Serological Antibody Tests Research Articles

Neuroborreliosis Presenting as Urinary Retention: Case Report.

Lyme disease is a tick-borne infectious disease caused by the spirochete Borrelia burgdorferi. Voiding dysfunction is a rare manifestation of neuroborreliosis with only a few cases reported. Here we describe a case of a 6-year-old male child with an acute urinary retention, paraparesis, and voiding difficulty in whom neuroborreliosis was diagnosed through serologic tests for antibodies, Western blot testing confirmation and intrathecal antibody synthesis. Magnetic resonance imaging (MRI) of the spine led to the diagnosis of acute transverse myelitis and a urodynamic study demonstrated detrusor areflexia. He received a 4-week course of intravenous ceftriaxone (2 g/d). The patient has recovered from the paraparesis but still suffers from a neurogenic bladder.

Validation of the Diabetomics CovAB SARS-CoV-2 antibody test in children: comparison with serology.

Recently a study determining the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in unvaccinated children in NJ (Katic et al. 2023. Pediatric Academic Societies Meeting; Washington, D.C. https://2023.pas-meeting.org/searchbyposterbucket.asp?bm=Public+Health+%26+Prevention&t=Public+Health+%26+Prevention&pfp=Track) was conducted using a gum swab method for antibody detection. The Diabetomics CovAB test, which qualitatively identifies antibodies to SARS-CoV-2 spike protein, is a point-of-care, low-cost test, that is easy to administer in children. While this test provides sensitive and specific results in adults [US Food and Drug Administration (FDA). 2022. Center for devices and radiological health. EUA authorized serology test performance. Available from: https://www.fda.gov/medical-devices/covid-19-emergency-use-authorizations-medical-devices/eua-authorized-serology-test-performance], data on its accuracy in children is lacking. As a follow-up to the above-mentioned study, we compared the results of the gum swab test to a serologic antibody test. We found that the gum swab test was inferior to serology but was fairly sensitive and specific with a high positive predictive value. While the test is not ideal for diagnostic purposes in children it can be a valuable tool for public health officials and pediatricians to understand the extent of past health interventions.

Mini review of diagnostic and therapeutic approaches in myositis-associated interstitial lung disease

Myositis-associated interstitial lung disease (ILD) presents a significant challenge in terms of diagnosis and management due to its heterogeneity and potential for rapid progression. This review outlines the current strategies for diagnosing and managing myositis-associated ILD, focusing on mild to moderate and severe or rapidly progressive cases. Initial diagnosis involves comprehensive clinical evaluation, high-resolution computed tomography (HRCT), pulmonary function tests (PFTs), and serological testing for myositis-specific antibodies and myositis-associated antibodies. Management of mild to moderate ILD includes using corticosteroids and steroid-sparing agents, supported by oxygen therapy, pulmonary rehabilitation, and preventive vaccinations. Regular monitoring through PFTs, HRCT, and clinical assessments is essential to ensure effective management and detect disease progression. In cases of severe or rapidly progressive ILD, aggressive treatment with high-dose corticosteroids, additional immunosuppressive agents such as cyclophosphamide, rituximab, and calcineurin inhibitors, and the use of anti-fibrotic agents like Nintedanib and Pirfenidone are crucial. Supportive care measures, including oxygen therapy and mechanical ventilation, may be necessary for patients with severe respiratory failure. Implementing structured algorithms for diagnosis and management helps streamline the process and improve patient outcomes. Continuous research and advancements in immunology and pharmacology are essential for developing more effective treatments for this challenging condition.

Detection of anti-enterovirus IgG in human sera by ELISA method using the KTL-510 peptide

Enterovirus (EV) infections occur frequently in humans. In some geographical areas they are more common. These viruses cause diseases with varying degrees of severity, from a simple respiratory tract infection to severe diseases. Since EVs include more than 70 serotypes currently circulating in the population, a methodology that detects most of them is needed. ELISA is a rapid, sensitive, and economical diagnostic method for the identification of EV serotypes and can also be used as a retrospective diagnostic tool or in the investigation of outbreaks of infection. Commercial EV-ELISAs often appear and gradually disappear from the market supply. We have used the KTL-510 peptide, a synthetic viral protein of poliovirus VP1, as an antigen in a peptide-based ELISA for the detection of a broader spectrum of anti-EV antibodies. We aimed to design, optimize, and standardize this in-house ELISA with the peptide, and implement the method for routine detection of anti-EV IgG in human sera. For determining the cut-off value, we used 100 patients’ sera which were previously tested negative for IgG antibodies against EVs using a commercial ELISA kit available. We monitored patients’ sera samples sent for serological testing of anti-coxsackievirus antibodies to the National Reference Center for the Identification of Enteric Viruses between 2018–2022. These serum samples were examined using a standard virus neutralization test as well as the newly developed ELISA method.

Comparing ergosterol identification by HPLC with fungal serology in human sera

BackgroundErgosterol, a predominant sterol in fungal cell membranes, holds promise as a specific marker for detecting fungal presence in human samples. This study investigated the performance of ergosterol detection compared to serological tests in identifying the presence of fungi in human sera. MethodsEighty-four non-duplicate human sera were analyzed by high performance liquid chromatography (HPLC) for ergosterol detection. Results were compared to serological tests for Aspergillus antigen, Candida antigen, Cryptococcus antigen, Aspergillus antibody and Candida antibody performed on the same patient sera. ResultsOut of the 84 serum samples, 51 (60.7 %) were positive for ergosterol. Among the 33 serology-positive sera, 26 (78.8 %) were also ergosterol-positive. In contrast, 26 out of 51 (51 %) serology-negative sera (including 20 negative controls) tested negative for ergosterol. Seven out of 33 (21.2 %) serology-positive sera were ergosterol-negative, while 25 out of 51 (49 %) serology-negative sera were ergosterol-positive. Compared to serological tests, HPLC detection of ergosterol had a sensitivity of 78.8 %, specificity of 51 %, positive predictive value of 51 %, negative predictive value of 78.8 % and overall accuracy of 61.9 %. ConclusionsErgosterol detection may serve as a useful supplementary tool for identifying fungi in human sera, acting as a broad-spectrum diagnostic marker. However, further research with larger sample sizes and clinical comparisons is needed to validate these findings.

Serological diagnosis of Toxocara canis in mothers and their neonate referred to selected teaching hospitals, Tehran, Iran, 2020.

Toxocariasis is a common zoonotic parasitic disease, primarily caused by the larvae of Toxocara canis or T. cati. Humans become infected through accidental ingestion of infective eggs in soil contaminated with feces of infected animals, or by consuming undercooked meat from paratenic hosts harboring Toxocara larvae. This cross-sectional study aimed to evaluate the seroprevalence of Toxocara spp. in 250 mothers and their 250 neonates referred to selected teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Iran in 2020. Data were recorded using a specialized questionnaire, and serum and peripheral blood smears (for eosinophil count) were collected. Serum samples were tested using the ELISA serological test for IgG antibodies against Toxocara spp. The collected data were analyzed using IBM SPSS Statistics software version 21.0. A chi-square test was performed, and a P value less than 0.05 was considered statistically significant. Among the 500 participants, 24 cases (4.8%) tested positive for anti-Toxocara canis IgG antibodies. Seropositive cases included 6 mothers only (25%), 6 neonates only (25%), and 12 cases both mother and their neonate (50%). Statistical analysis showed a significant relationship between the presence of anti-Toxocara antibodies and hospital type and nationality (P value < 0.05). However, no significant relationship was found between the presence of antibodies and other demographic variables such as age, sex, eosinophilia, and history of contact with animals in mothers and their neonates (P value > 0.05). This study indicates a substantial rate Toxocara infection in mothers and neonates, necessitating appropriate preventive measures by the relevant authorities.

Evaluation of microstructural brain changes in post-coronavirus disease 2019 (COVID-19) patients with neurological symptoms: a cross-sectional study.

Changes in both the vascular system and brain tissues can occur after a prior episode of coronavirus disease 2019 (COVID-19), detectable through modifications in diffusion parameters using magnetic resonance imaging (MRI) techniques. These changes in diffusion parameters may be particularly prominent in highly organized structures such as the corpus callosum (CC), including its major components, which have not been adequately studied following COVID-19 infection. Therefore, the study aimed to evaluate microstructural changes in whole-brain (WB) diffusion, with a specific focus on the CC. A total of 101 probands (age range from 18 to 69 years) participated in this retrospective study, consisting of 55 volunteers and 46 post-COVID-19 patients experiencing neurological symptoms. The participants were recruited from April 2022 to September 2023 at the Institute for Clinical and Experimental Medicine in Prague, Czech Republic. All participants underwent MRI examinations on a 3T MR scanner with a diffusion protocol, complemented by additional MRI techniques. Two volunteers and five patients were excluded from the study due to motion artefacts, severe hypoperfusion or the presence of lesions. Participants were selected by a neurologist based on clinical examination and a serological test for COVID-19 antibodies. They were then divided into three groups: a control group of healthy volunteers (n=28), an asymptomatic group (n=25) with a history of infection but no symptoms, and a symptomatic group (n=41) with a history of COVID-19 and neurological symptoms. Symptomatic patients did not exhibit neurological symptoms before contracting COVID-19. Diffusion data underwent eddy current and susceptibility distortion corrections, and fiber tracking was performed using default parameters in DSI studio. Subsequently, various diffusion metrics, were computed within the reconstructed tracts of the WB and CC. To assess the impact of COVID-19 and its associated symptoms on diffusion indices within the white matter of the WB and CC regions, while considering age, we employed a statistical analysis using a linear mixed-effects model within the R framework. Statistical analysis revealed a significant difference in mean diffusivity (MD) between the symptomatic and control groups in the forceps minor (P=0.001) and CC body (P=0.003). In addition to changes in diffusion, alterations in brain perfusion were observed in two post-COVID-19 patients who experienced a severe course. Furthermore, hyperintense lesions were identified in subcortical and deep white matter areas in the vast majority of symptomatic patients. The main finding of our study was that post-COVID-19 patients exhibit increased MD in the forceps minor and body of the CC. This finding suggests a potential association between microstructural brain changes in post-COVID-19 patients and reported neurological symptoms, with significant implications for research and clinical applications.

The Role of Artificial Intelligence in Predicting Optic Neuritis Subtypes From Ocular Fundus Photographs.

Optic neuritis (ON) is a complex clinical syndrome that has diverse etiologies and treatments based on its subtypes. Notably, ON associated with multiple sclerosis (MS ON) has a good prognosis for recovery irrespective of treatment, whereas ON associated with other conditions including neuromyelitis optica spectrum disorders or myelin oligodendrocyte glycoprotein antibody-associated disease is often associated with less favorable outcomes. Delay in treatment of these non-MS ON subtypes can lead to irreversible vision loss. It is important to distinguish MS ON from other ON subtypes early, to guide appropriate management. Yet, identifying ON and differentiating subtypes can be challenging as MRI and serological antibody test results are not always readily available in the acute setting. The purpose of this study is to develop a deep learning artificial intelligence (AI) algorithm to predict subtype based on fundus photographs, to aid the diagnostic evaluation of patients with suspected ON. This was a retrospective study of patients with ON seen at our institution between 2007 and 2022. Fundus photographs (1,599) were retrospectively collected from a total of 321 patients classified into 2 groups: MS ON (262 patients; 1,114 photographs) and non-MS ON (59 patients; 485 photographs). The dataset was divided into training and holdout test sets with an 80%/20% ratio, using stratified sampling to ensure equal representation of MS ON and non-MS ON patients in both sets. Model hyperparameters were tuned using 5-fold cross-validation on the training dataset. The overall performance and generalizability of the model was subsequently evaluated on the holdout test set. The receiver operating characteristic (ROC) curve for the developed model, evaluated on the holdout test dataset, yielded an area under the ROC curve of 0.83 (95% confidence interval [CI], 0.72-0.92). The model attained an accuracy of 76.2% (95% CI, 68.4-83.1), a sensitivity of 74.2% (95% CI, 55.9-87.4) and a specificity of 76.9% (95% CI, 67.6-85.0) in classifying images as non-MS-related ON. This study provides preliminary evidence supporting a role for AI in differentiating non-MS ON subtypes from MS ON. Future work will aim to increase the size of the dataset and explore the role of combining clinical and paraclinical measures to refine deep learning models over time.

Dementia Prevalence and Onchocerca volvulus Infection among Rural Elderly Persons in the Ntui Health District, Cameroon: A Population-Based Study.

Recent research suggests that infection with Onchocerca volvulus induces neurocognitive decline. This study sought to compare the cognitive outcomes of elderly persons based on onchocerciasis infection status and report the overall prevalence of dementia in the rural Ntui Health District in Cameroon. A community-based approach was used to recruit 103 participants aged ≥60 years. Dementia screening was done using the Community Screening Interview for Dementia (CSID) tool with a cut-off value of ≤29.5. O. volvulus infection was determined via microscopic examination of skin snips and serological testing of Ov16 antibodies using rapid diagnostic tests. Overall, the prevalence of dementia was 10.7%. Among the tested individuals, 17.9% (15/84) and 62.1% (41/66) were positive for O. volvulus and Ov16 antibodies, respectively. A multivariable linear regression model of CSID scores found a significant positive association with education level (8.654; 95% CI: 2.0870 to 15.222). However, having a positive skin snip for O. volvulus (-3.399; 95% CI: -6.805 to 0.007) and inhaling tobacco (-5.441; 95% CI: -9.137 to -1.744) tended to lower the CSID scores. Ongoing onchocerciasis transmission in the Ntui Health District may constitute a risk factor for dementia. Strengthening onchocerciasis elimination and adopting healthier lifestyles would contribute to dementia prevention among the elderly residing in endemic communities.

Anti-Phospholipase A2 Receptor Antibody (Anti-PLA2R) Testing to the Rescue

Serological testing for M-type anti-phospholipase A2 receptor antibodies (antiPLA2R Ab) has abrogated the need for kidney biopsy to diagnose membranous nephropathy in the appropriate clinical setting. We report a case of a 63-year-old hypertensive male who presented with nephrotic syndrome associated with autosomal dominant polycystic kidney disease which was effectively diagnosed with the use of antiPLA2R Ab test. He achieved complete remission upon treatment with Rituximab. Hitherto, all anecdotal case reports of this uncommon association were diagnosed only by kidney biopsy. We highlight the usefulness of PLA2RAb especially in such cases of difficult-to-biopsy kidneys.

Long-Term Symptoms Associated With SARS-CoV-2 Infection Among Blood Donors

Long-term symptoms, lasting more than 4 consecutive weeks after acute COVID-19 disease, are an important consequence of SARS-CoV-2 infection. Many prior studies have lacked a non-SARS-CoV-2-infected control population to distinguish background prevalence of symptoms from the direct impact of COVID-19 disease. To examine the prevalence of long-term physical and mental health symptoms associated with SARS-CoV-2 infection in a large population of blood donors based on self-report and serologic test results. This cross-sectional study included American Red Cross blood donors (aged ≥18 years) who were surveyed between February 22 and April 21, 2022, about new long-term symptoms arising after March 2020 and their SARS-CoV-2 infection status. All participants underwent at least 1 serologic test for antinucleocapsid antibodies between June 15, 2020, and December 31, 2021. SARS-CoV-2 infection as defined by a self-reported, confirmed acute infection or antinucleocapsid antibody positivity. New long-term symptoms since March 2020, including 5 symptom categories (neurologic, gastrointestinal, respiratory and cardiac, mental health, and other). Among 818 361 individuals who received the survey, 272 965 (33.4%) responded, with 238 828 meeting the inclusion criteria (138 576 [58.0%] female; median [IQR] age, 59.0 [47.0-67.0] years). Of the 83 015 individuals with a history of SARS-CoV-2 infection, 43.3% reported new long-term symptoms compared with 22.1% of those without a history of SARS-CoV-2 infection. After controlling for age, sex, race and ethnicity, and number of underlying conditions, those with a history of SARS-CoV-2 infection had an increased odds of new long-term symptoms compared with those without (adjusted odds ratio [AOR], 2.55; 95% CI, 2.51-2.61). Female sex and a history of chronic conditions were associated with new long-term symptoms. Long-term symptoms in the other category (AOR, 4.14; 95% CI, 4.03-4.25), which included changes in taste or smell, and the respiratory and cardiac symptom categories (AOR, 3.21; 95% CI, 3.12-3.31) were most associated with prior SARS-CoV-2 infection. Mental health long-term symptoms were also associated with prior SARS-CoV-2 infection (AOR, 1.05; 95%, CI, 1.02-1.08). This study's findings suggest that long-term symptoms lasting more than 4 weeks are common in the adult population, but there is a significantly higher prevalence among those with SARS-CoV-2 infection. Continued efforts to define and track long-term sequelae of SARS-CoV-2 using a control group without infection and serologic information to include those who had asymptomatic or unidentified infections are needed.

VLDL and LDL Subfractions Enhance the Risk Stratification of Individuals Who Underwent Epstein-Barr Virus-Based Screening for Nasopharyngeal Carcinoma: A Multicenter Cohort Study.

Serological tests for Epstein-Barr virus (EBV) antibodies have been widely conducted for the screening of nasopharyngeal carcinoma (NPC) in endemic areas. Further risk stratification of NPC can be achieved through plasma lipoprotein and metabolic profiles. A total of 297 NPC patients and 149 EBV-positive participants are enrolled from the NCT03919552 and NCT05682703 cohorts for plasma nuclear magnetic resonance (NMR) metabolomic analysis. Small, dense very low density lipoprotein particles (VLDL-5) and large, buoyant low density lipoprotein particles (LDL-1) are found to be closely associated with nasopharyngeal carcinogenesis. Herein, an NMR-based risk score (NRS), which combines lipoprotein subfractions and metabolic biomarkers relevant to NPC, is developed and well validated within a multicenter cohort. Combining the median cutoff value of the NRS (N50) with that of the serological test for EBV antibodies, the risk stratification model achieves a satisfactory performance in which the area under the curve (AUC) is 0.841 (95% confidence interval: 0.811-0.871), and the positive predictive value (PPV) reaches 70.08% in the combined cohort. These findings not only suggest that VLDL-5 and LDL-1 particles can serve as novel risk factors for NPC but also indicate that the NRS has significant potential in personalized risk prediction for NPC.

A comparative analysis of blood-borne infections among sickle cell anemia patients and first-time donors in Gabon

Managing sickle cell disease often requires transfusions, exposing multi-transfused sickle cell patients to a heightened risk of transfusion-transmitted infections. This study aimed to assess the seroprevalence of the human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) in multi-transfused sickle cell patients and first-time donors in Libreville. The serological testing for HBsAg, anti-HIV, and anti-HCV antibodies was conducted using commercial enzyme immunoassays and confirmed by the COBAS modular analyzer (Roche Diagnostics). The seroprevalence of HIV, HCV antibodies, and HBsAg was 4%, 10%, and 10%, respectively, in multi-transfused sickle cell patients and 5%, 0%, and 8% in first-time donors. Interestingly, HIV and HBsAg seroprevalence were similar in both groups, indicating that transfusion was not associated with these infections. However, HCV antibody seroprevalence was significantly higher in multi-transfused sickle cell patients than in first-time donors (10% vs. 0%, p&lt;0.001). Furthermore, the presence of anti-HCV antibodies in multi-transfused sickle cell patients was significantly associated with the number of donations received (7.20±2.37 vs. 3.96±2.06, p=0.042). These findings suggest that while blood transfusion is not a significant risk factor for HIV and HBsAg transmission, it may increase the risk of HCV transmission, particularly in multi-transfused sickle cell patients.

Case series of neuroretinitis in Korea

BackgroundTo present the clinical characteristics of neuroretinitis in Korea.MethodsTwelve patients with neuroretinitis between January 2009 and September 2020 were retrospectively reviewed. Neuroretinitis was diagnosed based on fundus findings, optical coherence tomography, and fluorescein angiography. The serological findings of each patient were reviewed.ResultsFifteen eyes of 12 patients (9 male and 3 female), with a mean age of 46.0 ± 10.7 years were included. Of the nine patients who underwent serological testing for Toxocara antibodies, six (66.6%) were positive. One patient had high titers of Toxoplasma immunoglobulins M and G. One patient diagnosed with dengue fever was suspected to have neuroretinitis in both eyes. There were no related abnormalities in the serological findings in four patients (33.3%) out of 12 patients. There were no suspected cases of cat-scratch disease. The six patients who were positive for Toxocara antibodies were older (mean age: 54.5 ± 9.1 years) than the others (mean age: 37.5 ± 4.4 years, p = 0.004). The four patients without any abnormal serological findings were relatively younger (mean age: 35.7 ± 3.0 years) than the other 8 patients (mean age: 51.1 ± 10.1 years, p = 0.008).ConclusionsTwo-thirds of neuroretinitis patients were seropositive for Toxocara in the current cohort from Koreans. Causative factors in cases of neuroretinitis may vary according to age and region.

Bilateral Sialadenitis as an Uncommon Initial Manifestation of Infectious Mononucleosis: A Case Report.

Sialadenitis has rarely been reported in patients with infectious mononucleosis (IM). Our patient was a 22-year-old man who presented with bilateral swelling of the parotid and submandibular glands, a fever, malaise, and splenomegaly. Laboratory tests revealed an increased percentage of atypical lymphocytes in the leukocyte fraction. Serological testing for antibodies against Epstein-Barr virus (EBV) revealed an acute infection pattern. The patient was diagnosed with sialadenitis associated with IM caused by EBV infection. With symptomatic treatment, the salivary gland swelling completely resolved within a week. This case suggests that EBV-induced IM should be included in the differential diagnosis of diffuse sialadenitis with elevated atypical lymphocyte counts.

Seroprevalence of brucellosis among animal handlers in West Bengal, India: an occupational health study.

Brucellosis is a highly contagious zoonotic disease and a major human health problem worldwide. Due to its ways of transmission, direct or indirect contact with infected animals or their contaminated biological products, the disease exhibits strong occupational association with animal handlers comprising a significant population at risk. This study was undertaken to estimate the seroprevalence of brucellosis in animal handlers and to understand the epidemiological and serological aspects of the same. The animal handlers from the state of West Bengal, India were included in this study. It was a prospective and observational cohort study from November 2021 to March 2022. A total of 669 sera samples were collected from animal handlers and tested using various serological tests for Brucella antibodies. All serum samples were tested using the Rose Bengal plate test (RBPT), standard tube agglutination test (STAT), and enzyme-linked immunosorbent assay (ELISA). 106 (15.8%) patients were diagnosed with brucellosis among the total number of patients tested. Most of the patients affected with brucellosis belonged to the age group 51-60 years (23.5%). The seropositivity rate in male animal handlers was higher than female animal handlers in this study. More studies are needed to understand the occupational association of this disease. Awareness programs, safe livestock practices, and prevention of the disease by timely diagnosis must be implemented in order to control human brucellosis.

Molecular and Serological Studies on Potential SARS-CoV-2 Infection among 43 Lemurs under Human Care-Evidence for Past Infection in at Least One Individual.

In the setting of the recent COVID-19 pandemic, transmission of SARS-CoV-2 to animals has been reported in both domestic and wild animals and is a matter of concern. Given the genetic and functional similarities to humans, non-human primates merit particular attention. In the case of lemurs, generally considered endangered, they are believed to be susceptible to SARS-CoV-2 infection. We have conducted a study for evidence of SARS-CoV-2 infection among the 43 lemurs of Mundomar, a zoological park in Benidorm, Spain. They belong to two endangered lemur species, 23 black-and-white ruffed lemurs (Varecia variegata) and 20 ring-tailed lemurs (Lemur catta). Health assessments conducted in 2022 and 2023 included molecular analyses for SARS-CoV-2 RNA of oral and rectal swabs using two different RT-qPCR assays, always with negative results for SARS-CoV-2 in all animals. The assessment also included serological testing for antibodies against the receptor-binding domain (RBD) of the spike protein (S) of SARS-CoV-2, which again yielded negative results in all animals except one black-and-white ruffed lemur, supporting prior infection of that animal with SARS-CoV-2. Our data, while not indicating a high susceptibility of lemurs to SARS-CoV-2 infection, show that they can be infected, adding to the existing information body on potential ways for SARS-CoV-2 virus spreading in zoos, highlighting the need for animal surveillance for the virus.

Multisystem Inflammatory Syndrome in Children (MIS-C) Post COVID-19 Infection: Diagnosis and Treatment from the Paediatric Intensive Care Unit (PICU) at a Tertiary Hospital in the Kingdom of Bahrain.

Post coronavirus disease 2019 (COVID-19) infections, children presented with varying clinical manifestations of a Multisystem Inflammatory Syndrome in Children (MIS-C). The aim of our study is to identify the clinical manifestations upon admission to paediatric intensive care unit (PICU) and to identify how different treatments affected post-treatment outcomes. Methods: A retrospective cross-sectional study included 11 patients diagnosed with multisystem inflammatory syndrome based on the World Health Organization (WHO) classification and treated by intravenous immunoglobulin (IVIG) with/without corticosteroids. Results: There were six female and five male patients with an average age of 5.08±4.7 years. Ten had a confirmed positive severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) serological antibody test or polymerase chain reaction (PCR) test, with one having only contact history. The most common systems affected by MIS-C were gastrointestinal and ophthalmological presentations. All presented with fever and raised inflammatory markers (erythrocyte sedimentation rate, C-reactive protein, procalcitonin, ferritin, d-dimer, and lactate dehydrogenase). There was no statistical difference between both treatment groups. Clinical and inflammatory markers significantly improved in both groups. This study highlights an improved outcome associated with combination therapy, although there is no statistical significance between both groups.

Diagnostic Efficacy of Serological Antibody Detection Tests for Hepatitis Delta Virus: A Systematic Review and Meta-Analysis.

Background and Aims Coinfection of hepatitis delta virus (HDV) with hepatitis B virus (HBV) causes the most severe form of viral hepatitis, and the global prevalence of HDV infection is underestimated. Although serological testing of anti-HDV antibodies is widely used in the diagnosis of HDV, its diagnostic efficacy remains unclear. This study aimed to evaluate the diagnostic efficacy of HDV serological tests, the results of which may assist in the diagnosis of HDV. Methods Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. The PubMed, Web of Science and Cochrane Library databases were searched from the beginning to 31 May 2023. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. STATA SE was used for the meta-analysis of the sensitivity, specificity, positive likelihood ratio and negative likelihood ratio. Results Among a total of 1376 initially identified studies, only 12 articles met the final inclusion criteria. The pooled sensitivity and specificity were 1.00 (95% CI: 0.00-1.00) and 0.71 (95% CI: 0.50-0.78) for HDV total antibodies, 0.96 (95% CI: 0.83-0.99) and 0.98 (95% CI: 0.82-1.00) for anti-HDV IgM and 0.95 (95% CI: 0.86-0.98) and 0.96 (95% CI: 0.67-1.00) for anti-HDV IgG. The pooled sensitivity and specificity for HDV serological tests were 0.99 (95% CI: 0.96-1.00) and 0.90 (95% CI: 0.79-0.96). Conclusions This meta-analysis suggests that serological tests have high diagnostic performance in detecting antibodies against HDV, especially in HDV IgM and IgG. However, this conclusion is based on studies of a limited number and quality, and the development of new diagnostic tools with higher precision and reliability is still necessary.

A fatal case of tick-borne encephalitis in an immunocompromised patient: case report from Northeastern Poland and review of literature

Tick-borne encephalitis (TBE) is an infectious illness of the central nervous system caused by the TBE virus, which is commonly transmitted through a tick-bite. TBE is endemic in Europe and mid-Asia. In this study, we report a case of a 36-year-old woman, living in Northeastern Poland, with a history of double corneal transplantation and post-transplant immunosuppressive therapy who was admitted to hospital because of progressive weakness, acute headache, nausea, vertigo, vomiting, and fever. The patient was diagnosed with TBE. However, the diagnosis was challenging as the initial serological tests for antibodies against the TBE virus were negative. We want to raise the awareness among the clinicians that the course of TBE is often unpredictable and that it tends to be more severe in immunocompromised individuals.. Delayed production of antibodies against TBE virus, which might inhibit the diagnosis of the disease, is observed in some immunocompromised patients.