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In Hungary, between February 2017 and July 2019, 70 confirmed measles cases were reported, raising questions about the adequacy of population-level immunity. Although the assumed vaccination coverage is ≥99%, in a recent study, we detected potential gaps in the anti-measles humoral immunity. In Hungary, according to a decree by the Ministry of Public Welfare, beginning from 2021, the healthcare provider should conduct a serosurvey of anti-measles protection levels of healthcare professionals. To facilitate the compliance with this requirement, we developed a quick ‘three-in-one’ or ‘triple’ MMR (measles, mumps and rubella) indirect ELISA (IgG); an assay format that is currently not available commercially. High throughput applicability of the ‘three-in-one’ ELISA was verified using 1736 sera from routine laboratory residual samples, using an automated platform (Siemens BEP 2000 Advance). Assay verification was performed by comparing the full antigen repertoire-based ‘target’ assay with in-house ‘control’ assays using recombinant viral antigen coatings, and by validated commercially available kits. Indirect immunofluorescence was used as an independent reference method. Data were analysed using OriginLab, IBM SPSS, RStudio and MedCalc. In case of measles, we combined our current results with previously published data (Ntotal measles = 3523). Evaluation of anti-mumps and anti-rubella humoral antibody levels was based on the measurement of 1736 samples. The lowest anti-measles seropositivity (79.3%) was detected in sera of individuals vaccinated between 1978 and 1987. Considering the antigen-specific seropositivity ratios of all samples measured, anti-measles, -mumps and -rubella IgG antibody titres were adequate in 89.84%, 91.82% and 92.28%, respectively. Based on the virus-specific herd immunity threshold (HIT) values (HITMeasles = 92–95%, HITMumps = 75–86%, HITRubella = 83–86), it can be stated that regarding anti-measles immunity, certain age clusters of the population may have inadequate levels of humoral immunity. Despite the potential gaps in herd immunity, the use of MMR vaccine remains an effective and low-cost approach for the prevention of measles, mumps and rubella infections.

ObjectiveAutoantibody detection is crucial for the early diagnosis of autoimmune encephalitis (AIE) since prompt therapy can determine the disease outcome. Here, we report a single‐center 6‐year retrospective study of autoantibody testing in AIE in the Hungarian population.MethodsSerum and/or cerebrospinal fluid (CSF) autoantibody tests were performed using cell‐based indirect immunofluorescence assay for AIE diagnosis. Samples were provided by neurology clinics as part of a nationwide program. Test results were analyzed for samples received during the period from 2012 to 2018.ResultsWe tested 1,247 samples from 1,034 patients with suspected AIE. Autoantibodies were present in 60 patients (5.8% of total). The distribution of patients with different autoantibodies by age and sex was as follows: NMDAR (70%), mostly in young females, LGI1 (15%) in middle‐aged males, GABABR (12%) in elderly males, and Caspr2 (7%) in males. Long‐term follow‐up was conducted in 30 patients with repeated test requests, of which 17 remained positive, and 13 switched to negative.ConclusionWe report the most comprehensive clinical laboratory study of autoantibody testing in AIE in the Hungarian population. Our results show that the frequency of different autoantibody types in AIE corresponds to the data described in the literature.

Patients suffering from encephalitis may present psychiatric symptoms; however, the clinical relevance of anti-neuronal antibodies in patients experiencing a psychotic episode without encephalitis is still unclear. In this study, we examined the presence of anti-neuronal cell surface autoantibodies and onconeural autoantibodies in serum samples of 22 synthetic cannabinoid users presenting with psychosis. We found only two positive cases; however, seven patients had borderline results. Nonetheless, we found no significant correlation between anti-neuronal autoantibodies and the intensity of psychosis indicated by the Positive and Negative Syndrome Scale (PANSS) scores. The length of drug use and the combination of other drugs with synthetic cannabinoids have no significant effect on anti-neuronal autoantibody positivity. Nonetheless, the ratio of anti-citrate synthase (anti-CS) IgM and IgG natural autoantibodies was significantly lower (p = 0.036) in the anti-neuronal autoantibody-positive/borderline samples, than in the negative group. Interestingly, anti-CS IgM/IgG showed a significant negative correlation with PANSS-positive score (p = 0.04, r = −0.464). Our results demonstrated that anti-neuronal autoantibody positivity occurs in synthetic cannabinoid users, and the alteration of anti-CS IgM/IgG natural autoantibody levels points to immunological dysfunctions in these cases.

Bevezetés: A primer aldosteronismus diagnosztikájában alapvető a plazma aldoszteron-renin hányados vizsgálata. Cél: A szerzők a diagnosztikai hasznosság megítélése céljából a hányadost két módszerrel határozták meg (plazmaaldoszteron/plazmarenin aktivitás és plazmaaldoszteron/direkt renin koncentráció). Módszerek: Összesen 134 személyben (80 nő, 54 férfi ; életkoruk: 46±15,5 év) radioimmunassay-vel meghatározták a plazmarenin-aktivitást és plazmaaldoszteron-koncentrációt, továbbá immunometriás assay-vel a plazmarenin-koncentrációt. A vizsgált személyek közül 49 egészséges, gyógyszert nem szedő (kontroll) személy volt, 59 hypertonia (34 kezeletlen, 25 kezelt) és 26 véletlenül felismert mellékvese-adenoma miatt vizsgált. Eredmények: A plazmarenin-aktivitás és reninkoncentráció között gyenge korrelációt találtak (r = 0,59) az alacsonyabb mérési tartományban (plazmareninaktivitás: 0,63±0,41 ng/ml/h; plazmarenin-koncentráció: 8,1±4,9 ng/l). A kontrollcsoport eredményeiből meghatározott "cut-off" értékek szerint (plazmaaldoszteron/plazmarenin aktivitás hányados: 30,0 ng/dl/ng/ml/h; plazmaaldoszteron/plazmarenin koncentráció hányados: 3,0 ng/dl/ng/l) az álpozitív esetek aránya különösen a béta-blokkolót szedők körében volt magas (plazmaaldoszteron/plazmarenin aktivitás 22,2%, plazmaaldoszteron/ plazmarenin koncentráció 44,4%). Következtetések: A plazmaaldoszteron/plazmarenin aktivitás hányados csak akkor helyettesíthető a plazmaaldoszteron/plazmarenin koncentráció hányadossal, ha mérlegeljük a különböző klinikai állapotokat és eltérő gyógyszerhatásokat. Orv. Hetil., 2012, 153, 1701-1710. Kulcsszavak: direkt renin, aldoszteron-renin hányados, antihipertenzív kezelés Clinical evaluation of the renin-aldosterone system: Comparison of two methods in different clinical conditionsIntroduction: Measurement of plasma aldosterone/renin ratio is the key step in the diagnosis of primary aldosteronism. Aim: The aim of the authors was to analyze and compare the diagnostic utility of plasma aldosterone/renin activity and plasma aldosterone/renin concentration ratios. Methods: Plasma aldosterone and plasma renin activity were determined by radioimmunoassays and plasma renin concentration was measured by immunoradiometric assay in 134 subjects (80 women and 54 men, aged 46±15.5 years) including 49 healthy blood donors (control group), 59 patients with hypertension (25 treated and 34 untreated) and 26 patients with incidentally discovered adrenal adenomas. Results: There was a weak correlation (r = 0.59) between plasma renin activity and plasma renin concentration in the lower range (plasma renin activity, 0.63±0.41 ng/ml/h; plasma renin concentration, 8.1±4.9 ng/l). Considering the cut-off value of plasma aldosterone/renin ratios determined in controls (plasma aldosterone/renin