Serology Laboratory Research Articles

Human Papillomavirus High-risk Type Infection on Perianal Giant Condyloma Acuminatum

Background: Giant condyloma acuminatum (GCA) is a large form of condyloma acuminatum that become locally invasive, destructive, but non-metastasizing, caused by human papillomavirus (HPV). Giant condyloma is a rare disease, with only 0.1% incidence in the general population. Most commonly caused by HPV type 6 and 11 infections, in this case, reported HPV high-risk type.
 Case presentation: A 20-years-old man, the main complaint is enlarging, easy bleeding perianal tumor with pruritus and constipation for 2 months. Physical examination found skin-colored, verrucous surface. Some have smooth surface, cauliflower-like tumor on perianal region, size 7x4x2cm. Syphilis and HIV Serology laboratory tests are non-reactive. Koilocytes appear on histopathologic examination. High-risk HPV type detected on HPV genotyping. This patient was diagnosed as GCA. Topical agent 25% podophyllin tincture applied to the lesions once a week. Improvement appears after eighth-time therapy.
 Discussion: High-risk type HPV infection, detected in the patient, have an important role in GCA development. Decreased immune system and other risk factors also have a role in GCA.

COVID-19 mRNA Vaccines May Cause False Reactivity in Some Serologic Laboratory Tests, Including Rapid Plasma Reagin Tests.

ObjectivesAcute viral infections and some vaccines have been shown to increase false positivity in serologic assays. We assessed if the messenger RNA coronavirus disease 2019 (COVID-19) vaccines could cause false reactivity in common serologic assays in a pilot longitudinal cohort.MethodsThirty-eight participants with sera available prevaccination, 2 weeks after each vaccine dose, and monthly thereafter for up to 5 months were tested for common infectious disease serologies and antiphospholipid syndrome (APS) serology markers on the BioPlex 2200, Sure-Vue rapid plasma reagin (RPR), and Macro-Vue RPR. Twenty-two participants received the Moderna vaccine and 16 received the Pfizer vaccine.ResultsMost assays had no change in reactivity over the course of the sample draws, including APS markers. Epstein-Barr virus immunoglobulin G (IgG), measles IgG, and rubella immunoglobulin M all had possible false reactivity in one to two participants. RPR tests demonstrated false reactivity, with baseline nonreactive participant samples becoming reactive following vaccination. There were more false reactive participants (7/38) in the BioPlex RPR than in the Sure-Vue (2/38) and Macro-Vue (1/38) tests. All falsely reactive RPR tests were in participants who received the Moderna vaccine.ConclusionsSerologic assays with results that do not fit the clinical picture following COVID-19 vaccination should be repeated. Effects of false reactivity can last more than 5 months in some assays. In particular, RPR is susceptible to false reactivity, and there is variability among assays. Larger longitudinal studies are needed to determine the incidence and window of false reactivity.

Nonutility of Diagnostic Testing in Ambulatory Patients With Supraventricular Tachycardia.

Supraventricular tachycardia (SVT) is the most common arrhythmia in the pediatric population. Patients often present to the emergency department and undergo extensive diagnostic assessment. The objective of this study is to determine the frequency of diagnostic studies obtained in such patients and to assess clinical significance of these results. A retrospective study was performed from 2011 to 2018 in a single-center ED, including patients 21 years of age or younger presenting with SVT without shock. A total of 40 patients with 92 encounters were included for analysis. The mean age was 8.58 (±5.51) years; 55% female. A total of 67.4% underwent serologic laboratory evaluation, of which 8 (12.9%) had any abnormality. Only one was deemed clinically significant to warrant intervention. Nearly 30% of patients underwent chest radiography, with no clinically significant findings. Patients undergoing ED management of uncomplicated SVT are likely to undergo laboratory investigation and unlikely to have abnormal studies impacting their care. Given the associated risk of false-positive studies, the discomfort to the patient and parent, and cost of these studies, routine laboratory or radiographic investigation in this population may be unwarranted.

Asymptomatic, reddish-brown papules and plaques in an elderly Japanese woman

Asymptomatic, reddish-brown papules and plaques in an elderly Japanese woman

Clinical, Methodological, and Practical Considerations for Algorithmic Testing in Autoimmune Serology.

Autoimmune serology tests are central to the classification, screening, diagnosis, and monitoring of a variety of autoimmune disorders. To improve the appropriateness of serologic evaluation and support laboratory resource utilization, reflex testing approaches have been proposed and implemented across clinical laboratories. Reflex testing involves a staged approach where an initial test result triggers subsequent tests based on prespecified rules. Various reflex testing approaches in the context of antinuclear antibody-associated rheumatic disease, antineutrophil cytoplasmic autoantibody-associated vasculitis, celiac disease, and myasthenia gravis are reviewed here. Clinical, analytical, and practical considerations of reflex testing implementation are addressed as well as associated limitations and challenges. Serology reflex testing algorithms for the evaluation of autoimmune diseases can support clinical diagnosis and laboratory resource use but may be challenging to implement and are often applied variably across institutions. Assessments of evidence-driven guidelines, clinical impact, and impact on laboratory workflow are essential to this task.

Etiology of granulomatous inflammation: A retrospective study of 174 children in a tertiary care center

Objective: To investigate granulomatous inflammation etiology based on clinical history and ancillary tests.Methods: Children aged <18 years with biopsy proven granulomatous lesions in any tissue specimens between January 2014 and January 2022 were included in the study. The diagnosis was based on the results of immunohistochemical staining, molecular tests, culture, serology, radiological and other auxiliary laboratory tests. Diagnoses were categorized into infectious and noninfectious causes.Results: In total, 174 patients with granulomatosis inflammation confirmed by histopathology were analyzed. Approximately 59.2% patients were males, and the median age was 4.48 (IQR 2.36-6.39) years (range: 16 months-18 years). The tissues/organs that were most commonly biopsied were lymph node, bone, skin, and lung (51.1%, 17.8%, 9.2%, and 5.7%, respectively). Infectious and non-infectious causes were identified in 73.0% and 12.6% patients, respectively, in terms of granulomatosis inflammation etiology; however, no cause was identified in 14.4% patients. The most common infectious cause was tuberculosis (in 51.7% patients), followed by toxoplasmosis, aspergillosis, mucormycosis, leishmaniasis, and cat-scratch disease (in 8.6%, 5.7%, 1.7%, 1.7%, and 1.1% patients, respectively). The common non-infectious cause was chronic granulomatous disease. Histopathological evaluation revealed granulomatosis inflammation in 33.3% patients, necrotizing granulomatosis inflammation in 30.5% patients, and caseating granulomatosis inflammation in 12.1% patients. When the pathology results of patients with and without tuberculosis were compared, the incidence of caseating granulomatosis inflammation (P=0.003) and necrotizing granulomatosis inflammation (P=0.005) was higher in patients with tuberculosis.Conclusions: Chronic granulomatous disease is the most common non-infectious cause in children. Moreover, primary or secondary immune deficiencies may cause granulomatosis inflammation, especially in pediatric patients.

Venereal disease research laboratory serology after COVID-19 vaccination: The first report.

Venereal disease research laboratory serology after COVID-19 vaccination: The first report.

C-Reactive Protein Levels and its Association with Acute and Chronic Inflammatory Diseases- An Observational Study

Background: C-reactive protein is a nonspecific, acute-phase, inflammatory protein, whose expression is increased in response to tissue injury, inflammation and infection. The highest concentrations of CRP are found in an individual having some bacterial infections where CRP level increase up to 1,000-fold. The present study was undertaken to determine the C-reactive protein levels in clinically suspected OPD and IPD patient by Latex agglutination test (LAT). Material and Methods: Blood samples were collected from clinically suspected OPD and IPD patients with signs of inflammation in plain vacutainer tubes and received in Serology laboratory of Microbiology Department for CRP testing. All blood samples were screened by Qualitative CRP assay by using commercially available kit. Blood samples that were positive were further tested for CRP titre by semi-quantitative test using same kit (Beacon Diagnostics Pvt Ltd ). Results: A total of 450 serum samples were received for CRP testing during a period of six months. Higher CRP levels were obtained in patients with chronic inflammatory diseases (76%) and as compared to patients with acute inflammatory diseases (24%). Conclusion: CRP is an inexpensive and easily available serological test helpful in correlating severity and mortality of any disease. Early CRP testing can be a very helpful tool to improve the clinical outcomes of patients and decreased mortality.

Laboratory Results of Cystic Echinococcosis in 2017 and 2018

This study aimed to retrospectively examine the indirect haemagglutination (IHA) test results of patients suspected of cystic echinococcosis (CE) and admitted to Bursa Uludağ University Health Practice and Research Center Hospital. Serum samples in the serology laboratory of our hospital were evaluated using the commercial Cellognost® echinococcosis IHA (Siemens Healthcare Diagnostics, Marburg, Germany) test based on the manufacturer's recommendations. In the IHA test, ≥1:64 serum titres were accepted as positive. Seropositivity was determined in 213 (19.9%) of 1.072 patients suspected of having CE by the IHA method. Of the patients with seropositivity, 120 (56.3%) were female and 93 (43.7%) were male. The highest positivity rate in both sexes was found in patients aged 20-29 years (22.5% in women; 14.1% in men). The results indicate that CE maintains its importance as a public health problem in Bursa as in Turkey.

Measurement of the IgG Avidity Index in the Diagnosis of Clinical Toxocariasis Patients

Toxocara spp. are parasitic nematodes responsible for human toxocariasis, a common zoonotic helminth infection. The five main features of human toxocariasis are the classical ocular toxocariasis and visceral larva migrans syndrome, followed by covert toxocariasis, common toxocariasis and neurotoxocariasis. The diagnosis of toxocariasis is feasible by considering clinical symptoms, anamnestic history and serology laboratory results; however, serological criteria cannot be used to distinguish active Toxocara infection from past exposure, which is an area of much discussion in clinical practice. In this context, we developed avidity tests (ELISA and immunoblotting) and evaluated their clinical usefulness in distinguishing past from active toxocariasis. Our study involved 46 patients divided into two groups: “active toxocariasis” (n = 14) and “chronic toxocariasis” (n = 32). According to the avidity indices obtained for both the chronic and active toxocariasis groups, we proposed two thresholds: first, an AI lower than 32% supports an active infection; secondly, a threshold above 42% can exclude an active infection. In order to use this assay in routine clinical practice, however, is still requires standardisation with regards to the method and threshold values, which can be established through studies involving larger populations.

Specific antibody response of patients with common variable immunodeficiency to BNT162b2 coronavirus disease 2019 vaccination

Specific antibody response of patients with common variable immunodeficiency to BNT162b2 coronavirus disease 2019 vaccination

The Comparison of 25-Hydroxyvitamin D3 between Patients With and Without Cervical Cancer

BACKGROUND: Vitamin D was currently believed to have effects on numerous cancer pathogenic processes. AIM: This study was to assess the correlation of Vitamin D serum level in women with carcinoma cervix and also evaluate the effect of carcinoma cervix on the Vitamin D serum. METHODS: This was an observational with a cross-sectional study. Participants were women with cervical cancer who have not received any treatment, presented to the Oncology Clinic of the Obstetrics and Gynecology Department of Dr. Hasan Sadikin General Hospital, and women without cervical cancer. The level of Vitamin D3 was analyzed in the Serology Laboratory of Clinical Pathology Department of Dr. Hasan Sadikin General Hospital. RESULTS: There were 113 participants consisted of 58 women with cervical cancer and 55 healthy women. Mean levels of Vitamin D3 were significantly lower in cervical cancer group than non-cervical cancer group (26.74 ± 13.166 vs. 32.16±14.86, p = 0.022). CONCLUSION: The level of Vitamin D3 was found to be significantly higher in the non-cervical cancer group than cervical cancer group.

Microbial Contaminants on Inanimate Surfaces and Non-critical Instruments at a Major Reference Hospital in Makurdi, Nigeria

Aims: There have been links between healthcare-acquired infections, contaminated surfaces, and medical instruments. The aim of this study was to: (i) investigate the variety of microorganisms that persist on inanimate/noncritical devices at Benue State University Teaching Hospital Makurdi, Nigeria, as a possible source of healthcare-acquired bacterial and fungal infections, and (ii) determine the prevalence of microorganisms on the instruments sampled.&#x0D; Study design: This study was a hospital-based cross-sectional study.&#x0D; Place and duration of study: Microbiology Laboratory (Bacteriology, Media/Washroom, Serology, and Phlebotomy Units), Benue State University Teaching Hospital Makurdi, Nigeria, between January 2021 and May 2021.&#x0D; Methodology: Swab specimens were collected from tables (14), sinks (8), hand jars (7), scissors (5), inoculating loops (7), refrigerators (6), and autoclaves (3) using sterile stick swabs. The bacterial and fungal investigation was performed using standard culture tests-gram stain, colony morphology, and biochemical tests.&#x0D; Results: All the samples tested positive for either bacteria or fungi, indicating a contamination rate of 100%. Tables were the most contaminated (28%), sinks (16%), inoculating loops (14%), hand jars (14%), refrigerators (12%), scissors (10%), and autoclaves (6%). Salmonella spp., Staphylococcus aureus, Streptococcus spp., Pseudomonas aeuroginosa, Escherichia coli, Klebsiella pneumonia, and the fungi Aspergillus niger and Candida albicans were identified.&#x0D; Conclusion: The results of this study have shown that hospital surfaces and healthcare-associated equipment is a potential source of nosocomial infections for patients, visitors, and health care workers. Hospitals should enforce regular cleaning and decontamination to forestall the occurrence of nosocomial infections.

Prevalence and clinical correlation of hepatitis E virus antibody in the patients\u2019 serum samples from a tertiary care hospital in Thailand during 2015\u20132018

BackgroundPrevalence and incidence of hepatitis caused by HEV infection are usually higher in developing countries. This study demonstrated the HEV seroprevalence and incidence of HEV infection in patients with clinical hepatitis in a tertiary hospital in Thailand.MethodsA laboratory-based cross-sectional study was conducted using 1106 serum samples from patients suspected of HEV infection sent to the Serology laboratory, Siriraj Hospital, for detecting HEV antibodies during 2015–2018. Prevalence of anti-HEV IgG and IgM antibodies in general patients, including organ transplant recipients and pregnant women in a hospital setting, were determined using indirect enzyme-linked immunosorbent assay (ELISA) kits. Comparison of laboratory data between groups with different HEV serological statuses was performed.ResultsHEV IgG antibodies were detected in 40.82% of 904 serum samples, while HEV IgM antibodies were detected in 11.75% of 1081 serum samples. Similar IgG and IgM antibody detection rates were found in pregnant women. Interestingly, anti-HEV IgM antibodies were detected in 38.5% of patients who underwent organ transplantation. Patients who tested positive for anti-HEV IgM antibodies had higher alanine aminotransferase levels than those who had not. In contrast, patients who tested positive for anti-HEV IgG had more elevated levels of total bilirubin than those who tested negative.ConclusionsHEV seroprevalence and incidence in patients with clinical hepatitis were relatively high in the Thai population, including the pregnancy and organ transplant subgroups. The results potentially benefit the clinicians in decision-making to investigate HEV antibodies and facilitating proper management for patients.

Blood Safety: On-Site Verification Of The Screening Of HIV, HBV And HCV By Enzyme Linked Immuno-Sorbent Assay (ELISA) Kits From Bio-Rad Laboratories At The “Centre National De Transfusion Sanguine” (CNTS) Of Lomé In Togo

Background: Blood transfusion improves health and saves lives. Safe blood must be ensured for our populations. Quality assurance is a process that includes a set of coordinated activities in order to achieve the quality objective. Compliance with the quality management rules of medical biology laboratories requires verification of methods prior to their use. This study aimed to verify the on-site verification of the performance of the Enzyme Linked Immuno-Sorbent Assay (ELISA) method performed at the serology laboratory of the CNTS of Lomé. Methods: The performance of ELISA method performed at the serology laboratory of CNTS for the diagnosis of HIV, Hepatitis B and C with Bio-Rad Genscreen ULTRA-HIV Ag-Ac, Bio-Rad Monolisa-HBs Ag ULTRA and Bio-Rad Monolisa HCV Ag-Ac ULTRA V2 kits respectively was evaluated on repeatability, reproducibility, sensitivity and specificity according to COFRAC's SH GTA 04 reference. Results: The evaluation of the repeatability and reproducibility of each kit used in the laboratory resulted in compliant Coefficients of Variation (CV) with manufacturers’ ones. Sensitivities obtained with Bio-Rad Monolisa HCV Ag-Ac ULTRA V2, Bio-Rad Monolisa HBs Ag ULTRA and Bio-Rad Genscreen ULTRA HIV Ag-Ac kits were 94.59%, 98.08% and 100% respectively. For specificity tests, we found 86.49% with BIO-Rad Genscreen ULTRA-HIV Ag-Ac kit, 94.34% with Bio-Rad Monolisa HCV Ag-Ac ULTRA V2 kit and 97.37% with Bio-Rad Monolisa-HBs Ag ULTRA. Conclusion: In general, results were compliant except HIV diagnosis specificity. This study appears as a contribution to the establishment of a verification file for ELISA method used at the serology laboratory of CNTS of Lomé.

HIV Seropositivity in Patients Admitted to Our Hospital: Six Year Evaluation

Aim: Detecting human immunodeficiency virus (HIV)-infected individuals is very important in terms of quality of patients’ lives. However, it should be kept in mind that there may be false positives and tests must be confirmed. In this study, it was aimed to determine HIV seropositivity in our hospital for a period of six years and to contribute to the epidemiological data of the country. Material and Methods: The samples that came to serology laboratory between January 2014 and December 2019 were analyzed retrospectively. Anti-HIV antibodies were screened in a total of 180,413 samples by the macro-ELISA method (Architect i2000sr, Abbott, USA). Patient samples were sent to the National HIV/AIDS Confirmation and Viral Hepatitis Reference Laboratory for verification of reagents results. Results: Anti-HIV results of 178 (0.1%) of 180,413 patients whose blood serum samples were studied with the macro-ELISA method were evaluated as reactive. Confirmation test of 102 patients were negative while 76 were positive. Patients with positive confirmation result account for 0.04% of all patients. While 67 (88.2%) of the patients with positive confirmation were male and 9 (11.8%) were female. The ages of 26-35 and 36-45 years were equal with the highest number of new cases detected (n=20, 26.3%). Conclusion: As a result of our retrospective evaluation, HIV seropositivity, gender and age distributions in our hospital were found to be compatible with the data of our country and other studies conducted in our country. The high false positivity rate of screening tests, again indicates the importance of confirmation tests.

Characterization of CD177-reactive iso- and auto-antibodies.

CD177 is a surface protein on neutrophils and a main mediator for the surface expression of proteinase 3 (PR3). Its functions are largely unknown. At least three types of antibodies have been described to target CD177: isoantibodies, which are formed in CD177-null individuals as a result of an immune reaction following transfusion or pregnancy; autoantibodies present in sera from patients with autoimmune neutropenia; and antineutrophil cytoplasmic antibodies in sera from patients with glomerulonephritis with polyangiitis. In this study, we aimed to compare the binding characteristics of auto- and iso-antibodies to optimize their detectability in the neutrophil serology laboratory. The reactivity of iso- and auto-antibodies against CD177 was studied using granulocytes, "native" CD177/PR3 complex, and recombinant CD177 or PR3. All iso- and auto-antibodies were reactive with CD177/PR3 when immobilized with monoclonal antibody (moab) 7D8. Seventy-five percent of autoantibodies, but none of the isoantibodies, did not react with CD177/PR3 immobilized with moab MEM166. The majority of autoantibodies did not react with recombinant CD177, whereas most isoantibodies tested positive. Our results suggest that iso- and auto-antibodies against CD177 target different epitopes. Isoantibodies mainly target CD177 alone, while the majority of autoantibodies target a native epitope present on the neutrophil surface, but absent from recombinant CD177 which lacks PR3. Moab MEM166 binds to the native epitope and hinders the binding of CD177 autoantibodies. The results may help to design diagnostic strategies, especially for the identification of autoantibodies.

Serological and Molecular Tests for COVID-19: a recent update

The COVID-19 pandemic is probably the most devastating worldwide challenge in recent century. COVID-19 leads to a mild to severe respiratory disease and affects different organs and has become a global concern since December 2019. Meanwhile, molecular biology and diagnostic laboratories played an essential role in diagnosis of the disease by introducing serological and molecular tests. Molecular-based techniques are reliable detection tools for SARS-CoV-2 and used for diagnosis of patients especially in the early stage of the disease. While, serological assays are considered as additional tools to verify the asymptomatic infections, tracing previous contacts of individuals, vaccine efficacy, and study the seroprevalance. The average time of the appearance of anti-SARS-CoV-2 antibodies in the patient's serum is 3-6 days after the onset of symptoms for both IgM and IgA and 10-18 days for IgG. Following the outbreak of COVID-19, FDA has approved and authorized a series of serological laboratory tests for early diagnosis. Serological assays have low-cost and provide fast results but have poor sensitivity in the early stage of the viral infection. Although the serological tests may not play an important role in the active case of COVID-19, it could be effective to determine the immunity of health care workers, and confirm late COVID-19 cases during the outbreak. In this review, we compared various laboratory diagnostic assays for COVID-19.

Clinical performance of a point-of-care Coccidioides antibody test in dogs.

BackgroundPoint‐of‐care (POC) Coccidioides antibody assays may provide veterinarians with rapid and accurate diagnostic information.ObjectivesTo determine the agreement of a POC lateral flow assay (LFA), sona Coccidioides (IMMY, Norman, Oklahoma) with the current diagnostic standard, the immunodiffusion assay (agar gel immunodiffusion [AGID]; Coccidioidomycosis Serology Laboratory, University of California, Davis, California).AnimalsForty‐eight sera specimens from 48 dogs.MethodsSera specimens were collected from client‐owned dogs that had a clinical suspicion for coccidioidomycosis. Animals were classified as Coccidioides antibody‐positive (n = 36) based on a positive AGID or Coccidioides antibody‐negative (n = 12) based on a negative AGID. The performance of the LFA assay was determined by comparing results to AGID results.ResultsThe LFA assay demonstrated agreement in 32 of 36 Coccidioides antibody‐positive specimens and 12 of 12 Coccidioides antibody‐negative specimens, resulting in a positive percentage agreement of 88.9% (95% confidence interval [CI], 74.7‐95.6%) and negative percentage agreement of 100% (95% CI, 75.8‐100%) as compared to AGID. A receiver operator characteristic curve was constructed, and the area under the curve was 0.944 (CI, 0.880‐1.000).Conclusion and Clinical importanceThis LFA is a rapid alternative to the traditional AGID. The LFA provides excellent predictive value for positive results. Positive agreement was lower in dogs with low AGID titers; therefore, confirmatory testing is recommended if a high index of suspicion exists.

Immunochromatography and laboratory serologies: an evaluation of immunodiagnoses in prenatal care.

to describe the use of affinity chromatographies and laboratory serologies in the evaluation of immunodiagnoses during prenatal. quantitative study, characterized as a descriptive observational research. Data was collected from the records of 46 pregnant women who were in prenatal follow up in the Primary Health Care in a capital in the South of Brazil. The data found was codified and analyzed using descriptive statistics. a mean of 43.1 days was found to take place between the request of laboratory serology and the evaluation by a professional. It was also found that 21.7% of pregnant women did not collect the serologies requested during the first prenatal consultation, and that the affinity chromatographies were only applied in 10.8% of the participants. in spite of the studies for the improvement of prenatal consultations, for the provision of new technologies and for the permanent education offered to the professionals, there are still questions that make the actual implementation of affinity chromatographies more difficult.