Atypical Serological Response Marked by a Lack of Detectable Anti-gp43 Antibodies in a Patient with Disseminated Paracoccidioidomycosis

Vidal, Mônica Scarpelli Martinelli; Benard, Gil; Brito, Thales de; Dantas, Kátia Cristina; Pereira, Cristiane N.; França, Francisco Oscar de Siqueira; Silva, Ana G.; Martins, José Eduardo

doi:10.1128/jcm.43.6.3014-3016.2005

Cited by 8 publications

(8 citation statements)

References 14 publications

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“…However, occasionally reference centers outside P. lutzii endemic areas may handle sera from PCM due to P. lutzii and release false negative serological results. This has already been documented [30] and will certainly be more common owing to the increasing migration rates in South American countries, particularly Brazil.…”

Section: Resultsmentioning

confidence: 76%

Serological Diagnosis of Paracoccidioidomycosis: High Rate of Inter-laboratorial Variability among Medical Mycology Reference Centers

et al. 2014

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BackgroundSerological tests have long been established as rapid, simple and inexpensive tools for the diagnosis and follow-up of PCM. However, different protocols and antigen preparations are used and the few attempts to standardize the routine serological methods have not succeeded.Methodology/Principal findingsWe compared the performance of six Brazilian reference centers for serological diagnosis of PCM. Each center provided 30 sera of PCM patients, with positive high, intermediate and low titers, which were defined as the “reference” titers. Each center then applied its own antigen preparation and serological routine test, either semiquantitative double immunodifusion or counterimmmunoelectrophoresis, in the 150 sera from the other five centers blindly as regard to the “reference” titers. Titers were transformed into scores: 0 (negative), 1 (healing titers), 2 (active disease, low titers) and 3 (active disease, high titers) according to each center's criteria. Major discordances were considered between scores indicating active disease and scores indicating negative or healing titers; such discordance when associated with proper clinical and other laboratorial data, may correspond to different approaches to the patient's treatment. Surprisingly, all centers exhibited a high rate of “major” discordances with a mean of 31 (20%) discordant scores. Alternatively, when the scores given by one center to their own sera were compared with the scores given to their sera by the remaining five other centers, a high rate of major discordances was also found, with a mean number of 14.8 sera in 30 presenting a discordance with at least one other center. The data also suggest that centers that used CIE and pool of isolates for antigen preparation performed better.ConclusionThere are inconsistencies among the laboratories that are strong enough to result in conflicting information regarding the patients' treatment. Renewed efforts should be promoted to improve standardization of the serological diagnosis of PCM.

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Section: Resultsmentioning

confidence: 76%

Serological Diagnosis of Paracoccidioidomycosis: High Rate of Inter-laboratorial Variability among Medical Mycology Reference Centers

et al. 2014

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“…Early observations from our group (5,6) and others (C. J. Fontes and A. P. Vicentini, unpublished data) have reported a lack of reactivity to Paracoccidioides brasiliensis antigens in routine serological assays by sera from PCM patients living in areas of Brazil outside the southern and southeastern regions endemic for the parasite. These observations suggest that fungi from different regions endemic for the parasite might present significant antigenic differences, and these differences have only recently been elucidated.…”

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confidence: 67%

Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry for Differentiation of the Dimorphic Fungal Species Paracoccidioides brasiliensis and Paracoccidioides lutzii

et al. 2015

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Isolates of Paracoccidioides brasiliensis and Paracoccidioides lutzii, previously characterized by molecular techniques, were identified for the first time by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). All isolates were correctly identified, with log score values of >2.0. Thus, MALDI-TOF MS is a new tool for differentiating species of the genus Paracoccidioides.

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“…Only one patient with PCM had OD values below the cut-off point when total IgG was assessed, which shows the suitability of this antigen for use in PCM diagnosis. Previous studies have shown that some patients with PCM may not be reactive to the gp43 antigen, the most-studied antigenic fraction of P. brasiliensis (Del Negro et al 1991, Neves et al 2003, Vidal et al 2005. Many factors may be involved in this absence of a serological response to antigens in some patients, such as the prozone effect, immunosuppression or immune complex formation.…”

Section: Discussionmentioning

confidence: 99%

Profile of total IgG, IgG1, IgG2, IgG3 and IgG4 levels in sera of patients with paracoccidioidomycosis: treatment follow-up using Mexo and rPb27 as antigens in an ELISA

Santos

Fernandes

Cruz

et al. 2012

Mem. Inst. Oswaldo Cruz

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Atypical Serological Response Marked by a Lack of Detectable Anti-gp43 Antibodies in a Patient with Disseminated Paracoccidioidomycosis

Cited by 8 publications

References 14 publications

Serological Diagnosis of Paracoccidioidomycosis: High Rate of Inter-laboratorial Variability among Medical Mycology Reference Centers

Serological Diagnosis of Paracoccidioidomycosis: High Rate of Inter-laboratorial Variability among Medical Mycology Reference Centers

Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry for Differentiation of the Dimorphic Fungal Species Paracoccidioides brasiliensis and Paracoccidioides lutzii

Profile of total IgG, IgG1, IgG2, IgG3 and IgG4 levels in sera of patients with paracoccidioidomycosis: treatment follow-up using Mexo and rPb27 as antigens in an ELISA

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