG2 and IgG4, and vitamin A decrease in children with RRTI. There might be some relationship between the decreased IgG2 and IgG4 levels and vitamin A deficiency.

Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin G ; blood ; classification ; Male ; Respiratory Tract Infections ; blood ; Vitamin A ; blood

BACKGROUNDThe false positive in conventional syphilis serological test was found in patients with multiple myeloma (MM).

OBJECTIVETo investigate the relationship between the M-protein of patients with MM and the false positive in conventional syphilis serologic test.

METHODSThe M-protein of 68 MM cases was typed with immunofixation electrophoresis and 68 cases of MM were screened with non-specific and specific syphilis serologic tests, then the samples with syphilic serological positive were chosen and confirmed with immonobloting test, finally the relationship between M protein of MM and the false positive of syphilis serological test were analysed.

RESULTSFour out of 68 cases showed the positive in syphilis serological test and further were confimed to be false positive by immunoblotting test, the false positive rate was nearly 6%. The M-protein of MM patients in our hospital mostly possessed IgG, κ type, followed by IgA, κ type, light chain κ type. In general, κ : λ = 2.4 : 1. Among samples of 4 cases with syphilis serological positive 2 cases were of IgG and κ type, 1 case was of IgG, λ type, another 1 case was IgA, κ type.

CONCLUSIONThe M-protein of IgG and IgA types in MM patients results in syphilis serological false positive reaction. The clinicians and laboratorial technicians should pay a great attention to screen the MM patients for the false positive syphilis serological test so as to avoid the misdiagnosis and subsequent embarassment.

Diagnostic Errors ; False Positive Reactions ; Humans ; Immunoglobulin A ; classification ; Immunoglobulin G ; classification ; Multiple Myeloma ; diagnosis ; Myeloma Proteins ; metabolism ; Syphilis ; diagnosis ; Syphilis Serodiagnosis

OBJECTIVETo explore the relationship between the major allergens of 6 common allergic foods and IgA nephropathy.

METHODSA sensitive sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of food-specific IgA1, IgG and IgE in 31 patients with IgA nephropathy and 80 healthy volunteers. All the patients were examined for a history of food allergy using a questionnaire.

RESULTSSerum levels of IgA1 and IgG against the major allergens of the 6 common allergic foods were significantly higher in patients with IgA nephropathy than in healthy volunteers (P<0.05). There was no detectable food-specific IgE antibodies in the two groups. No patients had a clear history of food allergy. All the patients with increased IgG levels specific to 4 or more foods simultaneously had proteinuria.

CONCLUSIONSSome foods especially the highly allergic ones may participate in the pathogenesis and progression of IgA nephropathy.

Adult ; Antibody Specificity ; Case-Control Studies ; Female ; Food Hypersensitivity ; classification ; immunology ; Glomerulonephritis, IGA ; blood ; immunology ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin E ; blood ; Immunoglobulin G ; blood ; Male ; Young Adult

Immunoglobulin deficiency with increased IgM, as defined by World Health Organization classification of primary immunodeficiency, is characterized by normal or increased concentrations of serum IgM and, in some cases, IgD, but decreased or absent IgG, IgA, and IgE. Patients with these disorders have a high incidence of recurrent pyogenic infections, including otitis media, pneumonia, and septisemia. We recently experienced a case of immunoglobulin deficiency with increased IgM in a 25-year old man. He had been suffered from recurrent pyogenic infections-pneumonia, otitis media-since about 6 months of his age. He was admitted due to pneumonia, and Haemophilus influenza was isolated from the sputum culture. Also chest X-ray showed bronchiectasis. His serum immunoglobulin levels revealed increased concentration of IgM and decreased IgG and IgA. He was successfully treated with antibiotics, and now he is being followed-up. So we present this case with the review of literature.
Adult ; Anti-Bacterial Agents ; Bronchiectasis ; Classification ; Haemophilus ; Humans ; Immunoglobulin A ; Immunoglobulin D ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M* ; Immunoglobulins* ; Incidence ; Influenza, Human ; Otitis ; Otitis Media ; Pneumonia ; Sputum ; Thorax ; World Health Organization

We evaluated tetanus specific IgG, IgM, IgG subclasses after DPT vaccination in infants and children. Tetanus toxoid specific IgG, IgM IgG subclasses were measured to characterize the isotope profile of antibody against tetanus toxoid. The values of the tetanus specific IgG in the positive group were significantly increased compared to those of the control group, and were significantly increased after two inoculation. Tetanus specific IgG was very low in adults and neonates. In our tetanus specific IgG subclasses study, forty-five of 56 cases (80%) showed predominantly IgG1 antibody responses to tetanus toxoid, while twenty-five of 56 cases (45%) showed IgG4 responses. Both IgG1 and IgG4 responses were demonstrated in 17 cases (30%). So we suggest that IgG was mainly involved in humoral immune response after DPT vaccination, and IgG1 may play an important role among IgG subclasses. IgG4, alone or together with IgG1, can also play a role in immune response to tetanus toxoid.
Antibodies, Bacterial/*biosynthesis ; Antibody Specificity ; Child ; Clostridium tetani/immunology ; Diphtheria-Tetanus-Pertussis Vaccine/*immunology ; Human ; Immunoglobulin G/biosynthesis/classification ; Immunoglobulin M/biosynthesis ; Infant

Hypersensitivity to the stings of the Hymenoptera has been described since antiquity. The hypersensitive reactions to insect stings vary from minor skin reactions to severe and sometimes fatal anaphylaxis. Concerns about sting hypersensitivity have been increasing because of many incidents of allergic reactions of patients to the fire ant in the southern area of the United States as well as the harvester ant in some areas. We experienced one unique case with severe allergic reactions by ant of the Ectomomyrmex spp. of the subfamily Ponerinae, which is not a harvester ant. For three years the patient had been suffering from generalized allergic reactions such as anaphylaxis after the ant stings four-five attacks in a year. We determined that her reactions were due to specific IgE mediated type I hypersensitivity by the detection of a high level of specific IgE to the ant venom in her serum. The high level of specific IgG4 to the ant venom was also noted in her serum, however, the role of ant venom IgG4 was not clearly determined.
Adult ; Anaphylaxis/*etiology ; Ant Venoms/*immunology ; Case Report ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Immunoglobulin E/*analysis ; Immunoglobulin G/*classification ; Support, Non-U.S. Gov't

Mast cells, which are major effector cells in allergic reactions, are found in the perivascular spaces of most tissues and contain pro-inflammatory and vasoactive mediators. These mediators are released after IgE receptor cross-linking induced by allergens or other stimuli, including anaphylatoxins (C3a and C5a), aggregated IgG, certain drugs, venoms, and physical stimuli (pressure and temperature changes), as well as cytokines and neuropeptides. The excess release of these mediators can cause variable allergic symptoms and signs, such as bronchospasm, itching, flushing, nausea, vomiting, diarrhea, abdominal pain, vascular instability, and anaphylaxis. Furthermore, mast cell disorders may involve either excessive proliferation of mast cells or abnormal mast cell reactivity. Mast cell disorders can be broadly divided into 3 types: primary, secondary, and idiopathic. All of these disorders present with signs and symptoms of mast cell activation and differ in severity and involvement of various organ systems. The best characterized primary disorder is mastocytosis. Systemic and cutaneous forms of the disease are well described. Secondary disorders include typical allergic diseases and some types of urticarial diseases. In this article, the biochemical characteristics of mast cells and the role of mast cells in allergic inflammation, as well as the classification, diagnosis, and management of mast cell-related disorders, will be reviewed.
Abdominal Pain ; Allergens ; Allergy and Immunology ; Anaphylatoxins ; Anaphylaxis ; Bronchial Spasm ; Classification ; Cytokines ; Diagnosis ; Diarrhea ; Flushing ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Inflammation* ; Mast Cells* ; Mastocytosis ; Nausea ; Neuropeptides ; Pruritus ; Venoms ; Vomiting

BACKGROUND: IgA nephropathy is characterized by showing a prominent mesangial deposition of IgA in biopsy specimens. More than 20% of these patients progress to an end-stage renal disease over a period of 20 years. However, it is difficult to perform renal biopsies in all patients who present with hematuria or proteinuria. The present study was undertaken to determine whether discriminant analysis before renal biopsy is useful in the diagnosis of IgA nephropathy. METHODS: A total of 144 patients who were diagnosed by renal biopsy were analyzed. This group of 144 patients included 76 patients who had an IgA nephropathy, and did not include those patients that had systemic lupus erythematosus, Henoch-Schonlein purpura or other systemic diseases, and 68 patients with a different kind of primary chronic glomerulonephritis. Discriminant analysis was used to clearly demarcate these two groups by using 20 clinical variables. RESULTS: Among the 20 clinical variables, the levels of serum albumin, serum IgG, serum IgA, the degree and quantitation of proteinuria, the degree of microhematuria, and the RBC counts of the urinary sediments in the IgA nephropathy group were significantly higher than those in the non-IgA nephropathy group. Also, the presence of subjective symptoms was significantly different between the two groups. Using the stepwise method, serum albumin (ALB), serum IgA (IGA), and the degree of microhematuria (MICRO) were chosen to be the discriminant markers and resulted in a correct classification rate of 81.3%. The discriminant function (D) was 'D=0.842XALB+0.523XIGA+0.414XMICRO'. CONCLUSIONS: It was considered that discriminant analysis using clinical markers such as serum albumin, serum IgA, and degree of microhematuria before renal biopsy is useful in the clinical diagnosis of IgA nephropathy.
Biomarkers ; Biopsy ; Classification ; Diagnosis* ; Discriminant Analysis ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Kidney Failure, Chronic ; Lupus Erythematosus, Systemic ; Proteinuria ; Purpura, Schoenlein-Henoch ; Serum Albumin

PURPOSE: A possible involvement of autoimmune mechanism in the pathogenesis of bronchial asthma has been proposed. Recently, alpha-enolase protein was identified as a major autoantigen recognized by circulating IgG autoantibodies in patients with severe asthma. To evaluate a possible pathogenetic significance of these autoantibodies in severe asthma, isotype (IgG, IgA, IgM, and IgE) and IgG subclass (IgG1, IgG2, IgG3, and IgG4) distributions of autoantibodies to recombinant human alpha-enolase protein were analyzed. PATIENTS AND METHODS: We examined serum samples from 10 patients with severe asthma and 7 patients with mild-to-moderate asthma, and 5 healthy controls by immunoblot analysis. Severe asthma was defined as patients having at least 1 severe asthmatic exacerbation requiring an emergency department visit or admission in the last year despite continuous typical therapies. RESULTS: IgG1 was the predominant IgG subclass antibody response to alpha-enolase protein in patients with severe asthma. IgG1 autoantibody to alpha-enolase protein was detected in 7 of 10 patients with severe asthma (70%), 1 of 7 patients with mild-to-moderate asthma (14.3%), and none of 5 healthy controls (0%) (chi-square test; p < 0.05). IgA, IgM, and IgE autoantibodies to alpha-enolase protein could not be detected in patients with severe asthma. CONCLUSION: IgG1 subclass was the predominant type of autoantibody response to alpha-enolase protein in patients with severe asthma, suggests a possibility of IgG1 autoantibody- mediated complement activation in the pathogenesis of severe asthma.
Adult ; Aged ; Asthma/*enzymology/*immunology ; Autoantibodies/*blood/classification ; Autoantigens ; Case-Control Studies ; Complement Activation ; Female ; Humans ; Immunoglobulin G/blood/classification ; Immunoglobulin Isotypes/blood ; Male ; Middle Aged ; Phosphopyruvate Hydratase/*immunology ; Recombinant Proteins/immunology ; Young Adult