Diagnostic value of the IgM Immunofluorescence test for chagas' disease in infants andadults.The IFAT-IgM with Trypanosoma cruzi antigen was applied in a double blind study of 242 serum samples previously examined by the IFAT-IgG for Chagas' disease. The sensitivity of the test was enhanced by prolonged incubation at 4°C. The specificity of the IgM reaction in normal sera, was checked repeting the test in alliquots, absorbed with IgG. The results were tabulated according to the origin of the samples and the presence, or absence, of IgG antibodies for Chagas' disease. 84 of die samples belonged to infants and 158 to adults,131 had IgG antibodies against T. cruzi and the remaining 111 served as negative controls in both groups.In was demonstrated that a high proportion of positive IgM-results obtained in normal sera, of infants (15,5%) and adults (28,5%), were due to otfier factors: Elimination of nonspecific IgM antibodies, by absorbtion, reduced the reactions of IgM, at liters of 1/10 and 1/20, to three samples in the infant's group. However, in the sera of adults, positive IgM results remained after absorbtion, at titers up to 1/20, in the infected individuals as well as in controls. Only one serum gaveatiterof 1/40, suggesting specificity.The three samples of the infant's group, in which IgM antibodies to T. cruzi were demonstrated, belonged to a child with Chagas' disease demonstrated by xeno-diagnosis. The specimen oi the adult in which a positive IFAT-IgM-Chagas was obtained at a titer of 1/40, corresponded to a women with recently acquired infection, as jugdedbyaseroconversion(from(-)to( + ) 1/40) in the IFAT-IgG for Chagas' disease.The results indicate that the test yields specific results, if it is applied in sera previously absorbed with IgG and confirm that low titers are of diagnostic value in sera of infants. However, in sera of adults, only titers from 1/40 onward are considered to be specific for Chagas's disease.El empleo de la reacci6n de inmunofluorescencia Indirecta (RIFI), ha permitido ampliar el estudio serologico en diferentes enfermedades inlecciosas. Dicha tecnica, de ejecuci6n relativamente simple y rapida, ofrece la doble ventaja de ser aplicable tanto en la pesquisa de diferentes agentes infecciosos, lo que depende del microorganismo que se emplee como antigeno, conio en la demostraci6n de diferentes tipos de anticuerpos, de acuerdo con la antigammaglobulina que se utilice como reactivo. La RIFI practicada con antigammaglobulina de tipo IgG y antigeno de Trypanosoma cruzi {RIFI-IgG-Chagas), ha tenido gran aceptacion en el estudio de la enfermedad de Chagas, recomendandose su empleo para el diagnostico del caso individual y para los estudios epidemiol6gicos. longada, incluso indefinida, diagnostica la infecci6n y permite establecer su prevalencia. Sin embargo, esta informaci6n puede ampliarse, si en los sueros positives se practica ademas, una RIFIIgM. Los anticuerpos de este tipo, debido a su aparicion precoz y duracion limitada, caracterizan la fase aguda de la infecci6n; de modo que l...
Determination of inmunoglobuline M in 129 normal newborns in Santiago.Cuantitative determination of total IgM, by the radial inmunodifrusion technique, was performed in 129 cord sera from full-term, normal infants in Santiago. The results obtained varied in amounts from 0 to 138 mgs %. A statistical analysis, covering 80% of the sample, gave a P 10 of 3mgs%andaPc )0 of36mgs%, with a mean value of 11 mgs%. Acoording to these results, 30 mgs% is suggested to be considered as cut off for elevated IgM values in cord sera in this population group.Cuantitation of cord serum IgM is of considerable value as a screening method to detect newborns who are at risk for interuterine infection; however, additional, specific technique should be employed to establish a definitive diagnosis.El diagn6stico de las infecciones por virus, protozoos o treponemas, trasmitidas por vias trasplacentarias suele ser dificil, especialmente en aqueIlos casos que no se manifiestan clinicamente en el momento del nacimiento, sino en etapas posteriores de la vida. Es innegable el valor del reconocimiento precoz de estas infecciones para instaurar el tratamiento especifico.El diagnostico directo, con el aislamiento o la demostracion del agente causal, suele ser dificil y las tecnicas empleadas para este objeto son en general de bajo rendimiento. De alii los esfuerzos de los investigadores porbuscarmetodos indirectos, mediante tecnicas inmunobiol6gicas, que pongan de manifiesto la presencia de anticuerpos en el recien nacido.El estudio serologico se basa habitualmente en metodos que detectan anticuerpos de tipo Ig G; sin embargo, la interpretaci6n de dichos resultados en sangre de cordon se complica debido al pasaje de los anticuerpos Ig G maternos al feto. La distinci6n entre anticuerpos Ig G matemos y los producidos por el nino, puede lograrse s6lo mediante repeticidn sucesiva del examen serol6gico durante los primeros meses de la vida. Con el fin de lograr un diagn6stico mas precoz de las infecciones perinatales en los recien nacidos, se recurre al estudio de las inmunoglobulinas M. Esta macroglobulina no atraviesa la placenta intacta y su presencia en la sangre de cord6n se debe normalmente a una respuesta inmune del feto.El feto es capaz de producir inmunoglobulinas con sus propios organos Iinfaticos a partir de la 1 l. a semana de la gestacidn 1 y un estimulo antigenico excesivo, producido por un agente pat6geno, ya sea bacteriano, viral o parasitario, aumenta los anticuerpos de tipo Ig M a niveles patologicos. 2 Esta respuesta inmune es detectable ya sea determinando la cantidad de Ig M total por 100 ml de sangre o al demostrar la presencia de anticuerpos (Ig M) especificos contra diferentes agentes infecciosos. La cuantificaci6n de la Ig M total en sangre de cord6n constituye una prueba inespecifica util para pesquisar aquellos casos que por presentar valores elevados de Ig M podrian corresponder a infecciones congenitas.Para poder apreciar el valor diagn6stico de la cantidad de Ig M total en sangre de cord6n debe establecerse prev...
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