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Sample records for aloinmune neonatal igg

  1. Trombocitopenia fetal/neonatal aloinmune: Revisión a propósito de un caso Foetal/neonatal alloimmune thrombocytopenia: A review and case report

    Directory of Open Access Journals (Sweden)

    P. Rodríguez Wilhelmi

    2008-12-01

    Full Text Available La trombocitopenia fetal/neonatal aloinmune (TFNA es la causa más frecuente de trombocitopenia grave en el recién nacido. Es un proceso agudo donde las plaquetas fetales son destruidas durante la gestación por un anticuerpo de tipo IgG presente en la madre aloinmunizada. En la raza caucásica, tiene especificidad frente al antígeno específico plaquetar HPA-1a en más del 80% de los casos. La hemorragia intracraneal, que ocurre hasta en un 30%, es la complicación más grave, con un 10% de mortalidad y un 20% de secuelas neurológicas irreversibles. El alto riesgo de repetición de hemorragia grave en futuras gestaciones obliga a plantearse profilaxis o tratamiento antenatal. El diagnóstico precoz puede permitir administrar un tratamiento eficaz basado en la transfusión de plaquetas de fenotipo HPA compatible o de inmunoglobulinas endovenosas. Presentamos el caso de una gestante de 27 años, que en la semana 35 de su segunda gestación fue diagnosticada por ecografía de hidrocefalia fetal bilateral. En la cesárea realizada en la semana 36, el neonato presentó hematomas en hombro y glúteo izquierdos, macrocefalia con fontanelas a tensión y salida de líquido cefalorraquídeo hemorrágico tras la colocación de un catéter de derivación externo. El hemograma reveló trombocitopenia grave (9 x 10(9/L. Ante sospecha clínica de TFNA, se transfundieron plaquetas de donante no fenotipado para el HPA-1a y se inició tratamiento con inmunoglobulinas endovenosas, con recuperación de la trombocitopenia, pero con secuelas neurológicas probablemente irreversibles. El estudio inmunohematológico confirmó el fenotipo materno HPA-1a negativo, el fenotipo neonatal HPA-1a positivo y la presencia de aloanticuerpos anti-HPA-1a en el suero materno. La profilaxis y el tratamiento continúan siendo, en la actualidad, motivo de discusión y controversia, así como la posibilidad de realizar un cribado antenatal.Foetal/neonatal alloimmune

  2. IgG transport across mucosal barriers by neonatal Fc receptor for IgG and mucosal immunity.

    Science.gov (United States)

    Yoshida, Masaru; Masuda, Atsuhiro; Kuo, Timothy T; Kobayashi, Kanna; Claypool, Steven M; Takagawa, Tetsuya; Kutsumi, Hiromu; Azuma, Takeshi; Lencer, Wayne I; Blumberg, Richard S

    2006-12-01

    Mucosal secretions of the human gastrointestinal, respiratory, and genital tracts contain significant quantities of IgG. The neonatal Fc receptor for IgG (FcRn) plays a major role in regulating host IgG levels and transporting IgG and associated antigens across polarized epithelial barriers. The FcRn can then recycle the IgG/antigen complex back across the intestinal barrier into the lamina propria for processing by dendritic cells and presentation to CD4(+) T cells in regional organized lymphoid structures. FcRn, through its ability to secrete and absorb IgG, thus integrates luminal antigen encounters with systemic immune compartments and, as such, provides essential host defense and immunoregulatory functions at the mucosal surfaces. PMID:17051393

  3. Neonatal Fc Receptor-Mediated IgG Transport Across Porcine Intestinal Epithelial Cells: Potentially Provide the Mucosal Protection.

    Science.gov (United States)

    Guo, Jinyue; Li, Fei; He, Qigai; Jin, Hui; Liu, Mei; Li, Shaowen; Hu, Sishun; Xiao, Yuncai; Bi, Dingren; Li, Zili

    2016-06-01

    It has been well characterized that piglets can absorb colostrum IgG across the intestine to neonatal bloodstream and a certain level of IgG has been found in the mucosal secretions of the porcine intestinal tract. However, little is known about how the maternal IgG transport across the intestinal barrier and how IgG enter the lumen of intestinal tract. In this study, we demonstrated that the porcine neonatal Fc receptor (pFcRn) was expressed in a model of normal porcine intestinal epithelial cells (IPEC-J2) as well as in kidney cells (PK-15), and pFcRn was mainly distributed in the apical side of the polarized IPEC-J2 cells. Analyzing the phylogenetic relatedness of this gene we found that swine and human neonatal Fc receptor (FcRn) amino acid sequence are closer than rodents. We also showed that pFcRn mediated bidirectional IgG transport across polarized IPEC-J2 cells and bound to IgG in a pH-dependent manner. Furthermore, pFcRn-transcytosed viral-specific IgG reduced the transmissible gastroenteritis virus (TGEV) yield from the luminal direction by a 50% tissue culture infective dose (TCID50) assay. Our results indicate that pFcRn-dependent bidirectional IgG transport across the intestinal epithelium plays critical role in the acquisition of humoral immunity in early life and in host defense at mucosal surfaces. PMID:26982157

  4. Preterm and term neonates transplacentally acquire IgG antibodies specific to LPS from Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa.

    Science.gov (United States)

    Silveira Lessa, Ana Lúcia; Krebs, Vera Lúcia Jornada; Brasil, Tatiana Braga; Pontes, Gerlândia Neres; Carneiro-Sampaio, Magda; Palmeira, Patricia

    2011-07-01

    High incidences of Gram-negative bacteria are found in neonatal nosocomial infections. Our aim was to investigate placental transmission of immunoglobulin G (IgG) reactive with lipopolysaccharide from Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli O111, O6 and O26. The total and lipopolysaccharide-specific IgM and IgG were determined in 11 maternal/umbilical-cord sera aged ≤33 weeks (GI); 21 aged >33 and <37 weeks (GII); and 32 term newborns (GIII). The total and lipopolysaccharide-specific IgM concentrations were equivalent in maternal sera. The total IgG concentrations were equivalent in maternal and newborn sera, with the exception of GIII newborns as compared with their mothers (P<0.0001) and with neonates from GI and GII (P<0.05). Lipopolysaccharide-specific IgG concentrations were lower in GI neonates than in their mothers (P<0.01) and lower in GII (P<0.05). Lower lipopolysaccharide-specific IgG levels were observed among neonates only for O111 in GI (P<0.05) and for O26 and Pseudomonas in GII, both as compared with GIII (P<0.05). The anti-lipopolysaccharide IgG transfer ratios were lower in GI (except for O26) and in GII (except for Klebsiella and O111) as compared with GIII (P<0.05). Our results suggest that the greater susceptibility to infections in preterm infants is influenced (besides the humoral response) by factors intrinsic and extrinsic to the condition of prematurity. PMID:21481015

  5. The neonatal Fc receptor (FcRn) binds independently to both sites of the IgG homodimer with identical affinity

    Science.gov (United States)

    Abdiche, Yasmina Noubia; Yeung, Yik Andy; Chaparro-Riggers, Javier; Barman, Ishita; Strop, Pavel; Chin, Sherman Michael; Pham, Amber; Bolton, Gary; McDonough, Dan; Lindquist, Kevin; Pons, Jaume; Rajpal, Arvind

    2015-01-01

    The neonatal Fc receptor (FcRn) is expressed by cells of epithelial, endothelial and myeloid lineages and performs multiple roles in adaptive immunity. Characterizing the FcRn/IgG interaction is fundamental to designing therapeutic antibodies because IgGs with moderately increased binding affinities for FcRn exhibit superior serum half-lives and efficacy. It has been hypothesized that 2 FcRn molecules bind an IgG homodimer with disparate affinities, yet their affinity constants are inconsistent across the literature. Using surface plasmon resonance biosensor assays that eliminated confounding experimental artifacts, we present data supporting an alternate hypothesis: 2 FcRn molecules saturate an IgG homodimer with identical affinities at independent sites, consistent with the symmetrical arrangement of the FcRn/Fc complex observed in the crystal structure published by Burmeister et al. in 1994. We find that human FcRn binds human IgG1 with an equilibrium dissociation constant (KD) of 760 ± 60 nM (N = 14) at 25°C and pH 5.8, and shows less than 25% variation across the other human subtypes. Human IgG1 binds cynomolgus monkey FcRn with a 2-fold higher affinity than human FcRn, and binds both mouse and rat FcRn with a 10-fold higher affinity than human FcRn. FcRn/IgG interactions from multiple species show less than a 2-fold weaker affinity at 37°C than at 25°C and appear independent of an IgG's variable region. Our in vivo data in mouse and rat models demonstrate that both affinity and avidity influence an IgG's serum half-life, which should be considered when choosing animals, especially transgenic systems, as surrogates. PMID:25658443

  6. Effect of birthweight, total protein, serum IgG and packed cell volume on risk of neonatal diarrhea in calves on two California dairies.

    Science.gov (United States)

    Paré, J; Thurmond, M C; Gardner, I A; Picanso, J P

    1993-10-01

    The objective of the study was to determine if there was a relationship between hematological, immunological and physiological variables of newborn calves and risk of diarrhea during the neonatal period. Four hundred and seventeen heifer calves from two dairies (A and B) in the San Joaquin Valley of California were enrolled at birth and scored daily, to 28 days of age, for evidence and severity of diarrhea (0 to 3). Calves were weighted at birth and blood sampled at two to five days of age to determine packed cell volume (PCV), total protein (TP) and IgG serum concentration. The Cox proportional hazards model was used to determine if age at onset of the first diarrhea episode and length of the first episode were associated with the hypothesized variables (PCV, TP, IgG and birthweight). The IgG concentration was not associated with the age at onset of diarrhea (p = 0.6052, Dairy A; p = 0.4393, Dairy B) but a high IgG concentration was associated with a decreased length of episode (p = 0.0325, Dairy A; p = 0.0912, Dairy B), particularly for calves born in the winter on dairy A (p = 0.0211). For calves born in the winter, those with either a high or a low birthweight had diarrhea at a younger age (p = 0.0102, Dairy A; p = 0.0020, Dairy B). Associations were also found for PCV and TP with both the age at onset and length of the first episode of diarrhea. Results suggest that parameters measurable at, or shortly after birth may have important prognostic value in evaluating risk of calf diarrhea. PMID:8269362

  7. 新生儿时期食物特异性IgG检测的临床意义%Clinical significance of food intolerance-specific IgG antibody detection in neonates

    Institute of Scientific and Technical Information of China (English)

    高沙沙; 俞生林; 包丽丽

    2013-01-01

    [目的]测定疑似新生儿时期出现食物不耐受症状的患儿血清特异性IgG抗体,并对影响特异性IgG抗体结果的相关因素进行分析,探讨特异性IgG抗体在检测新生儿食物不耐受中的意义及新生儿食物不耐受发生的可疑危险因素. [方法]应用酶联免疫法检测临床疑似出现食物(主要是牛奶蛋白)不耐受症状的60例患儿及对照组60例新生儿血清特异性IgG抗体;采用Logistic回归模型分析影响特异性IgG抗体结果的相关因素. [结果]93.3%患儿存在不同种类食物过敏原特异性IgG升高,6项指标单因素分析中有3项指标具有显著性意义(P<0.05);其中2项指标被选人Logistic回归方程(P均<0.05).过敏性疾病家族史的OR值为3.170(95%CI:1.240~8.103),母乳喂养的OR值为0.359(95 %CI:0.157~0.822);未发现新生儿性别、分娩方式、胎龄、母孕期吸烟情况等与食物IgG抗体结果有关. [结论]食物不耐受在新生儿时期就可表现出一系列症状,其中特异性IgG抗体检测具有较高阳性率;母乳喂养是新生儿食物不耐受IgG抗体阳性结果的保护因素,家族过敏史是其危险因素;对新生儿时期出现食物不耐受情况提高意识,及早诊断,予以干预,避免对以后生长发育产生严重影响.%[Objective] To ascertain the significance of food intolerance-specific IgG antibody detection and suspicious risk factors of food intolerance in neonates.[Methods] The food intolerance-specific IgG antibodies in serum were measured by Enzyme-Linked Immunosorbnent Assay (ELISA) in 60 neonates who were considered to be food intolerance(especially cow's milk) and in 60 control neonates,analyzed the influential factors of IgG results by Logistic regression models.[Results] 93.3 % of patients appeared positive results in different food IgG antibodics;In the single factor analysis,3 indexes were obviously significant (P<0.05) and 2 of them were also significant

  8. Mass spectrometry detection of G3m and IGHG3 alleles and follow-up of differential mother and neonate IgG3.

    Directory of Open Access Journals (Sweden)

    Célia Dechavanne

    Full Text Available Mass spectrometry (MS analysis for detection of immunoglobulins (IG of the human IgG3 subclass is described that relies on polymorphic amino acids of the heavy gamma3 chains. IgG3 is the most polymorphic human IgG subclass with thirteen G3m allotypes located on the constant CH2 and CH3 domains of the gamma3 chain, the combination of which leads to six major G3m alleles. Amino acid changes resulting of extensive sequencing previously led to the definition of 19 IGHG3 alleles that have been correlated to the G3m alleles. As a proof of concept, MS proteotypic peptides were defined which encompass discriminatory amino acids for the identification of the G3m and IGHG3 alleles. Plasma samples originating from ten individuals either homozygous or heterozygous for different G3m alleles, and including one mother and her baby (drawn sequentially from birth to 9 months of age, were analyzed. Total IgG3 were purified using affinity chromatography and then digested by a combination of AspN and trypsin proteases, and peptides of interest were detected by mass spectrometry. The sensitivity of the method was assessed by mixing variable amounts of two plasma samples bearing distinct G3m allotypes. A label-free approach using the high-performance liquid chromatography (HPLC retention time of peptides and their MS mass analyzer peak intensity gave semi-quantitative information. Quantification was realized by selected reaction monitoring (SRM using synthetic peptides as internal standards. The possibility offered by this new methodology to detect and quantify neo-synthesized IgG in newborns will improve knowledge on the first acquisition of antibodies in infants and constitutes a promising diagnostic tool for vertically-transmitted diseases.

  9. Neonatal Death

    Science.gov (United States)

    ... Home > Complications & Loss > Loss & grief > Neonatal death Neonatal death E-mail to a friend Please fill in ... your baby. What are common causes of neonatal death? The most common causes of neonatal death are: ...

  10. IgG Placental Transfer in Healthy and Pathological Pregnancies

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    Patricia Palmeira

    2012-01-01

    Full Text Available Placental transfer of maternal IgG antibodies to the fetus is an important mechanism that provides protection to the infant while his/her humoral response is inefficient. IgG is the only antibody class that significantly crosses the human placenta. This crossing is mediated by FcRn expressed on syncytiotrophoblast cells. There is evidence that IgG transfer depends on the following: (i maternal levels of total IgG and specific antibodies, (ii gestational age, (iii placental integrity, (iv IgG subclass, and (v nature of antigen, being more intense for thymus-dependent ones. These features represent the basis for maternal immunization strategies aimed at protecting newborns against neonatal and infantile infectious diseases. In some situations, such as mothers with primary immunodeficiencies, exogenous IgG acquired by intravenous immunoglobulin therapy crosses the placenta in similar patterns to endogenous immunoglobulins and may also protect the offspring from infections in early life. Inversely, harmful autoantibodies may cross the placenta and cause transitory autoimmune disease in the neonate.

  11. Colostrogenesis: IgG1 transcytosis mechanisms.

    Science.gov (United States)

    Baumrucker, Craig R; Bruckmaier, Rupert M

    2014-03-01

    Biological transport of intact proteins across epithelial cells has been documented for many absorptive and secretory tissues. Immunoglobulins were some of the earliest studied proteins in this category. The transcellular transport (transcytosis) of immunoglobulins in neonatal health and development has been recognized; the process is especially significant with ungulates because they do not transcytose immunoglobulins across the placenta to the neonate. Rather, they depend upon mammary secretion of colostrum and intestinal absorption of immunoglobulins in order to provide intestinal and systemic defense until the young ungulate develops its own humoral defense mechanisms. The neonatal dairy calf's ability to absorb immunoglobulins from colostrum is assisted by a ~24 h "open gut" phenomenon where large proteins pass the intestinal epithelial cells and enter the systemic system. However, a critical problem recognized for newborn dairy calves is that an optimum mass of colostrum Immunoglobulin G (IgG) needs to be absorbed within that 24 h window in order to provide maximal resistance to disease. Many calves do not achieve the optimum because of poor quality colostrum. While many studies have focused on calf absorption, the principal cause of the problem resides with the extreme variation (g to kg) in the mammary gland's capacity to transfer blood IgG1 into colostrum. Colostrum is a unique mammary secretory product that is formed during late pregnancy when mammary cells are proliferating and differentiating in preparation for lactation. In addition to the transcytosis of immunoglobulins, the mammary gland also concentrates a number of circulating hormones into colostrum. Remarkably, the mechanisms in the formation of colostrum in ungulates have been rather modestly studied. The mechanisms and causes of this variation in mammary gland transcytosis of IgG1 are examined, evaluated, and in some cases, explained. PMID:24474529

  12. IgG4 Cholangiopathy

    OpenAIRE

    Yoh Zen; Yasuni Nakanuma

    2012-01-01

    IgG4 cholangiopathy can involve any level of the biliary tree which exhibits sclerosing cholangitis or pseudotumorous hilar lesions. Most cases are associated with autoimmune pancreatitis, an important diagnostic clue. Without autoimmune pancreatitis, however, the diagnosis of IgG4-cholangiopathy is challenging. Indeed such cases have been treated surgically. IgG4-cholangiopathy should be diagnosed based on serological examinations including serum IgG4 concentrations, radiological features, a...

  13. A prominent lack of IgG1-Fc fucosylation of platelet alloantibodies in pregnancy

    OpenAIRE

    Kapur, R.; Kustiawan, I.; Vestrheim, A.; Koeleman, C. A. M.; de Visser, R; Einarsdottir, H. K.; Porcelijn, L.; Jackson, D; Kumpel, B; Deelder, A. M.; Blank, D.; Skogen, B.; Killie, M. K.; Michaelsen, T. E.; Haas, M.

    2014-01-01

    Immunoglobulin G (IgG) formed during pregnancy against human platelet antigens (HPAs) of the fetus mediates fetal or neonatal alloimmune thrombocytopenia (FNAIT). Because antibody titer or isotype does not strictly correlate with disease severity, we investigated by mass spectrometry variations in the glycosylation at Asn297 in the IgG Fc because the composition of this glycan can be highly variable, affecting binding to phagocyte IgG-Fc receptors (FcγR). We found markedly decreased levels of...

  14. Tirosinemia neonatal Neonatal tyrosinemia

    OpenAIRE

    Rafael J. Manotas Cabarcas; Luis Carlos Burgos Herrera

    1995-01-01

    Mediante la técnica de Udenfriend y Cooper, se midieron los niveles de tirosina en la sangre del cordón de 26 prematuros y 31 niños de término, con el fin de comparar las concentraciones según la edad gestacional y detectar la presencia de la tirosinemia neonatal. Se encontró un caso de esta entidad en un niño de 31 semanas de edad gestacional, lo cual correspondió al 3.8% de los prematuros y al 1.8% del grupo total. La concentración de tirosina en el paciente fue de 53 JJ.M. El promedio de l...

  15. Tuberculosis neonatal

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    Pastor Durán, Xavier

    1986-01-01

    PROTOCOLOS TERAPEUTICOS. TUBERCULOSIS NEONATAL 1. CONCEPTO La tuberculosis neonatal es la infección del recién nacido producida por el bacilo de Koch. Es una situación rara pero grave que requiere un diagnóstico precoz y un tratamiento enérgico..

  16. A strategy for bacterial production of a soluble functional human neonatal Fc receptor

    DEFF Research Database (Denmark)

    Andersen, Jan Terje; Justesen, Sune; Berntzen, Gøril;

    2008-01-01

    The major histocompatibility complex (MHC) class I related receptor, the neonatal Fc receptor (FcRn), rescues immunoglobulin G (IgG) and albumin from lysosomal degradation by recycling in endothelial cells. FcRn also contributes to passive immunity by mediating transport of IgG from mother to fetus...

  17. Organ Correlation in IgG4-Related Diseases

    OpenAIRE

    Koizumi, Satomi; Kamisawa, Terumi; Kuruma, Sawako; Tabata, Taku; Chiba, Kazuro; Iwasaki, Susumu; Kuwata, Go; Fujiwara, Takashi; Fujiwara, Junko; Arakawa, Takeo; Koizumi, Koichi; Momma, Kumiko

    2015-01-01

    IgG4-related disease (IgG4-RD) is a potentially multiorgan disorder. In this study, clinical and serological features from 132 IgG4-RD patients were compared about organ correlations. Underlying pathologies comprised autoimmune pancreatitis (AIP) in 85 cases, IgG4-related sclerosing cholangitis (IgG4-SC) in 12, IgG4-related sialadenitis (IgG4-SIA) in 56, IgG4-related dacryoadenitis (IgG4-DAC) in 38, IgG4-related lymphadenopathy (IgG4-LYM) in 20, IgG4-related retroperitoneal fibrosis (IgG4-RF)...

  18. IgG4 Related Sclerosing Cholangitis

    OpenAIRE

    D. Joshi; Webster, G. J. M.

    2014-01-01

    IgG4 related disease (IgG4-RD) is a multisystemic disorder which has only recently been recognized. IgG4 related sclerosing cholangitis (IgG4-SC) is the biliary manifestation of the disease, often in association with autoimmune pancreatitis (AIP). In this review, we provide an overview of IgG4-RD, with a focus on the biliary manifestations. In particular, we describe the important differential diagnoses of IgG4-SC that need to be considered, namely, primary sclerosing cholangitis (PSC) and ch...

  19. Cutoff Values of Serum IgG4 and Histopathological IgG4+ Plasma Cells for Diagnosis of Patients with IgG4-Related Disease

    OpenAIRE

    Hisanori Umehara; Susumu Sugai; Toshihiro Fukushima; Katumi Eguchi; Miyuki Miki; Masao Tanaka; Yoshimasa Fujita; Tomoyuki Sakai; Akio Nakajima; Haruka Iwao; Takafumi Kawanami; Takuji Nakamura; Hiroshi Minato; Naoto Umeda; Akira Hirabayashi

    2012-01-01

    IgG4-related disease is a new disease classification established in Japan in the 21st century. Patients with IgG4-related disease display hyper-IgG4-gammaglobulinemia, massive infiltration of IgG4+ plasma cells into tissue, and good response to glucocorticoids. Since IgG4 overexpression is also observed in other disorders, it is necessary to diagnose IgG4-related disease carefully and correctly. We therefore sought to determine cutoff values for serum IgG4 and IgG4/IgG and for IgG4+/IgG+ plas...

  20. Neonatal neurosonography

    International Nuclear Information System (INIS)

    Paediatric and particularly neonatal neurosonography still remains a mainstay of imaging the neonatal brain. It can be performed at the bedside without any need for sedation or specific monitoring. There are a number of neurologic conditions that significantly influence morbidity and mortality in neonates and infants related to the brain and the spinal cord; most of them can be addressed by ultrasonography (US). However, with the introduction of first CT and then MRI, neonatal neurosonography is increasingly considered just a basic first line technique that offers only orienting information and does not deliver much relevant information. This is partially caused by inferior US performance – either by restricted availability of modern equipment or by lack of specialized expertise in performing and reading neurosonographic scans. This essay tries to highlight the value and potential of US in the neonatal brain and briefly touching also on the spinal cord imaging. The common pathologies and their US appearance as well as typical indication and applications of neurosonography are listed. The review aims at encouraging paediatric radiologists to reorient there imaging algorithms and skills towards the potential of modern neurosonography, particularly in the view of efficacy, considering growing economic pressure, and the low invasiveness as well as the good availability of US that can easily be repeated any time at the bedside

  1. Neonatal neurosonography

    Energy Technology Data Exchange (ETDEWEB)

    Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at

    2014-09-15

    Paediatric and particularly neonatal neurosonography still remains a mainstay of imaging the neonatal brain. It can be performed at the bedside without any need for sedation or specific monitoring. There are a number of neurologic conditions that significantly influence morbidity and mortality in neonates and infants related to the brain and the spinal cord; most of them can be addressed by ultrasonography (US). However, with the introduction of first CT and then MRI, neonatal neurosonography is increasingly considered just a basic first line technique that offers only orienting information and does not deliver much relevant information. This is partially caused by inferior US performance – either by restricted availability of modern equipment or by lack of specialized expertise in performing and reading neurosonographic scans. This essay tries to highlight the value and potential of US in the neonatal brain and briefly touching also on the spinal cord imaging. The common pathologies and their US appearance as well as typical indication and applications of neurosonography are listed. The review aims at encouraging paediatric radiologists to reorient there imaging algorithms and skills towards the potential of modern neurosonography, particularly in the view of efficacy, considering growing economic pressure, and the low invasiveness as well as the good availability of US that can easily be repeated any time at the bedside.

  2. IgG4-related ophthalmic disease

    OpenAIRE

    Mejico, Luis J.

    2014-01-01

    IgG4-related disease is a fibro-inflammatory condition with tendency to form tumors with inflammatory infiltrate with IgG4 rich plasma cells and elevation of IgG4 level in serum, which may affect virtually every organ and tissue in the organism. IgG4-related ophthalmic disease may present as dacryoadenitis, myositis, other orbital tissues, hypophysitis or pachymeningitis causing cranial neuropathies. The diagnosis of IgG4-related disease is based on a typical clinical scenario, supportive lab...

  3. Distribution of the IgG Fc Receptor, FcRn, in the Human Fetal Intestine

    OpenAIRE

    Shah, Uzma; Dickinson, Bonny L.; Blumberg, Richard S.; Simister, Neil E.; Lencer, Wayne I.; Walker, W. Allan

    2003-01-01

    The intestinal Fc receptor, FcRn, functions in the maternofetal transfer of gamma globulin (IgG) in the neonatal rodent. In humans, most of this transfer is presumed to occur in utero via the placenta. Although the fetus swallows amniotic fluid that contains immunoglobulin, it is unknown whether this transfer also occurs via the fetal intestine. A human FcRn has been identified in the syncytiotrophoblast that mediates the maternofetal transfer of antibody. It has also been identified in human...

  4. IgG4-Related Lymphadenopathy

    OpenAIRE

    Tadashi Yoshino; Yasuharu Sato

    2012-01-01

    Lymphadenopathy is frequently observed in patients with immunoglobulin G4-related disease (IgG4-RD) and sometimes appears as the first manifestation of the disease. The diagnosis of IgG4-related lymphadenopathy is complicated owing to a great histological diversity, with at least 5 histological subtypes. Indeed, lymph node biopsy may be performed under the suspicion that the lymphadenopathy is a malignant lymphoma or other lymphoproliferative disorder. The diagnosis of IgG4-RD is characterize...

  5. IgG4-related skin disease.

    Science.gov (United States)

    Tokura, Y; Yagi, H; Yanaguchi, H; Majima, Y; Kasuya, A; Ito, T; Maekawa, M; Hashizume, H

    2014-11-01

    IgG4-related disease (IgG4-RD) is a recently established clinical entity characterized by high levels of circulating IgG4, and tissue infiltration of IgG4(+) plasma cells. IgG4-RD exhibits a distinctive fibroinflammatory change involving multiple organs, such as the pancreas and salivary and lacrimal glands. The skin lesions of IgG4-RD have been poorly characterized and may stem not only from direct infiltration of plasma cells but also from IgG4-mediated inflammation. Based on the documented cases together with ours, we categorized the skin lesions into seven subtypes: (1) cutaneous plasmacytosis (multiple papulonodules or indurations on the trunk and proximal part of the limbs), (2) pseudolymphoma and angiolymphoid hyperplasia with eosinophilia (plaques and papulonodules mainly on the periauricular, cheek and mandible regions), (3) Mikulicz disease (palpebral swelling, sicca syndrome and exophthalmos), (4) psoriasis-like eruption (strikingly mimicking psoriasis vulgaris), (5) unspecified maculopapular or erythematous eruptions, (6) hypergammaglobulinaemic purpura (bilateral asymmetrical palpable purpuric lesions on the lower extremities) and urticarial vasculitis (prolonged urticarial lesions occasionally with purpura) and (7) ischaemic digit (Raynaud phenomenon and digital gangrene). It is considered that subtypes 1-3 are induced by direct infiltration of IgG4(+) plasma cells, while the other types (4-7) are caused by secondary mechanisms. IgG4-related skin disease is defined as IgG4(+) plasma-cell-infiltrating skin lesions that form plaques, nodules or tumours (types 1-3), but may manifest secondary lesions caused by IgG4(+) plasma cells and/or IgG4 (types 4-7). PMID:25065694

  6. Cutoff Values of Serum IgG4 and Histopathological IgG4+ Plasma Cells for Diagnosis of Patients with IgG4-Related Disease

    Directory of Open Access Journals (Sweden)

    Yasufumi Masaki

    2012-01-01

    Full Text Available IgG4-related disease is a new disease classification established in Japan in the 21st century. Patients with IgG4-related disease display hyper-IgG4-gammaglobulinemia, massive infiltration of IgG4+ plasma cells into tissue, and good response to glucocorticoids. Since IgG4 overexpression is also observed in other disorders, it is necessary to diagnose IgG4-related disease carefully and correctly. We therefore sought to determine cutoff values for serum IgG4 and IgG4/IgG and for IgG4+/IgG+ plasma cells in tissue diagnostic of IgG4-related disease. Patients and Methods. We retrospectively analyzed serum IgG4 concentrations and IgG4/IgG ratio and IgG4+/IgG+ plasma cell ratio in tissues of 132 patients with IgG4-related disease and 48 patients with other disorders. Result. Serum IgG4 >135  mg/dl demonstrated a sensitivity of 97.0% and a specificity of 79.6% in diagnosing IgG4-related disease, and serum IgG4/IgG ratios >8% had a sensitivity and specificity of 95.5% and 87.5%, respectively. IgG4+cell/IgG+ cell ratio in tissues >40% had a sensitivity and specificity of 94.4% and 85.7%, respectively. However, the number of IgG4+ cells was reduced in severely fibrotic parts of tissues. Conclusion. Although a recent unanimous consensus of all relevant researchers in Japan recently established the diagnostic criteria for IgG4-related disease, findings such as ours indicate that further discussion is needed.

  7. Pros and cons of VP1-specific maternal IgG for the protection of Enterovirus 71 infection.

    Science.gov (United States)

    Kim, Young-In; Song, Jae-Hyoung; Kwon, Bo-Eun; Kim, Ha-Neul; Seo, Min-Duk; Park, KwiSung; Lee, SangWon; Yeo, Sang-Gu; Kweon, Mi-Na; Ko, Hyun-Jeong; Chang, Sun-Young

    2015-11-27

    Enterovirus 71 (EV71) causes hand, foot, and mouth diseases and can result in severe neurological disorders when it infects the central nervous system. Thus, there is a need for the development of effective vaccines against EV71 infection. Here we report that viral capsid protein 1 (VP1), one of the main capsid proteins of EV71, efficiently elicited VP1-specific immunoglobulin G (IgG) in the serum of mice immunized with recombinant VP1. The VP1-specific IgG produced in female mice was efficiently transferred to their offspring, conferring protection against EV71 infection immediately after birth. VP1-specific antibody can neutralize EV71 infection and protect host cells. VP1-specific maternal IgG in offspring was maintained for over 6 months. However, the pre-existence of VP1-specific maternal IgG interfered with the production of VP1-specific IgG antibody secreting cells by active immunization in offspring. Therefore, although our results showed the potential for VP1-specific maternal IgG protection against EV71 in neonatal mice, other strategies must be developed to overcome the hindrance of maternal IgG in active immunization. In this study, we developed an effective and feasible animal model to evaluate the protective efficacy of humoral immunity against EV71 infection using a maternal immunity concept. PMID:26529069

  8. Neonatal Fc receptor promotes immune complex-mediated glomerular disease.

    Science.gov (United States)

    Olaru, Florina; Luo, Wentian; Suleiman, Hani; St John, Patricia L; Ge, Linna; Mezo, Adam R; Shaw, Andrey S; Abrahamson, Dale R; Miner, Jeffrey H; Borza, Dorin-Bogdan

    2014-05-01

    The neonatal Fc receptor (FcRn) is a major regulator of IgG and albumin homeostasis systemically and in the kidneys. We investigated the role of FcRn in the development of immune complex-mediated glomerular disease in mice. C57Bl/6 mice immunized with the noncollagenous domain of the α3 chain of type IV collagen (α3NC1) developed albuminuria associated with granular capillary loop deposition of exogenous antigen, mouse IgG, C3 and C5b-9, and podocyte injury. High-resolution imaging showed abundant IgG deposition in the expanded glomerular basement membrane, especially in regions corresponding to subepithelial electron dense deposits. FcRn-null and -humanized mice immunized with α3NC1 developed no albuminuria and had lower levels of serum IgG anti-α3NC1 antibodies and reduced glomerular deposition of IgG, antigen, and complement. Our results show that FcRn promotes the formation of subepithelial immune complexes and subsequent glomerular pathology leading to proteinuria, potentially by maintaining higher serum levels of pathogenic IgG antibodies. Therefore, reducing pathogenic IgG levels by pharmacologic inhibition of FcRn may provide a novel approach for the treatment of immune complex-mediated glomerular diseases. As proof of concept, we showed that a peptide inhibiting the interaction between human FcRn and human IgG accelerated the degradation of human IgG anti-α3NC1 autoantibodies injected into FCRN-humanized mice as effectively as genetic ablation of FcRn, thus preventing the glomerular deposition of immune complexes containing human IgG. PMID:24357670

  9. IgG4-Related Disease without Overexpression of IgG4: Pathogenesis Implications

    OpenAIRE

    Naoshi Nishina; Yuko Kaneko; Masataka Kuwana; Hironari Hanaoka; Hideto Kameda; Shuji Mikami; Tsutomu Takeuchi

    2012-01-01

    IgG4-related disease is a new disease group that affects multiple organs. It is characterized by high serum IgG4 and abundant infiltration of IgG4-bearing plasma cells in the affected organ. Here, we describe an intriguing case that suggested that IgG4-related disease might present without IgG4 overexpression or infiltration, at least during a relapse. A 47-year-old man had been diagnosed with systemic lupus erythematosus 15 years. He was admitted due to a pituitary mass, systemic lymphadenop...

  10. IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy

    OpenAIRE

    Li, Dujuan; Kan, Yunzhen; Fu, Fangfang; Wang, Shuhuan; Shi, Ligang; Liu, Jie; Kong, Lingfei

    2015-01-01

    Immunoglobulin G4-related disease (IgG4-RD) is a recently described inflammatory disease involving multiple organs. Prostate involvement with IgG4-RD is very rare. In this report, we describe a case of IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy. This patient was present with urine retention symptoms. MRI and CT examination revealed the prostatic enlargement and the multiple lymphadenopathy. Serum IgG4 levels were elevated. Prostatic tissue samples resected...

  11. IgG4-related spinal pachymeningitis.

    Science.gov (United States)

    Lu, Zhang; Tongxi, Liu; Jie, Luo; Yujuan, Jiao; Wei, Jiang; Xia, Liu; Yumin, Zheng; Xin, Lu

    2016-06-01

    The aim of this study is to study the clinical, laboratory, imaging pathology, and prognosis features of IgG4-related spinal pachymeningitis. We worked with a 55-year-old man suffering from IgG4-related spinal pachymeningitis who had the most widespread lesion in his dura mater. We also review previous related studies and discuss the clinical characteristics of this rare disease. In total, eight IgG4-related spinal pachymeningitis patients have been reported in the literature since 2009. They were mostly male patients, 51.7 ± 11.9 years old on average. Cervical and thoracic vertebrae were the most common sites for lesions. The most prominent symptom was varying numbness and weakness of the limbs and/or body associated with spinal cord compression. There was one patient (1/5) with elevated serum IgG4 levels and three patients (3/3) with increased cerebrospinal fluid (CSF) IgG4 index. Positive histopathologic findings are the strongest basis for a diagnosis. All the patients with IgG4-related spinal pachymeningitis responded well to glucocorticoid therapy. IgG4-related spinal pachymeningitis is an orphan disease that mainly occurs in cervical and thoracic vertebrae. Older males are the most susceptible group. Serum IgG4 levels were consistently normal in these cases, so analysis of CSF for IgG4 production (IgG4 index) could become a useful tool. Pathological findings remain the gold standard for diagnosis. Most patients responded favorably to glucocorticoid treatment. PMID:26567899

  12. The future of neonatal BCG.

    Science.gov (United States)

    Odent, Michel R

    2016-06-01

    We hypothesise that neonatal BCG (Bacillus Calmette-Guérin) might be used to adapt to a new phase in the history of human births. Among most mammals, the placenta is not effective at transferring antibodies to the fetus: antibodies are transferred immediately after birth via the colostrum. Among humans (and other mammals with hemochorial placentas) the transplacental transfer of antibodies (namely IgG) is effective. In humans, foetal concentrations of IgG sub-classes approximate to maternal concentrations at 38weeks and continue to increase thereafter. These facts explain inter-species differences regarding the basic needs of neonates. Among most mammals, the early colostrum is, strictly speaking, vital. Among humans, the main questions are about the bacteriological environment in the birthing place and how familiar it is to the mother. Today, most human beings are born in unfamiliar bacteriological environments characterized by a low microbial diversity. The effects of clinical environments may be amplified by the use of antibiotics and birth by caesarean, i.e. by-passing the bacteriologically rich perineal zone. There is already an accumulation of data confirming that the maturation of a balanced Th1/Th2 immune response is affected by the mode of delivery. There is also an accumulation of epidemiological studies detecting risk factors in the perinatal period for health conditions such as type 1 diabetes (and other autoimmune diseases), atopy, autism and obesity. In such a context there are reasons to plan randomized controlled trials with long term follow-up of the effects of BCG given immediately after birth, as a modulator of Th-1/Th-2 responses. A follow-up period in the region of 6-10years would be long enough to evaluate the prevalence of several nosologically well defined diseases. These studies would be ethically acceptable, since BCG is the only infancy vaccine that has been evaluated through randomised controlled trials with long term follow

  13. Screening neonatal

    OpenAIRE

    Urbón Artero, Alfonso; Reig del Moral, Celia

    2006-01-01

    Los autores de este artículo revisan el screening neonatal, desde la descripción por Wilson y Jungner en 1968 de los criterios que hansido aplicados en la detección precoz de enfermedades enel recién nacido, hasta los avances actuales en la medicina genómica que han modificado sustancialmente estas bases. Se comentan los métodos diagnósticos prenatales más utilizados como los analíticos y ultrasonografia prenatal. Se describen los procedimientos que se aplican en la actualidad y se describen ...

  14. Adverse effects of IgG therapy.

    Science.gov (United States)

    Berger, Melvin

    2013-01-01

    IgG is widely used for patients with immune deficiencies and in a broad range of autoimmune and inflammatory disorders. Up to 40% of intravenous infusions of IgG may be associated with adverse effects (AEs), which are mostly uncomfortable or unpleasant but often are not serious. The most common infusion-related AE is headache. More serious reactions, including true anaphylaxis and anaphylactoid reactions, occur less frequently. Most reactions are related to the rate of infusion and can be prevented or treated just by slowing the infusion rate. Medications such as nonsteroidal anti-inflammatory drugs, antihistamines, or corticosteroids also may be helpful in preventing or treating these common AEs. IgA deficiency with the potential of IgG or IgE antibodies against IgA increases the risk of some AEs but should not be viewed as a contraindication if IgG therapy is needed. Potentially serious AEs include renal dysfunction and/or failure, thromboembolic events, and acute hemolysis. These events usually are multifactorial, related to combinations of constituents in the IgG product as well as risk factors for the recipient. Awareness of these factors should allow minimization of the risks and consequences of these AEs. Subcutaneous IgG is absorbed more slowly into the circulation and has a lower incidence of AEs, but awareness and diligence are necessary whenever IgG is administered. PMID:24565701

  15. IgG4-related sclerosing disease

    Institute of Scientific and Technical Information of China (English)

    Terumi Kamisawa; Atsutake Okamoto

    2008-01-01

    Based on histological and immunohistochemical examination of various organs of patients with autoimmune pancreatitis (AIP), a novel clinicopathological entity of IgG4-related sclerosing disease has been proposed. This is a systemic disease that is characterized by extensive IgG4-positive plasma cells and T-lymphocyte infiltration of various organs. Clinical manifestations are apparent in the pancreas, bile duct, gallbladder, salivary gland, retroperitoneum, kidney, lung, and prostate, in which tissue fibrosis with obliterative phlebitis is pathologically induced. AIP is not simply pancreatitis but, in fact, is a pancreatic disease indicative of IgG4-related sclerosing diseases. This disease includes AIP, sclerosing cholangitis, cholecystitis, sialadenitis, retroperitoneal fibrosis, tubulointerstitial nephritis, interstitial pneumonia, prostatitis, inflammatory pseudotumor and lymphadenopathy, all IgG4-related. Most IgG4-related sclerosing diseases have been found to be associated with AIP, but also those without pancreatic involvement have been reported. In some cases, only one or two organs are clinically involved, while in others, three or four organs are affected. The disease occurs predominantly in older men and responds well to steroid therapy. Serum IgG4 levels and immunostaining with anti-IgG4 antibody are useful in making the diagnosis. Since malignant tumors are frequently suspected on initial presentation, IgG4-related sclerosing disease should be considered in the differential diagnosis to avoid unnecessary surgery.

  16. Pathologies Associated with Serum IgG4 Elevation

    OpenAIRE

    Mikael Ebbo; Aurélie Grados; Emmanuelle Bernit; Frederic Vély; José Boucraut; Jean-Robert Harlé; Laurent Daniel; Nicolas Schleinitz

    2012-01-01

    Statement of Purpose. IgG4-related disease (IgG4-RD) is usually associated to an increase of serum IgG4 levels. However other conditions have also been associated to high serum IgG4 levels. Methods. All IgG subclasses analyses performed in our hospital over a one-year period were analyzed. When IgG4 level were over 1.35 g/L, the patient’s clinical observation was analyzed and both final diagnosis and reason leading to IgG subclasses analysis were recorded. Only polyclonal increases of IgG4 we...

  17. Neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Angelica Dessì

    2014-06-01

    Full Text Available In this paper on neonatal sepsis, after a short presentation of etiopathogenesis and physiopathology, we will briefly present the clinical picture, the diagnosis and the therapy. Concerning diagnosis, we will focus our attention on procalcitonin (PCT, serum amyloid A (SAA, presepsin (sCD14 and metabolomics. Three practical tables complete the review. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  18. IgG4-related sclerosing disease

    OpenAIRE

    Kamisawa, Terumi; Okamoto, Atsutake

    2008-01-01

    Based on histological and immunohistochemical examination of various organs of patients with autoimmune pancreatitis (AIP), a novel clinicopathological entity of IgG4-related sclerosing disease has been proposed. This is a systemic disease that is characterized by extensive IgG4-positive plasma cells and T-lymphocyte infiltration of various organs. Clinical manifestations are apparent in the pancreas, bile duct, gallbladder, salivary gland, retroperitoneum, kidney, lung, and prostate, in whic...

  19. IgG4-related disease: why high IgG4 and fibrosis?

    OpenAIRE

    Koike, Takao

    2013-01-01

    The hallmarks of IgG4-related disease (IgG4-RD) are lymphoplasmacytic tissue infiltration with a predominance of IgG4-positive plasma cells, accompanied by fibrosis, obliterative phlebitis, dacryoadenitis, and elevated levels of IgG4. In a recent issue of Arthritis Research & Therapy, Tsuboi and colleagues demonstrated that regulatory T (Treg) cell-and T helper 2 (Th2) cell-derived cytokines contribute to the pathogenesis of Mikulicz's disease, an activation pathway that appears to be common ...

  20. Management of a pregnant woman with common variable immunodeficiency and previous reactions to intravenous IgG administration

    OpenAIRE

    Danieli, Maria Giovanna; Moretti, Romina; Pettinari, Lucia; Gambini, Simona

    2012-01-01

    Common variable immunodeficiency is the most common symptomatic primary immunodeficiency in adulthood. Pregnant women with common variable immunodeficiency have different needs from other patients with the same disease. Because of immature state of the fetal and neonatal immune system, transplacental transfer of immunoglobulin G (IgG) has a relevant role in protecting the infant. We here report on a high-risk pregnant woman with common variable immunodeficiency with adverse reactions to intra...

  1. Neonatal neoplasms

    International Nuclear Information System (INIS)

    Purpose: To describe neoplasms diagnosed in children ≤ 28 days of age along with their treatment, associated congenital anomalies, and the long-term consequences of the diagnoses and treatments. Methods and Materials: Utilizing autopsy records, a computerized tumor registry, and medical records, we identified patients and stillborns at Duke University Medical Center (DUMC) diagnosed with neoplasms at ≤ 28 days of age between 1930 and 1998. Results: Twenty-three neonates with neoplasms were identified. There were 7 males (30%) and 16 females (70%). Follow-up of survivors ranged from 4 months to 27 years (mean 9 years). The 20 patients identified via the computerized registry system for 1980-1998 constitute 2% (20/925) of all neoplasms seen in patients ≤ 16 years of age over this same time period at DUMC. The histologic diagnoses were teratoma/germ cell tumor (n = 8, 35%), neuroblastoma (n = 5, 22%), retinoblastoma (n = 4, 17%), primary central nervous system (CNS) tumor (n = 3, 13%), and one case each of rhabdomyosarcoma, glossal glial choristoma, and hemangioma in the setting of Kasabach-Merritt Syndrome. Of the eight teratoma/germ cell tumor patients, 6 were female (75%) and 2 male (25%). There was one malignant germ cell tumor, 2 immature teratomas, and 5 teratomas. Two of the seven patients with immature teratomas or teratoma were long-term survivors following surgery. The one patient with malignant germ cell tumor, treated with surgery and chemotherapy, died. Associated anomalies were imperforate anus, congenital absence of a limb, left ventricular hypertrophy, fusion or absence of toes, coarctation of the aorta, and pulmonary valve dysplasia. Of the five children with neuroblastoma, 4 were female. INSS Stages were 1 (n = 1), 2A (n = 1), 3 (n = 1), and 4S (n = 2). Two were treated with surgery + chemotherapy + radiotherapy; two with surgery + chemotherapy; and one with surgery alone. Four children are long-term survivors. Associated congenital anomalies

  2. Role of intravenous immunoglobulin in suspected or proven neonatal sepsis

    Institute of Scientific and Technical Information of China (English)

    GAUTAM M. K.; JIANG Li

    2013-01-01

    Neonatal sepsis remains the major cause of mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay in newborn infants .Despite of advances in technology and optimal antibiotic tre-atment, incidence of neonatal sepsis and its complications remains unacceptably high especially in developing countries .Premature neonates in particular are at higher risk due to developmentally immature host defence mecha-nisms.Though not approved by Food and Drug Administration ( FDA ) U.S.A, off label use of intravenous immunoglobulin as prophylactic or adjuvant agent in suspected or proven neonatal infections continues in many countries.In a recent large multicenter clinical trial by International Neonatal Immunotherapy Study (INIS) group, the use of polyvalent IgG immune globulin was not associated with significant differences in the risk of major com -plications or other adverse outcomes in neonates with suspected or proven sepsis .Hence, use of intravenous immu-noglobulin in suspected or proven neonatal sepsis is not recommended .The expense of prophylactic use of intrave-nous immunoglobulin administration for both term and preterm newborn population , given the minimal benefit as demonstrated by many individual studies and by meta-analysis is not justified .

  3. A prominent lack of IgG1-Fc fucosylation of platelet alloantibodies in pregnancy.

    Science.gov (United States)

    Kapur, Rick; Kustiawan, Iwan; Vestrheim, Anne; Koeleman, Carolien A M; Visser, Remco; Einarsdottir, Helga K; Porcelijn, Leendert; Jackson, Dave; Kumpel, Belinda; Deelder, André M; Blank, Dennis; Skogen, Björn; Killie, Mette Kjaer; Michaelsen, Terje E; de Haas, Masja; Rispens, Theo; van der Schoot, C Ellen; Wuhrer, Manfred; Vidarsson, Gestur

    2014-01-23

    Immunoglobulin G (IgG) formed during pregnancy against human platelet antigens (HPAs) of the fetus mediates fetal or neonatal alloimmune thrombocytopenia (FNAIT). Because antibody titer or isotype does not strictly correlate with disease severity, we investigated by mass spectrometry variations in the glycosylation at Asn297 in the IgG Fc because the composition of this glycan can be highly variable, affecting binding to phagocyte IgG-Fc receptors (FcγR). We found markedly decreased levels of core fucosylation of anti-HPA-1a-specific IgG1 from FNAIT patients (n = 48), but not in total serum IgG1. Antibodies with a low amount of fucose displayed higher binding affinity to FcγRIIIa and FcγRIIIb, but not to FcγRIIa, compared with antibodies with a high amount of Fc fucose. Consequently, these antibodies with a low amount of Fc fucose showed enhanced phagocytosis of platelets using FcγRIIIb(+) polymorphonuclear cells or FcγRIIIa(+) monocytes as effector cells, but not with FcγRIIIa(-) monocytes. In addition, the degree of anti-HPA-1a fucosylation correlated positively with the neonatal platelet counts in FNAIT, and negatively to the clinical disease severity. In contrast to the FNAIT patients, no changes in core fucosylation were observed for anti-HLA antibodies in refractory thrombocytopenia (post platelet transfusion), indicating that the level of fucosylation may be antigen dependent and/or related to the immune milieu defined by pregnancy. PMID:24243971

  4. Neonatal lupus erythematosus associated with unilateral pectoralis major atrophy.

    Science.gov (United States)

    Mondal, Rakesh; Nandi, Madhumita; Sarkar, Sumantra; Mukherjee, Krishnendu

    2011-11-01

    Neonatal lupus erythematosus (NLE), in most cases, presents with cardiac and dermatological manifestation due to transferred IgG auto antibodies (anti Ro/SSA and anti La/SSB) from the mother. Some unusual associations with myelopathy, vasculopathy, transient myasthenia gravis, congenital nephrotic syndrome, chondrodysplasia punctata etc. are also reported. Here, the authors present a case of NLE with isolated left sided pectoralis major muscle atrophy, which has not been reported earlier. PMID:21553209

  5. Neonatal screening.

    Science.gov (United States)

    Pàmpols, Teresa

    2003-01-01

    Neonatal screening (NS) is a medical act in the context of preventive medicine aimed at the early identification of infants affected by certain conditions that threaten their life and long-term health, for which a timely intervention can lead to a significant reduction of morbidity, mortality and associated disabilities. It emerged three decades ago in the context of prevention of mental retardation. Since then, around 600 inborn metabolic disorders have been described and technological progress has been impressive; nevertheless only around 5% of the disorders have been the object of NS. The most frequently cited reasons for the limitation are low prevalence and the lack of treatment. The tandem mass spectrometry has come in place in recent years across the globe, expanding NS to include several disorders of intermediary metabolism. This has shown, in addition to a prevalence much higher than previously thought, the benefits of early detection. The present work is a review of NS, not only from the point of view of technological/medical achievements, but also considering other factors which will affect specific disease selection, according to the social and organizational infrastructure that may expand the borders of NS. PMID:12921292

  6. Neonatal euthanasia.

    Science.gov (United States)

    Kon, Alexander A

    2009-12-01

    Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts. Due to the realization that some infants suffer unbearably (ie, the burdens of suffering outweigh the benefits of life), the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate. PMID:19914522

  7. Diagnosis of IgG4-related sclerosing cholangitis

    OpenAIRE

    2013-01-01

    IgG4-related sclerosing cholangitis (IgG4-SC) is often associated with autoimmune pancreatitis. However, the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cholangitis (PSC), and the presence of segmental stenosis suggests cholangiocarcinoma (CC). IgG4-SC responds well to steroid therapy, whereas PSC is only effectively treated with liver transplantation and CC requires surgical intervention. Since IgG4-SC was first described, it h...

  8. Screening for IgG4-type anti-nuclear antibodies in IgG4-related disease

    OpenAIRE

    Kiyama, Kazuhiro; Yoshifuji, Hajime; Kandou, Tsugumitsu; Hosono, Yuji; Kitagori, Koji; Nakashima, Ran; Imura, Yoshitaka; Yukawa, Naoichiro; Ohmura, Koichiro; Fujii, Takao; Kawabata, Daisuke; Mimori, Tsuneyo

    2015-01-01

    Background Immunoglobulin (Ig) G4-related disease (IgG4-RD) is characterized by elevated serum IgG4 and infiltration of IgG4+ plasma cells into multiple organs. It is not known whether serum IgG4 is autoreactive in IgG4-RD. Methods We measured anti-nuclear antibody (ANA) in 19 IgG4-RD cases, determined IgG subclasses of the ANA, and compared them with those of other systemic autoimmune diseases (systemic lupus erythematosus, Sjögren’s syndrome, systemic sclerosis, and polymyositis), using sub...

  9. Analysis of IgG4 class switch-related molecules in IgG4-related disease

    OpenAIRE

    Tsuboi, Hiroto; Matsuo, Naomi; Iizuka, Mana; Tsuzuki, Sayaka; Kondo, Yuya; Tanaka, Akihiko; Moriyama, Masafumi; Matsumoto, Isao; Nakamura, Seiji; Sumida, Takayuki

    2012-01-01

    Introduction Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a new disease entity characterized by high serum IgG4 levels, IgG4-positive plasmacytic infiltration, and fibrosis in various organs. The purpose of this study was to determine the mechanism of upregulation of IgG4 class switch recombination in IgG4-RD. Methods We extracted RNA from peripheral blood mononuclear cells (PBMCs) of patients with IgG4-RD (n = 6), Sjögren syndrome (SS) (n = 6), and healthy controls (n = 8), from CD3...

  10. Detection of Serum IgG4 Levels in Patients with IgG4-Related Disease and Other Disorders

    OpenAIRE

    Su, Yuying; Sun, Wei; Wang, Chenqiong; Wu, Xuefen; Miao, Ye; Xiong, Hui; Bai, Lin; Dong, Lingli

    2015-01-01

    Objective Elevated serum IgG4 levels are an important hallmark for diagnosing IgG4-related disease (IgG4-RD), but can also be observed in other diseases. This study aimed to compare two different testing methods for IgG4: ELISA and nephelometric assay. Both assays were used to measure serum IgG4 concentrations, and to assess the prevalence of high serum IgG4 levels in both IgG4-RD and non-IgG4-RD diseases. Methods A total of 80 serum samples were tested using the nephelometric assay and ELISA...

  11. A novel clinical entity, IgG4-related disease (IgG4RD): general concept and details

    OpenAIRE

    Umehara, Hisanori; Okazaki, Kazuichi; Masaki, Yasufumi; Kawano, Mitsuhiro; Yamamoto, Motohisa; Saeki, Takako; Matsui, Shoko; Sumida, Takayuki; Mimori, Tsuneyo; Tanaka, Yoshiya; Tsubota, Kazuo; Yoshino, Tadashi; Kawa, Shigeyuki; Suzuki, Ritsuro; Takegami, Tsutomu

    2011-01-01

    IgG4-related disease (IgG4RD) is a novel clinical disease entity characterized by elevated serum IgG4 concentration and tumefaction or tissue infiltration by IgG4-positive plasma cells. IgG4RD may be present in a certain proportion of patients with a wide variety of diseases, including Mikulicz’s disease, autoimmune pancreatitis, hypophysitis, Riedel thyroiditis, interstitial pneumonitis, interstitial nephritis, prostatitis, lymphadenopathy, retroperitoneal fibrosis, inflammatory aortic aneur...

  12. Histopathology of IgG4-Related Autoimmune Hepatitis and IgG4-Related Hepatopathy in IgG4-Related Disease.

    Science.gov (United States)

    Nakanuma, Yasuni; Ishizu, Yoji; Zen, Yoh; Harada, Kenichi; Umemura, Takeji

    2016-08-01

    Immunoglobulin G4-related disease (IgG4-RD) is a systemic disease involving many organs; it includes IgG4-related sclerosing cholangitis and inflammatory pseudotumor in the hepatobiliary system. Two types of hepatic parenchymal involvement have been reported in IgG4-RD: IgG4-related autoimmune hepatitis (AIH) and IgG4-hepatopathy. Moreover, only three cases of IgG4-related AIH have been reported. Immunoglobulin G4-related AIH is clinicopathologically similar to AIH, except for an elevated serum IgG4 level and heavy infiltration of IgG4-positive plasma cells in the liver tissue. Interestingly, IgG4-related AIH can be complicated by well-known IgG4-RD(s). Immunoglobulin G4-hepatopathy, which includes various histopathological lesions encountered in the liver of patients with type I autoimmune pancreatitis, is classified into five histological categories: portal inflammation, large bile duct damage, portal sclerosis, lobular hepatitis, and cholestasis. Immunoglobulin G4-hepatopathy is currently a collective term covering hepatic lesions primarily or secondarily related to IgG4-related sclerosing cholangitis and type 1 autoimmune pancreatitis. In conclusion, the liver is not immune to IgG4-RD, and at least two types of hepatic involvement in IgG4-RD have been reported: IgG4-related AIH and IgG4-hepatopathy. Additional studies are required to clarify their precise clinical significance with respect to IgG4-RD and inherent liver diseases. PMID:27466793

  13. IgG Subclass Staining in Routine Renal Biopsy Material.

    Science.gov (United States)

    Hemminger, Jessica; Nadasdy, Gyongyi; Satoskar, Anjali; Brodsky, Sergey V; Nadasdy, Tibor

    2016-05-01

    Immunofluorescence staining plays a vital role in nephropathology, but the panel of antibodies used has not changed for decades. Further classification of immunoglobulin (Ig)G-containing immune-type deposits with IgG subclass staining (IgG1, IgG2, IgG3, and IgG4) has been shown to be of diagnostic utility in glomerular diseases, but their value in the evaluation of renal biopsies has not been addressed systematically in large renal biopsy material. Between January 2007 and June 2014, using direct immunofluorescence, we stained every renal biopsy for the IgG subclasses if there was moderate to prominent glomerular IgG staining and/or IgG-predominant or IgG-codominant glomerular staining. The total number of biopsies stained was 1084, which included 367 cases of membranous glomerulonephritis, 307 cases of lupus nephritis, 74 cases of fibrillary glomerulonephritis, 53 cases of proliferative glomerulonephritis with monoclonal IgG deposits, and 25 cases of antiglomerular basement membrane disease, among others. We found that monoclonality of IgG deposits cannot always be reliably determined on the basis of kappa and lambda light chain staining alone, particularly if concomitant (frequently nonspecific) IgM staining is present. In IgG heavy and heavy and light chain deposition disease (3 cases), subclass staining is very helpful, and in proliferative glomerulonephritis with monoclonal IgG deposits subclass staining is necessary. IgG subclass staining is useful in differentiating primary from secondary membranous glomerulonephritis. In proliferative glomerulonephritis with polyclonal IgG deposition, IgG1 dominance/codominance with concomitant IgG3 and IgG2 but weak or absent IgG4 staining favors an underlying autoimmune disease. IgG subclass staining is a very useful diagnostic method in a selected cohort of renal biopsies, particularly in biopsies with glomerulonephritis with monoclonal IgG deposits. PMID:26848798

  14. Purificación de IgG1, IgG2 e IgG3 mediante cromatografía de afinidad a partir de intacglobín Purification of IgG1, IgG2 and IgG3 by affinity chromatography starting from Intacglobin

    OpenAIRE

    Ada A Arce Hernández; Julio C. Merlín Linares; Rinaldo Villaescusa Blanco; Manuel Padilla López; Yamilka González de Armas; Ana M Guerreiro Hernández

    2001-01-01

    Se describe un método de purificación de las subclases IgG1, IgG2 e IgG3 a partir de Intacglobin mediante cromatografía de afinidad con el empleo de proteína A Sepharose y la aplicación de un gradiente lineal de pH. Se detectó la presencia de IgG1, IgG2 e IgG3 en las fracciones eluidas mediante doble inmunodifusión e inmunoelectroforesis, utilizando sueros comerciales anti IgG, anti IgG1, anti IgG2 y anti IgG3. El procedimiento desarrollado se caracterizó por su sencillez, elevada resolución ...

  15. Purificación de IgG1, IgG2 e IgG3 mediante cromatografía de afinidad a partir de intacglobín Purification of IgG1, IgG2 and IgG3 by affinity chromatography starting from Intacglobin

    Directory of Open Access Journals (Sweden)

    Ada A Arce Hernández

    2001-08-01

    Full Text Available Se describe un método de purificación de las subclases IgG1, IgG2 e IgG3 a partir de Intacglobin mediante cromatografía de afinidad con el empleo de proteína A Sepharose y la aplicación de un gradiente lineal de pH. Se detectó la presencia de IgG1, IgG2 e IgG3 en las fracciones eluidas mediante doble inmunodifusión e inmunoelectroforesis, utilizando sueros comerciales anti IgG, anti IgG1, anti IgG2 y anti IgG3. El procedimiento desarrollado se caracterizó por su sencillez, elevada resolución y la relativa pureza de las subclases aisladas. Se logró un rendimiento total del 53,7 %, lo que indica la eficiencia del métodoA method for the purification of IgG1, IgG2, and IgG3 subclasses starting from Intacglobin by affinity chromatography with the use of protein A Sepharose and the application of a lineal gradient of pH is described. IgG1, IgG2 and IgG3 were detected in the eluted fractions by doble immunodifussion and immunoelectrophoresis by using anti IgG, anti IgG1, anti IgG2 and anti IgG3 commercial sera. The procedure developed was characterized by its simplicity, high resolution and the relative purity of the isolated subclasses. A total yield of 53.7 % was attained, which demonstrates the efficiency of this method

  16. IgG4-related kidney disease – an update

    OpenAIRE

    Kawano, Mitsuhiro; Saeki, Takako

    2015-01-01

    Purpose of review IgG4-related disease (IgG4-RD) is a recently recognized systemic inflammatory disorder that can affect most organs/tissues such as sarcoidosis. The kidney is a frequently affected organ with tubulointerstitial nephritis (TIN), the representative lesion of IgG4-RD. This review focuses on the latest knowledge of IgG4-related kidney disease (IgG4-RKD). Recent findings A wide range of renal manifestations of IgG4-RD, that is TIN, membranous glomerulonephritis (MGN) and other glo...

  17. Otologic Manifestation in IgG4-Related Systemic Disease

    OpenAIRE

    Cho, Han-Kyu; Lee, Yun Jong; Chung, Jin-Haeng; Koo, Ja-Won

    2011-01-01

    IgG4-related systemic disease, including autoimmune pancreatitis, is a multi-organ disorder characterized by elevated serum immunoglobulin G4 (IgG4) concentration and IgG4-positive plasma cell infiltration. We report a case of a 66-year-old woman with IgG4-related hearing disorder, presenting with fluctuating mixed hearing loss with middle ear effusion. The serum IgG4 level was elevated and pathological examination revealed dense infiltration of IgG4-positive lymphocyte in the renal parenchym...

  18. SERUM SODIUM CHANGES IN NEONATES RECEIVING PHOTOTHERAPY FOR NEONATAL HYPERBILIRUBINEMIA

    OpenAIRE

    Sunil Kumar; Uday Shankar

    2015-01-01

    BACKGROUND : Neonates receiving phototherapy have side effects like hypocalcemia and electrolyte changes. Our study is hereby intended to study the serum sodium changes due to phototherapy. AIMS : To evaluate the serum sodium changes in neonates receiving phototherapy f or neonatal hyperbilirubinemia. SETTINGS AND DESIGN : A prospective hospital based comparative study conducted on neonates admitted in the Neonatal Intensive Care Unit receiving photot...

  19. Requirements for neonatal cots. Northern Neonatal Network.

    OpenAIRE

    1993-01-01

    A prospective survey of activity in neonatal nurseries associated with 17 specialist maternity units delivering some 38,700 babies in the Northern region was undertaken during 1991. Data were collected concerning the numbers of babies requiring various forms of neonatal care, using a nursing dependency scale validated by work study. Facilities for prolonged high dependency care are partially decentralised in the Northern region, with a network of five units operating on a flexible and collabo...

  20. Development of an IgG4-RD Responder Index

    OpenAIRE

    Arezou Khosroshahi; Carruthers, Mollie N.; Vikram Deshpande; John H. Stone

    2012-01-01

    IgG4-related disease (IgG4-RD) is a multiorgan inflammatory disease in which diverse organ manifestations are linked by common histopathological and immunohistochemical features. Prospective studies of IgG4-RD patients are required to clarify the natural history, long-term prognosis, and treatment approaches in this recently recognized condition. Patients with IgG4-RD have different organ manifestations and are followed by multiple specialties. Divergent approaches to the assessment of patien...

  1. IgG4-related Disease of the Genitourinary Tract

    OpenAIRE

    Divatia, Mukul K; Ro, Jae Y.

    2014-01-01

    IgG4-related disease (IgG4-RD) is a recently established albeit well recognized fibro-inflammatory condition with distinctive features including a characteristic histopathological appearance; a propensity to develop tumefactive lesions in multiple body sites; and oft elevated serum IgG4 levels. The consensus statement on IgG-4 RD equips practicing pathologists with a set of working guidelines for the diagnosis of pathologic lesions identified in a host of different organ system affected with ...

  2. Glycosylation of plasma IgG in colorectal cancer prognosis

    OpenAIRE

    Evropi Theodoratou; Kujtim Thaçi; Felix Agakov; Timofeeva, Maria N.; Jerko Štambuk; Maja Pučić-Baković; Frano Vučković; Peter Orchard; Anna Agakova; DIN, FARHAT V. N.; Ewan Brown; Rudd, Pauline M; Susan M. Farrington; Dunlop, Malcolm G; Harry Campbell

    2016-01-01

    In this study we demonstrate the potential value of Immunoglobulin G (IgG) glycosylation as a novel prognostic biomarker of colorectal cancer (CRC). We analysed plasma IgG glycans in 1229 CRC patients and correlated with survival outcomes. We assessed the predictive value of clinical algorithms and compared this to algorithms that also included glycan predictors. Decreased galactosylation, decreased sialylation (of fucosylated IgG glycan structures) and increased bisecting GlcNAc in IgG glyca...

  3. IgG4-related Disease of the Genitourinary Tract

    Directory of Open Access Journals (Sweden)

    Mukul K. Divatia

    2014-02-01

    Full Text Available IgG4-related disease (IgG4-RD is a recently established albeit well recognized fibro-inflammatory condition with distinctive features including a characteristic histopathological appearance; a propensity to develop tumefactive lesions in multiple body sites; and oft elevated serum IgG4 levels. The consensus statement on IgG-4 RD equips practicing pathologists with a set of working guidelines for the diagnosis of pathologic lesions identified in a host of different organ system affected with this disease. The diagnosis of IgG4-RD requires the combined presence of the characteristic histopathological appearance and increased numbers of IgG4-positive plasma cells. The essential histopathological features include a dense lymphoplasmacytic infiltrate, a storiform pattern of fibrosis, and obliterative phlebitis. Tissue IgG4-positive plasma cell counts and IgG4: IgG ratios are significant ancillary aids in establishing the diagnosis. The spectrum of IgG4-RD continues to expand and involve multiple body sites. The genitourinary system comprising of the kidneys, ureters, urinary bladder, urethra, prostate gland, testes and penis is one of the multiple organ systems to be affected by IgG4-RD. This review describes the clinical and histopathologic patterns of involvement of the genitourinary system by IgG4-RD, in association with serologic and radiological features. [J Interdiscipl Histopathol 2014; 2(1.000: 3-18

  4. Permanent neonatal diabetes mellitus

    OpenAIRE

    Al-Matary, Abdulrahman; Hussain, Mushtaq; Nahari, Ahmed; Ali, Jaffar

    2012-01-01

    Summary Background: Neonatal diabetes is a rare cause of hyperglycemia, affecting 1: 500,000 births, with persistent hyperglycemia occurring in the first months of life lasting more than 2 weeks and requiring insulin. This condition in infants less than 6 months of age is considered as permanent neonatal diabetes mellitus. Case Report: A rare case of permanent neonatal diabetes mellitus presented with intrauterine growth retardation (IUGR; birth weight: 1460 grams; female), hyperglycemia, gly...

  5. Diagnostic Performance of Serum IgG4 Levels in Patients With IgG4-Related Disease

    OpenAIRE

    Yu, Kuang-Hui; Chan, Tien-Ming; Tsai, Ping-Han; Chen, Ching-Hui; Chang, Pi-Yueh

    2015-01-01

    Abstract The aim of this study is to study the clinical features and diagnostic performance of IgG4 in Chinese populations with IgG4-related diseases (IgG4-RDs). The medical records of 2901 adult subjects who underwent serum IgG4 level tests conducted between December 2007 and May 2014 were reviewed. Serum concentrations of IgG4 were measured in 2901 cases, including 161 (5.6%) patients with IgG4-RD and 2740 (94.4%) patients without IgG4-RD (non-IgG4-RD group). The mean age of the IgG4-RD pat...

  6. Neonatal abstinence syndrome

    Science.gov (United States)

    ... JR, Isemann B, Ward LP, et al. Current management of neonatal abstinence syndrome secondary to ... MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of ...

  7. Asma y deficiencia de subclases de IgG Asthma and IgG subclases deficiency

    Directory of Open Access Journals (Sweden)

    Lucía Santamaría Ortiz

    1995-04-01

    Full Text Available

    Se estudiaron 45 pacientes asmáticos adultos de difícil manejo, de más de 5 años de evolución, 37 de ellos esteroide dependientes y 8 no dependientes, con asma alérgica o intrínseca y algunos con Infecciones respiratorias recurrentes de predominio viral. Por nefelometría se midieron los niveles séricos de las IgsG, M y A, y por ELISA se determinó la IgE total. Se encontraron 4 pacientes con deficiencia de IgG total, en el grupo de los esteroide dependientes. Mediante ELISA tipo sandwich y con anticuerpos monoclonales específicos para las sub clases de IgG se investigaron los niveles sé ricos de IgG1, 2, 3 y 4. En el 55.6% de los enfermos se encontraron una O más deficiencias de sub clases. No hubo diferencias significativas entre los grupos esteroide y no esteroide dependientes, ni entre los asmáticos alérgicos e intrínsecos, ni entre los con infección recurrente o sin ella. predominó la deficiencia de IgG1; en total el 46.7% de los pacientes tenían deficiencia aislada o combinada de IgG1, el 31.1% de IgG2, el 24.4% de IgG3 y el 17.8% de Igd4. La alta incidencia de deficiencia de sub clases podría deberse a la acción de los esteroides o a una alteración en la regulación de la síntesis de Igs producida por un defecto Inmune primario. Esta deficiencia sería la responsable del comportamiento agresivo de la enfermedad.

    We studied 45 adult asthmatic patients with difficult to care disease and who had more than five years of evolution; they suffered from elther allergic or intrinsic asthma and some had experienced recurrent respiratory tract infections. predominantly of viral etiology. Serum levels of IgA, IgG and IgM were measured by nephelometry and total lgE was determined by an Enzyme-Linked immunosorbent Assay (ELISA. Total lg

  8. IgG4-related sialadenitis: IgG4 is helpful, but biopsies are still crucial

    OpenAIRE

    Witte, Torsten; Schulze-Koops, Hendrik

    2015-01-01

    IgG4-related disease is rare, but a frequent differential diagnosis for malignant and for autoimmune diseases. Li and colleagues report the largest cohort of patients with IgG4-related sialadenitis. The observations reveal that the most important diagnostic step is obtaining biopsies. In addition, the IgG4 serum concentration may be a biomarker for the disease progression.

  9. Diagnostic performance of serum IgG4 level for IgG4-related disease: a meta-analysis.

    Science.gov (United States)

    Xu, Wen-Long; Ling, Ying-Chun; Wang, Zhi-Kai; Deng, Fang

    2016-01-01

    An elevated serum IgG4 level is one of the most useful factors in the diagnosis of IgG4-related disease (IgG4-RD). In this study, we performed a meta-analysis of the published articles assessing the diagnostic accuracy of serum IgG4 concentrations for IgG4-RD. The databases of MEDLINE/PubMed, EMBASE and Web of Science were systematically searched for relevant studies. Sensitivities and specificities of serum IgG4 in each study were calculated, and the hierarchical summary receiver operating characteristic (HSROC) model with a random effects model were employed to obtain the individual and pooled estimates of sensitivities and specificities. In total, twenty-three studies comprising 6048 patients with IgG4-RD were included in the meta-analysis. The pooled sensitivity was 85% with a 95% confidence interval (CI) of 78-90%; the pooled specificity was 93% with a 95% CI of 90-95%. The HSROC curve for quantitative serum IgG4 lies closer to the upper left corner of the plot, and the area under the curve (AUC) was 0.95 (95% CI 0.93, 0.97), which suggested a high diagnostic accuracy of serum IgG4 for the entity of IgG4-RD. Our study suggests that serum IgG4 has high sensitivity and specificity in the diagnosis of IgG4-RD. PMID:27558881

  10. Cholangiocarcinoma with respect to IgG4 Reaction

    OpenAIRE

    Kenichi Harada; Yasuni Nakanuma

    2014-01-01

    IgG4 reactions marked by infiltration of IgG4-positive plasma cells in affected organs occur in cancer patients and in patients with IgG4-related diseases. Extrahepatic cholangiocarcinomas including gall bladder cancer are often accompanied by significant IgG4 reactions; these reactions show a negative correlation with CD8-positive cytotoxic T cells, suggesting that the evasion of immune surveillance is associated with cytotoxic T cells. The regulatory cytokine IL-10 may induce IgG4-positive ...

  11. Isolated intrapancreatic IgG4-related sclerosing cholangitis

    OpenAIRE

    Nakazawa, Takahiro; Ikeda, Yushi; Kawaguchi, Yoshiaki; KITAGAWA, HIROHISA; Takada, Hiroki; Takeda, Yutaka; Makino, Isamu; Makino, Naohiko; Naitoh, Itaru; Tanaka, Atsushi

    2015-01-01

    Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is frequently associated with type 1 autoimmune pancreatitis (AIP). Association with AIP can be utilized in the diagnosis of IgG4-SC. However, some cases of IgG4-SC are isolated from AIP, which complicates the diagnosis. Most of the reported cases of isolated IgG4-SC displayed hilar biliary strictures, whereas isolated IgG4-SC with intrapancreatic biliary stricture is very rare. Recently, we have encountered 5 isolated intrapancreatic...

  12. IgG4-Associated Cholangitis Can Mimic Hilar Cholangiocarcinoma

    OpenAIRE

    Zaydfudim, Victor M.; Andrew Y Wang; de Lange, Eduard E.; Zhao, Zimin; Moskaluk, Christopher A.; Bauer, Todd W.; Adams, Reid B

    2015-01-01

    IgG4-associated cholangitis can mimic hilar cholangiocarcinoma. Previously reported patients with IgG4-associated cholangitis mimicking cholangiocarcinoma had elevated serum IgG4 levels and long-segment biliary strictures. However, in the absence of other diagnostic criteria for malignancy, IgG4-associated cholangitis should remain a consideration among patients with normal serum IgG4 and a hilar mass suspicious for cholangiocarcinoma. The presence of a hilar mass and a malignant-appearing bi...

  13. IgG4-Related Disease: A Multispecialty Condition

    OpenAIRE

    2014-01-01

    IgG4-related disease (IgG4-RD) is a recently recognized group of conditions, characterized by tumor-like swelling of involved organs, lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, variable degrees of fibrosis, and elevated serum IgG4 concentrations. Currently IgG4-RD is recognized as a systemic condition that can affect several organs and tissues. Herein we report the case of a 34-year-old male patient who was admitted to our hospital with diffuse abdominal pain, weight los...

  14. Effect of gut active carbohydrates on plasma IgG concentrations in piglets and calves.

    Science.gov (United States)

    Lazarevic, M; Spring, P; Shabanovic, M; Tokic, V; Tucker, L A

    2010-06-01

    Improving immune status in neonates is crucial to health and production. Gut active carbohydrates (GAC) have been associated with increasing immunoglobin levels and immonucompetence development in mammals. The objective of the following studies was to evaluate whether GAC (mannan-oligosaccharides) applied orally to progeny immediately following parturition, improved blood plasma immunoglobulin (Ig) type G concentrations in piglets and calves. Three trials were conducted comparing control groups with those receiving GAC orally. The first two trials used piglets that were monitored for blood IgG at 2 days of age and for changes in body weight (BW), and the third trial monitored calf IgG from birth to 21 days of age. Piglets in the experimental group received 0.75 g GAC in 10 ml saline at birth and 24 h of age. The calf trial compared the control group against calves that received 22.5 g GAC mixed into 4.5 l of colostrum (to give 5 g/l) in the first 24 h after parturition. Blood serum samples were taken at 2 days post partum in piglets, and at several time points from 6 h to 21 days of age in calves, and were analysed for IgG levels by radial immunodiffusion. In the first piglet trial, significantly higher levels (32%) of IgG were observed for piglets fed GAC (P < 0.001), and in the second, IgG concentration was elevated by 23% (P < 0.01) and BW increased by 9% (P = 0.023) with GAC supplementation. Significant improvements for calves were recorded at all time points in those fed GAC (P < 0.05), with an increase in serum IgG observed after the first day, which was maintained throughout the sampling period, resulting in a difference of 39% at the end of the trial (21 d). These findings form a basis for further studies, which are required to investigate possible modes of action involved in enhancing blood immunoglobulin concentrations in young animals, and the longer-term effects this may have on the development of the immune response. PMID:22444266

  15. NEONATAL TOBACCO SYNDROME

    OpenAIRE

    R A Kireev; A.I.Popovsky; M.V. Ershova; L.G. Bochkova

    2008-01-01

    The objective of the research is to study neonatal adaptation in new-born children from the tobacco abused mothers. A comparative analysis of clinical and neuroendochnal status and lipid metabolism in new-born children from smoking and non-smoking mothers was carried out Neonatal adaptation disorders were revealed in new-born children from the smoking mothers.

  16. NEONATAL TOBACCO SYNDROME

    Directory of Open Access Journals (Sweden)

    R.A.Kireev

    2008-12-01

    Full Text Available The objective of the research is to study neonatal adaptation in new-born children from the tobacco abused mothers. A comparative analysis of clinical and neuroendochnal status and lipid metabolism in new-born children from smoking and non-smoking mothers was carried out Neonatal adaptation disorders were revealed in new-born children from the smoking mothers.

  17. Distress respiratorio neonatal

    OpenAIRE

    Pastor Durán, Xavier

    1985-01-01

    PROTOCOLOS TERAPÉUTICOS. Distress respiratorio neonatal. El distress respiratorio neonatal puede ser una situación grave que llegue a poner en peligro la vida del recién nacido. 1) Diagnóstico. Es fundamentalmente clínico y se establece cuando el test de Silverman es superior a 2...

  18. Management of a pregnant woman with common variable immunodeficiency and previous reactions to intravenous IgG administration.

    Science.gov (United States)

    Danieli, Maria Giovanna; Moretti, Romina; Pettinari, Lucia; Gambini, Simona

    2012-01-01

    Common variable immunodeficiency is the most common symptomatic primary immunodeficiency in adulthood. Pregnant women with common variable immunodeficiency have different needs from other patients with the same disease. Because of immature state of the fetal and neonatal immune system, transplacental transfer of immunoglobulin G (IgG) has a relevant role in protecting the infant. We here report on a high-risk pregnant woman with common variable immunodeficiency with adverse reactions to intravenous immunoglobulin that was successfully rescued with a new Ig human intravenous, 10% liquid preparation. The treatment was tailored to the health status and characteristics of the patient. The new product was safe and well tolerated. The mother did not report any infections during pregnancy and the baby had a healthy course with 'protective' serum IgG levels. Our case is a further demonstration that intravenous immunoglobulin tolerability in patients with immunodeficiency could be linked to a product's characteristics. PMID:23257273

  19. Neonatal diabetes mellitus

    OpenAIRE

    Aydın, Mustafa; Zenciroğlu, Ayşegül; Aycan, Zehra; Çetinkaya, Semra; Hakan, Nilay; Okumuş, Nurullah; Karagöl, Belma Saygılı; Gündüz, Ramiz Coşkun

    2012-01-01

    Neonatal diabetes is a monogenic disease causing cellular and functional defects in pancreatic beta; cells seen at first six months of life It has an estimated prevalence of 1 in 400 000 500 000 live births Mutations in KCNJ11 ABCC8 and INS are the cause of neonatal diabetes mellitus in about 50 of patients We present a rare case of neonatal diabetes mellitus in the light of literature A 32 day old male infant born at 37th weeks of gestation with a 1400 g birth weight was referred us because ...

  20. Oral Lesions in Neonates

    Science.gov (United States)

    Rao, Roopa S; Majumdar, Barnali; Jafer, Mohammed; Maralingannavar, Mahesh; Sukumaran, Anil

    2016-01-01

    ABSTRACT Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138. PMID:27365934

  1. The neonatal chest

    Energy Technology Data Exchange (ETDEWEB)

    Lobo, Luisa [Servico de Imagiologia Geral do Hospital de Santa Maria, Av. Prof. Egas Moniz, 1649-035 Lisbon (Portugal)]. E-mail: mluisalobo@gmail.com

    2006-11-15

    Lung diseases represent one of the most life threatening conditions in the newborn. Important progresses in modern perinatal care has resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes are presented.

  2. The neonatal chest

    International Nuclear Information System (INIS)

    Lung diseases represent one of the most life threatening conditions in the newborn. Important progresses in modern perinatal care has resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes are presented

  3. The different effector function capabilities of the seven equine IgG subclasses have implications for vaccine strategies.

    Science.gov (United States)

    Lewis, Melanie J; Wagner, Bettina; Woof, Jenny M

    2008-02-01

    Recombinant versions of the seven equine IgG subclasses were expressed in CHO cells. All assembled into intact immunoglobulins stabilised by disulphide bridges, although, reminiscent of human IgG4, a small proportion of equine IgG4 and IgG7 were held together by non-covalent bonds alone. All seven IgGs were N-glycosylated. In addition IgG3 appeared to be O-glycosylated and could bind the lectin jacalin. Staphylococcal protein A displayed weak binding for the equine IgGs in the order: IgG1>IgG3>IgG4>IgG7>IgG2=IgG5>IgG6. Streptococcal protein G bound strongly to IgG1, IgG4 and IgG7, moderately to IgG3, weakly to IgG2 and IgG6, and not at all to IgG5. Analysis of antibody effector functions revealed that IgG1, IgG3, IgG4, IgG5 and IgG7, but not IgG2 and IgG6, were able to elicit a strong respiratory burst from equine peripheral blood leukocytes, predicting that the former five IgG subclasses are able to interact with Fc receptors on effector cells. IgG1, IgG3, IgG4 and IgG7, but not IgG2, IgG5 and IgG6, were able to bind complement C1q and activate complement via the classical pathway. The differential effector function capabilities of the subclasses suggest that, for maximum efficacy, equine vaccine strategies should seek to elicit antibody responses of the IgG1, IgG3, IgG4, and IgG7 subclasses. PMID:17669496

  4. Serum IgG Subclasses in Autoimmune Diseases

    OpenAIRE

    Zhang, Haoze; Ping LI; Wu, Di; Xu, Dong; Hou, Yong; Qian WANG; Li, Mengtao; Li, Yongzhe; Zeng, Xiaofeng; Zhang, Fengchun; Shi, Qun

    2015-01-01

    Abstract To characterize serum IgG subclass levels in several autoimmune diseases, including primary Sjogren syndrome (pSS), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), and primary biliary cirrhosis (PBC). We aimed to analyze serum IgG subclass distribution and to test whether serum IgG4 levels are elevated in these diseases. Serum IgG subclass levels from 102 pSS, 102 SSc, 100 SLE, and 59 PBC patients, as well as 40 healthy controls (HCs), were measured using the immunoneph...

  5. IgG4 Inflammatory Pseudotumor of the Kidney

    OpenAIRE

    Ahmed N. Alkhasawneh; Allan, Robert W.

    2012-01-01

    Hyper-IgG4 disease is a rare systemic disorder that usually affects middle age males. It is characterized by elevated serum IgG4 levels and infiltration of organs by IgG4 positive plasma cells associated with fibrosis. Patients usually present with mass or masses in the involved organ that mimic neoplasia. While initially described in the pancreas, IgG4-related inflammatory tumors have been now described in many organs. We describe an unusual case of an IgG4-related pseudotumor of the kidney.

  6. Diagnosis of IgG4-related sclerosing cholangitis

    Directory of Open Access Journals (Sweden)

    Shuya Simizu

    2013-01-01

    Full Text Available IgG4-related sclerosing cholangitis (IgG4-SC is often associated with autoimmune pancreatitis. However, the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cholangitis (PSC, and the presence of segmental stenosis suggests cholangiocarcinoma (CC. IgG4-SC responds well to steroid therapy, whereas PSC is only effectively treated with liver transplantation and CC requires surgical intervention. Since IgG4-SC was first described, it has become a third distinct clinical entity of sclerosing cholangitis. The aim of this review was to introduce the diagnostic methods for IgG4-SC. IgG4-SC should be carefully diagnosed based on a combination of characteristic clinical, serological, morphological, and histopathological features after cholangiographic classification and targeting of a disease for differential diagnosis. When intrapancreatic stenosis is detected, pancreatic cancer or CC should be ruled out. If multiple intrahepatic stenoses are evident, PSC should be distinguished on the basis of cholangiographic findings and liver biopsy with IgG4 immunostaining. Associated inflammatory bowel disease is suggestive of PSC. If stenosis is demonstrated in the hepatic hilar region, CC should be discriminated by ultrasonography, intraductal ultrasonography, bile duct biopsy, and a higher cutoff serum IgG4 level of 182 mg/dL.

  7. Neonatal Cerebral Sinovenous Thrombosis

    OpenAIRE

    J Gordon Millichap

    2006-01-01

    The presentation, treatment, and outcome of neonatal cerebral sinovenous thrombosis (SVT) were studied in 42 children, using neurology clinic records (1986-2005) at Indiana University School of Medicine.

  8. Neonatal herpes simplex pneumonia.

    OpenAIRE

    Lissauer, T J; Shaw, P. J.; Underhill, G

    1984-01-01

    A neonate with herpes simplex pneumonia is described. Herpes simplex infection should be considered in the differential diagnosis of pneumonia in newborn infants, even in the absence of clinically apparent herpes in the mother.

  9. Neonatal pain management

    Directory of Open Access Journals (Sweden)

    Tarun Bhalla

    2014-01-01

    Full Text Available The past 2-3 decades have seen dramatic changes in the approach to pain management in the neonate. These practices started with refuting previously held misconceptions regarding nociception in preterm infants. Although neonates were initially thought to have limited response to painful stimuli, it was demonstrated that the developmental immaturity of the central nervous system makes the neonate more likely to feel pain. It was further demonstrated that untreated pain can have long-lasting physiologic and neurodevelopmental consequences. These concerns have resulted in a significant emphasis on improving and optimizing the techniques of analgesia for neonates and infants. The following article will review techniques for pain assessment, prevention, and treatment in this population with a specific focus on acute pain related to medical and surgical conditions.

  10. Neonatal Monitoring System

    Directory of Open Access Journals (Sweden)

    L. Suresh

    2014-07-01

    Full Text Available Childbirth is generally time of joy for parents and families. As per the medical reports each year 4 million newborns die within 28 days of birth and more suffer from disability, disease, infection and injury. The enabling environment for safe childbirth depends on the care and attention required to newborns by health personnel and the availability of adequate health-care facilities, equipment, and medicines and emergency care when needed. Neonatal monitoring refers to the monitoring of vital physiological parameters of premature infants. Continuous health monitoring of the neonates provides crucial parameters for early detection of adverse events. Health monitoring for the neonates provides crucial parameters for urgent diagnoses and corresponding medical procedures, subsequently increasing the survival rates. In the present paper, we propose a proto type design of a neonatal monitoring system. The system is designed and integrated with different health measurement and display devices. The prototype design is very much useful for monitor the physiological parameters of infants.

  11. Sonomammography in Neonatal Mastauxe

    Directory of Open Access Journals (Sweden)

    Sushil Ghanshyam Kachewar

    2015-03-01

    Full Text Available Prominence or even enlargement of one or both breasts is known in neonates. It is believed to be a physiological response to falling levels of maternal estrogen towards last trimester of pregnancy. This input stimulates prolactin release from the newborn's pituitary leading to transient neonatal breast enlargement. This phenomenon is independent of the gender of the neonate. It presents in the first few weeks of life and resolves subsequently. Often fluid discharge is noted from the prominent or swollen breast that resolves without treatment in subsequent weeks. Manual breast manipulation for discharge removal may lead to undesirable effects like local irritation, enhanced enlargement, prolonged tissue hypertropy or even mastitis. A case of such 7-days female neonate is presented here backed with imaging evaluation for confirmation of diagnosis. Typical sonomammographic findings are described. [Cukurova Med J 2015; 40(Suppl 1: 22-24

  12. Baby Acne (Neonatal Acne)

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Baby Acne (Neonatal Acne) A parent's guide for infants and babies A A A Acne whiteheads and bumps (papules) typically involve the forehead ...

  13. Neonatal orbital abscess

    Directory of Open Access Journals (Sweden)

    Khalil M Al-Salem

    2014-01-01

    Full Text Available Orbital complications due to ethmoiditis are rare in neonates. A case of orbital abscess due to acute ethmoiditis in a 28-day-old girl is presented. A Successful outcome was achieved following antimicrobial therapy alone; spontaneous drainage of the abscess occurred from the lower lid without the need for surgery. From this case report, we intend to emphasize on eyelid retraction as a sign of neonatal orbital abscess, and to review all the available literature of similar cases.

  14. Neonatal Stroke : Risk Factors

    OpenAIRE

    2005-01-01

    Neonatal stroke refers to cerebrovascular events between 28 weeks of gestational age and 28 days postnatal and includes thromboembolic cerebral infarction and all kinds of intracranial haemorrhage. Neonatal stroke may contribute to severe neurological deficit, such as cerebral palsy and even death. International reports suggest the incidence to be approximately 1/4000 live births per year (1). There are several etiological hypothesises regarding risk factors, such as maternal, obstetrical...

  15. Detection of IgG1 and IgG4 subtypes reactive against potato apyrase in schistosomiasis patients

    Directory of Open Access Journals (Sweden)

    Priscila de Faria-Pinto

    2010-07-01

    Full Text Available In this paper, we showed for the first time that the conserved domains within Schistosoma mansoni ATP diphosphohydrolase isoforms, shared with potato apyrase, possess epitopes for the IgG1 and IgG4 subtypes, as 24 (80% of the 30 schistosomiasis patients were seropositive for this vegetable protein. The analyses for each patient cured (n = 14 after treatment (AT with praziquantel revealed variable IgG1 and IgG4 reactivity against potato apyrase. Different antigenic epitopes shared between the vegetable and parasite proteins could be involved in susceptibility or resistance to S. mansoni AT with praziquantel and these possibilities should be explored.

  16. Charge variants in IgG1

    Science.gov (United States)

    Goswami, Sirj; Hutchinson, Ryan; Kwong, Zephania W; Yang, Jihong; Wang, Xiangdan; Yao, Zhenling; Sreedhara, Alavattam; Cano, Tony; Tesar, Devin; Nijem, Ihsan; Allison, David E; Wong, Pin Yee; Kao, Yung-Hsiang; Quan, Cynthia; Joshi, Amita; Harris, Reed J; Motchnik, Paul

    2010-01-01

    Antibody charge variants have gained considerable attention in the biotechnology industry due to their potential influence on stability and biological activity. Subtle differences in the relative proportions of charge variants are often observed during routine biomanufacture or process changes and pose a challenge to demonstrating product comparability. To gain further insights into the impact on biological activity and pharmacokinetics (PK) of monoclonal antibody (mAb) charge heterogeneity, we isolated the major charge forms of a recombinant humanized IgG1 and compared their in vitro properties and in vivo PK. The mAb starting material had a pI range of 8.7–9.1 and was composed of about 20% acidic variants, 12% basic variants and 68% main peak. Cation exchange displacement chromatography was used to isolate the acidic, basic and main peak fractions for animal studies. Detailed analyses were performed on the isolated fractions to identify specific chemical modification contributing to the charge differences and were also characterized for purity and in vitro potency prior to being administered either subcutaneously (SC) or intravenously (IV) in rats. All isolated materials had similar potency and rat FcRn binding relative to the starting material. Following IV or SC administration (10 mg/kg) in rats, no difference in serum PK was observed, indicating that physiochemical modifications and pI differences among charge variants were not sufficient to result in PK changes. Thus, these results provided meaningful information for the comparative evaluation of charge-related heterogeneity of mAbs and suggested that charge variants of IgGs do not affect the in vitro potency, FcRn binding affinity or the PK properties in rats. PMID:20818176

  17. Neonatal stroke: Neonatal neuroimaging & brain plasticity

    OpenAIRE

    van der Aa, N.E.

    2013-01-01

    Despite major improvements in perinatal care, perinatal stroke remains a severe problem of the newborn and is commonly encountered in the care of these infants in the neonatal intensive care setting. The reported incidence of perinatal arterial ischemic stroke (PAIS) varies from 1:1600-1:5000, and most likely depends on how often neuroimaging studies are performed. Periventricular haemorrhagic infarction (PVHI) has a lower incidence, but still occurs in 1-10% of the very preterm born infants,...

  18. IgG4 disease: The great masquerader.

    Science.gov (United States)

    Yadav, Divya; Liu, Xiuli; Chahal, Prabhleen

    2016-06-01

    Systemic IgG4 disease can have a wide spectrum of clinical presentation, which can mimic several other disease entities. In this report, we describe a series of two patients with IgG4-related disease who were referred to us initially with the diagnosis of acute cholecystitis and the second patient with metastatic pancreatic adenocarcinoma with peritoneal metastasis respectively. PMID:26164258

  19. IgG4-Related Disease: A Multispecialty Condition

    Directory of Open Access Journals (Sweden)

    Iuri Usêda Santana

    2014-01-01

    Full Text Available IgG4-related disease (IgG4-RD is a recently recognized group of conditions, characterized by tumor-like swelling of involved organs, lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, variable degrees of fibrosis, and elevated serum IgG4 concentrations. Currently IgG4-RD is recognized as a systemic condition that can affect several organs and tissues. Herein we report the case of a 34-year-old male patient who was admitted to our hospital with diffuse abdominal pain, weight loss, and painful stiffness in his neck. He had a history of tumoral mass of the left maxillary region, right palpebral ptosis with protrusion of the eyeball, and chronic dry cough for about 6 years. Laboratory tests revealed polyclonal hypergammaglobulinemia and increased serum IgG4 levels. Immunohistochemical staining of the maxillary biopsy was compatible with IgG4-RD. He had an excellent response to corticosteroid therapy. This case highlights that IgG4-RD should be included in the differential diagnosis with multisystem diseases.

  20. IgG glycosylation changes and MBL2 polymorphisms

    DEFF Research Database (Denmark)

    Troelsen, Lone N; Jacobsen, Søren; Abrahams, Jodie L;

    2012-01-01

    To examine whether IgG glycosylation changes and MBL2 genotypes are associated with systemic inflammation and joint destruction in rheumatoid arthritis (RA).......To examine whether IgG glycosylation changes and MBL2 genotypes are associated with systemic inflammation and joint destruction in rheumatoid arthritis (RA)....

  1. Clinical study on IgG4-related autoimmune pancreatitis

    Institute of Scientific and Technical Information of China (English)

    吴庆军

    2013-01-01

    Objective To investigate the clinical features of IgG4-related autoimmune pancreatitis(IgG4-related AIP). Methods A prospective cohort study on IgG4 related disease(IgG4-RD) was carried out in Peking Union Medical College Hospital during December 2010 to June

  2. The value of neonatal autopsy.

    LENUS (Irish Health Repository)

    Hickey, Leah

    2012-01-01

    Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals.

  3. Bacterial Culture of Neonatal Sepsis

    OpenAIRE

    AH Movahedian; R Moniri; Z Mosayebi

    2006-01-01

    Neonatal bacterial sepsis is one of the major cause of morbidity and mortality in neonates. This retrospective study was performed to determine the incidence of bacterial sepsis with focus on Gram negative organisms in neonates admitted at Beheshti Hospital in Kashan, during a 3-yr period, from September 2002 to September 2005. Blood culture was performed on all neonates with risk factors or signs of suggestive sepsis. Blood samples were cultured using brain heart infusion (BHI) broth accordi...

  4. Regulation of immune responses by the neonatal Fc receptor and its therapeutic implications

    Directory of Open Access Journals (Sweden)

    Timo eRath

    2015-01-01

    Full Text Available As a single receptor, the neonatal Fc receptor (FcRn is critically involved in regulating albumin and IgG serum concentrations by protecting these two ligands from degradation. In addition to these essential homeostatic functions, FcRn possesses important functions in regulating immune responses that are equally as critical and are increasingly coming to attention. During the first stages of life, FcRn mediates the passive transfer of IgG across the maternal placenta or neonatal intestinal walls of mammals, thereby conferring passive immunity to the offspring before and after birth. In fact, FcRn is one of the very few molecules that is known to move from luminal to serosal membranes of polarized cells that form epithelial barriers of the lung and intestines. Together with FcRn’s recently explored critical role in eliciting MHC II presentation and MHC class I cross-presentation of IgG complexed antigen, this renders FcRn capable of exerting broad and potent functions in regulating immune responses and immunosurveillance at mucosal sites. Further, it is now clear that FcRn dependent mucosal absorption of therapeutic molecules is a clinically feasible and potent novel route of non-invasive drug delivery, and the interaction between FcRn and IgG has also been utilized for the acquisition of humoral immunity at mucosal sites. In this review we begin by briefly summarizing the basic knowledge on FcRn expression and IgG binding, then describe more recent discoveries pertaining to the mechanisms by which FcRn orchestrates IgG related mucosal immune responses and immunosurveillance at host-environment interfaces within the adult organism. Finally, we outline how the knowledge of actions of FcRn at mucosal boundaries can be capitalized for the development and engineering of powerful mucosal vaccination strategies and novel routes for the non-invasive delivery of Fc-based therapeutics.

  5. [Treatment of neonatal hyperbilirubinemia

    Science.gov (United States)

    Carvalho, M D

    2001-07-01

    OBJECTIVE: To review the recent medical literature on the treatment of neonatal jaundice, focusing on practical aspects that are relevant to pediatricians and neonatologists. SOURCES: An extensive review of the related literature was performed, also including the authors clinical experience in this field of investigation. SUMMARY OF THE FINDINGS: Jaundice is very common among infants during the first days of life. Several factors such as maternal and neonatal history have to be considered before implementing treatment. Significant advances have been made in the past few years concerning the treatment of jaundiced newborn infants. This review focuses on three forms of treatment of neonatal hyperbilirubinemia: phototherapy, exchange transfusion and the use of drugs to reduce serum bilirubin concentration. CONCLUSIONS: Nowadays, the in-depth knowledge about the mechanism of action of phototherapy, the development of intensified phototherapy units and the use of drugs to reduce bilirubin formation, have contributed to significantly decrease the need for exchange transfusion. PMID:14676895

  6. NEONATAL SEIZURES: ETIOLOGY AND FREQUENCY

    Directory of Open Access Journals (Sweden)

    F. Eghbalian

    2008-11-01

    Full Text Available ObjectiveThe aim of the present study was to evaluate the etiology and frequency of neonatal seizure in hospitalized neonates.Materials and MethodsIn this descriptive, cross-sectional study, we evaluated 1295 neonates with seizures admitted to neonatal and NICU wards in our center. Data was collected on age, sex, birth weight, serum levels of calcium, glucose, and sodium, CT scan findings, history of maternal opium abuse, blood and cerebrospinal fluid culture, and analyzed using SPSS 13.ResultsOf a total of 1295 patients, 34 (2.62% had seizure. Mean age was 14.03 ± 10.05 days (range, 1 to 29 days; twenty-five (73.5% neonates were boys and 9 (26.5% were girls. Of 34 neonates with neonatal seizures, 12 (35.3%, 11 (32.4%, 9 (26.5%, 7 (20.6%, and 3 (8.8% had hypocalcemia, asphyxia, hypoglycemia, intracranial hemorrhage, and hypernatremia, respectively.Maternal addiction, meningitis, and sepsis were found in 3 (8.8%, 1 (2.9% and 1 (2.9% of neonates, respectively.ConclusionThe incidence rate of neonatal seizure in the neonates in our NICU and neonatal ward was 2.62%. Common causes of seizure in this study included hypocalcemia, asphyxia, hypoglycemia, intracranial hemorrhage, and hypernatremia. Maternal ddiction, meningitis and sepsis had the lowest prevalence.Keywords:Neonate, Seizure, Etiologies.

  7. Measuring neonatal nursing workload. Northern Neonatal Network.

    OpenAIRE

    1993-01-01

    A dependency scale has been devised for the assessment of the needs of neonates for nursing time. It has been validated by work studies which have shown that non-surgical babies can be grouped into one of two categories: high dependency babies generating a mean (SD) 25 (5) minutes and low dependency babies generating 12 (3) minutes of nursing work per hour, when the work is averaged out over the whole shift. Any one of five simple and unambiguous criteria serve as robust markers for identifyi...

  8. Rings in the neonate.

    LENUS (Irish Health Repository)

    Hackett, C B

    2011-02-01

    Neonatal lupus erythematosus (NLE) is an uncommon disease of the neonate. It is believed to be caused by the transplacental passage of maternal autoantibodies to the ribonucleoproteins (Ro\\/SSA, La\\/SSB or rarely U RNP) as these are almost invariably present in NLE sera. The most common clinical manifestations include cutaneous lupus lesions and congenital complete heart block. Hepatobiliary and haematologic abnormalities are reported less frequently. We describe a patient with cutaneous NLE to illustrate and raise awareness of the characteristic annular eruption of this condition. We also emphasize the need for thorough investigation for concomitant organ involvement and for maternal education regarding risk in future pregnancies.

  9. Ultrasonography of Neonatal Cholestasis

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun [Seoul National University Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography (US) is as an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. Beyond two weeks of age, extrahepatic biliary atresia and neonatal hepatitis are the two most common causes of persistent neonatal jaundice: differentiation of extrahepatic biliary atresia, which requires early surgical intervention, is very important. Meticulous analysis should focus on size and configuration of the gallbladder and anatomical changes of the portahepatis. In order to narrow the differential diagnosis, combined approaches using hepatic scintigraphy, MR cholangiography, and, at times, percutaneous liver biopsy are necessary. US is useful for demonstrating choledochal cyst, bile plug syndrome, and spontaneous perforation of the extrahepatic bile duct

  10. IgG4-related disease of the rectum

    Science.gov (United States)

    Choi, Sung-Bong; Lim, Chul-Hyun; Cha, Myung-Guen

    2016-01-01

    IgG4-related disease is a relatively new disease entity characterized by elevated serum IgG4 levels and marked infiltration of IgG4-positive plasma cells in lesions. Organ enlargement or nodular lesions consisting of abundant infiltration of lymphocytes and IgG4-positive plasma cells and fibrosis are seen in various organs throughout. We encountered a patient with an inflammatory pseudotumor of the rectum, which was histopathologically confirmed to be an IgG4-related disease. The patient was a 28-year-old woman who had constipation for 3 months. The endoluminal ultrasonography showed a lesion that was heterogeneous and low echogenic in lower rectum. The result of colonoscopic biopsy findings was of chronic proctitis with lymphoid aggregates. For a confirmative diagnosis, excision was performed. Histopathological examination represented plasma cell infiltration and fibrosis. Immunohistochemistry revealed prominence of IgG4-positive plasma cells and confirmed the diagnosis of IgG4-related disease. The patient is currently under observation on low-dose oral prednisolone without relapse. PMID:27186575

  11. Diagnosis of IgG4-Related Tubulointerstitial Nephritis

    OpenAIRE

    Raissian, Yassaman; Nasr, Samih H.; Larsen, Christopher P.; Colvin, Robert B.; Smyrk, Thomas C.; Takahashi, Naoki; Bhalodia, Ami; Sohani, Aliyah R.; ZHANG, LIZHI; Chari, Suresh; Sethi, Sanjeev; Fidler, Mary E.; Cornell, Lynn D

    2011-01-01

    IgG4-related systemic disease is an autoimmune disease that was first recognized in the pancreas but also affects other organs. This disease may manifest as tubulointerstitial nephritis (IgG4-TIN), but its clinicopathologic features in the kidney are not well described. Of the 35 patients with IgG4-TIN whose renal tissue specimens we examined, 27 (77%) had acute or progressive chronic renal failure, 29 (83%) had involvement of other organ systems, and 18 of 23 (78%) had radiographic abnormali...

  12. Extrapancreatic findings of IgG4-related disease

    International Nuclear Information System (INIS)

    IgG4-related disease is a systemic fibro-inflammatory condition, which includes autoimmune pancreatitis as part of the disease spectrum. Imaging has been demonstrated to play a major role in the diagnosis of autoimmune pancreatitis. Recognizing the wide spectrum of extrapancreatic manifestations of IgG4-related disease coupled with a high clinical index of suspicion will allow for an accurate and timely diagnosis to be made, thus avoiding unnecessary invasive procedures and ensuring that early effective corticosteroid therapy is commenced. This review aims to serve as a concise reference tool for both clinicians and radiologists in the diagnosis of extrapancreatic IgG4-related disease

  13. Different glycosylation pattern of human IgG1 and IgG3 antibodies isolated from transiently as well as permanently transfected cell lines.

    Science.gov (United States)

    Vestrheim, A C; Moen, A; Egge-Jacobsen, W; Bratlie, D B; Michaelsen, T E

    2013-05-01

    The effector functions of IgG depend on the presence of carbohydrates attached to asparagine 297 in the Fc-portion. In this report, glycosylation profiles of recombinant wild-type and mutant IgG1 and IgG3 antibodies produced from three cell lines were analysed using LC-ESI-Orbitrap. Clear differences were detected between IgG1 and IgG3 glycoforms, where IgG1 generally contained fucosylated glycoforms, whilst IgG3 mainly were non-fucosylated. When using NS-0 and J558L cells for permanent transfection, IgG1 wt glycoforms differed between the two cell lines, whilst IgG3 wt glycoforms did not. Transiently transfected HEK 293E cells were used to produce IgG1 and IgG3 wt and mutants, affecting complement activation. Cell supernatants were harvested at early and late time points and analysed separately. IgGs harvested late showed simpler and less developed glycosylation structure compared to those harvested early. The IgG harvested early was slightly more effective in complement activation than those harvested late, whilst the antibody-dependent cell-mediated cytotoxicity was unaltered. Generally, the glycosylation pattern of the mutants tested, including a hinge truncate mutant of IgG3, did not differ significantly from the wild-type IgGs. The striking difference in glycosylation pattern of IgG1 compared to IgG3 therefore appears not to be due to the long hinge region of IgG3 (62 amino acids) relative to the IgG1 hinge region (15 amino acids). Furthermore, mutation variants at or near the C1q binding site showed similar glycosylation structure and difference in their complement activation activity observed earlier is thus most likely due to differences in protein structure only. PMID:23488770

  14. Iatrogenic neonatal bladder perforation

    Directory of Open Access Journals (Sweden)

    Lilia Trigui

    2011-01-01

    Full Text Available Neonatal bladder rupture is rare as a complication of bladder obstruction due to abnormal anatomy or iatrogenic causes. The present study describes the case of a 3-day-old infant with ascites due to bladder perforation secondary probably to manual decompression of the bladder. The infant underwent successful surgical repair of the perforation.

  15. Epigenetics in neonatal diseases

    Institute of Scientific and Technical Information of China (English)

    XU Xue-feng; DU Li-zhong

    2010-01-01

    Objective To review the role of epigenetic regulation in neonatal diseases and better understand Barker's "fetal origins of adult disease hypothesis".Data sources The data cited in this review were mainly obtained from the articles published in Medline/PubMed between January 1953 and December 2009.Study selection Articles associated with epigenetics and neonatal diseases were selected.Results There is a wealth of epidemiological evidence that lower birth weight is strongly correlated with an increased risk of adult diseases, such as type 2 diabetes mellitus, hypertension, and cardiovascular disease. This phenomenon of fetal origins of adult disease is strongly associated with fetal insults to epigenetic modifications of genes. A potential role of epigenetic modifications in congenital disorders, transient neonatal diabetes mellitus (TNDM), intrauterine growth retardation (IUGR), and persistent pulmonary hypertension of the newborn (PPHN) have been studied.Conclusions Acknowledgment of the role of these epigenetic modifications in neonatal diseases would be conducive to better understanding the pathogenesis of these diseases, and provide new insight for improved treatment and prevention of later adult diseases.

  16. Hyperbilirubinemia and Neonatal Infection

    Directory of Open Access Journals (Sweden)

    Gholmali Maamouri

    2013-12-01

    Full Text Available Introduction: Hyperbilirubinemia is a relatively common disorder among infants in Iran. Bacterial infection and jaundice may be associated with higher morbidity. Previous studies have reported that jaundice may be one of the signs of infection. The aim of this study was to determine the incidence rate, presentation time, severity of jaundice, signs and complications of infection within neonatal hyperbilirubinemia.   Materials and Methods: This cross sectional study was conducted between 2003 and 2011, at Ghaem Hospital, Mashhad- Iran. We prospectively evaluated 1763 jaundiced newborns. We Finally found 434 neonates who were categorized into two groups.131 neonates as case group (Blood or/and Urine culture positive or sign of pneumonia and 303 neonates with idiopathic jaundice as control group. Demographic data including prenatal, intrapartum, postnatal events and risk factors were collected by questionnaire. Biochemical markers including bilirubin level, urine and blood cultures were determined at the request of the clinicians.   Results: Jaundice presentation time, age on admission, serum bilirubin value and hospitalization period were reported significantly higher among case group in comparison with control group (p

  17. Neonatal typhoid fever.

    OpenAIRE

    Chin, K C; Simmonds, E.J.; Tarlow, M J

    1986-01-01

    Three infants of Pakistani immigrant mothers developed typhoid fever in the neonatal period. All three survived, but two became chronic excretors of Salmonella typhi. The risk of an outbreak of typhoid fever in a maternity unit or special care baby unit is emphasized.

  18. IgG4-RELATED DISEASE. CLINICAL NOTES

    Directory of Open Access Journals (Sweden)

    Vladimir Ivanovich Vasilyev

    2013-12-01

    Full Text Available IgG4-related diseases are a new nosological entity that encompasses a few previously known diseases. IgG4-related systemic disease is diagnosed if two or more affected organs are detected. This group of diseases has two similar signs: serological (elevated serum IgG4 subclass concentrations and histological (organ and tissue infiltration from plasmo-cytes secreting IgG4, and eosinophils, and the development of fibrosclerosis and phlebitis obliterans. The paper describes two cases. In one case, a multisystemic disease was observed virtually at its onset whereas in the other this lesion was diagnosed several years after the natural course of the disease.

  19. Indel Group in Genomes (IGG) Molecular Genetic Markers.

    Science.gov (United States)

    Toal, Ted W; Burkart-Waco, Diana; Howell, Tyson; Ron, Mily; Kuppu, Sundaram; Britt, Anne; Chetelat, Roger; Brady, Siobhan M

    2016-09-01

    Genetic markers are essential when developing or working with genetically variable populations. Indel Group in Genomes (IGG) markers are primer pairs that amplify single-locus sequences that differ in size for two or more alleles. They are attractive for their ease of use for rapid genotyping and their codominant nature. Here, we describe a heuristic algorithm that uses a k-mer-based approach to search two or more genome sequences to locate polymorphic regions suitable for designing candidate IGG marker primers. As input to the IGG pipeline software, the user provides genome sequences and the desired amplicon sizes and size differences. Primer sequences flanking polymorphic insertions/deletions are produced as output. IGG marker files for three sets of genomes, Solanum lycopersicum/Solanum pennellii, Arabidopsis (Arabidopsis thaliana) Columbia-0/Landsberg erecta-0 accessions, and S. lycopersicum/S. pennellii/Solanum tuberosum (three-way polymorphic) are included. PMID:27436831

  20. Concomitant administration of Mycobacterium bovis BCG with the meningococcal C conjugate vaccine to neonatal mice enhances antibody response and protective efficacy.

    Science.gov (United States)

    Brynjolfsson, Siggeir F; Bjarnarson, Stefania P; Mori, Elena; Del Giudice, Giuseppe; Jonsdottir, Ingileif

    2011-11-01

    Mycobacterium bovis BCG is administered to human neonates in many countries worldwide. The objective of the study was to assess if BCG could act as an adjuvant for polysaccharide-protein conjugate vaccines in newborns and thereby induce protective immunity against encapsulated bacteria in early infancy when susceptibility is high. We assessed whether BCG could enhance immune responses to a meningococcal C (MenC) conjugate vaccine, MenC-CRM(197), in mice primed as neonates, broaden the antibody response from a dominant IgG1 toward a mixed IgG1 and IgG2a/IgG2b response, and increase protective efficacy, as measured by serum bactericidal activity (SBA). Two-week-old mice were primed subcutaneously (s.c.) with MenC-CRM(197). BCG was administered concomitantly, a day or a week before MenC-CRM(197). An adjuvant effect of BCG was observed only when it was given concomitantly with MenC-CRM(197), with increased IgG response (P = 0.002) and SBA (8-fold) after a second immunization with MenC-CRM(197) without BCG, indicating increased T-cell help. In neonatal mice (1 week old) primed s.c. with MenC-CRM(197) together with BCG, MenC-polysaccharide (PS)-specific IgG was enhanced compared to MenC-CRM(197) alone (P = 0.0015). Sixteen days after the second immunization with MenC-CRM(197), increased IgG (P CRM(197) plus BCG showed affinity maturation and detectable SBA (SBA > 128). Thus, vaccination with a meningococcal conjugate vaccine (and possibly with other conjugates) may benefit from concomitant administration of BCG in the neonatal period to accelerate and enhance production of protective antibodies, compared to the current infant administration of conjugate which follows BCG vaccination at birth. PMID:21900528

  1. IgG4-Related Disease: Imitating A Great Imitator

    OpenAIRE

    Fenderson, Joshua; Berenberg, Jeffrey; Tom, Linda; Gress, Francis

    2015-01-01

    Immunoglobulin G4-related disease (IgG4-RD) is a rare, but increasingly recognized, multi-organ fibro-inflammatory condition characterized by distinct pathologic and histologic features. The clinical variability and relative novelty of IgG4-RD make accurate diagnosis of the condition quite challenging. We report a case of a 71-year-old man presenting with hypertrophy of the facial glands and generalized lymphadenopathy who was previously diagnosed with sarcoidosis. We recognized that he had a...

  2. IgG4-Related Disease in a Urachal Tumor

    Directory of Open Access Journals (Sweden)

    Travis W. Dum

    2014-01-01

    Full Text Available IgG4-related disease is a newly recognized fibroinflammatory disorder that has the ability to affect nearly every organ system. It is characterized by tumefactive lesions and fibrosis and closely mimics neoplasms. Only one case of IgG4-related bladder mass has been reported in the literature, but there are no reports of IgG4-related disease in a urachal mass. Herein, we report a 26-year-old male who initially presented with symptoms of recurrent UTI. Work-up revealed a 6 cm urachal tumor, a 1.4 cm pulmonary lesion, and mediastinal lymphadenopathy; all metabolically active on PET scan and suspicious for urachal adenocarcinoma. Lung lesion fine needle aspiration and TURBT pathology revealed inflammation but no evidence of malignancy. The patient underwent a partial cystectomy and umbilectomy with pathology demonstrating dense plasmacytic cells, a high rate of immunohistochemistry staining positive for IgG4 plasma cells, a storiform pattern of fibrosis, and an obliterative phlebitis. Furthermore, the patient had an elevated serum IgG4 level of 227 mg/dL (range 2.4–121 mg/dL. IgG4-related disease is a newly recognized fibroinflammatory disorder that can mimic neoplastic processes and a high index of suspicion and accurate tissue pathology is necessary for an accurate diagnosis.

  3. IgG4-Related Disease in a Urachal Tumor.

    Science.gov (United States)

    Dum, Travis W; Zhang, Da; Lee, Eugene K

    2014-01-01

    IgG4-related disease is a newly recognized fibroinflammatory disorder that has the ability to affect nearly every organ system. It is characterized by tumefactive lesions and fibrosis and closely mimics neoplasms. Only one case of IgG4-related bladder mass has been reported in the literature, but there are no reports of IgG4-related disease in a urachal mass. Herein, we report a 26-year-old male who initially presented with symptoms of recurrent UTI. Work-up revealed a 6 cm urachal tumor, a 1.4 cm pulmonary lesion, and mediastinal lymphadenopathy; all metabolically active on PET scan and suspicious for urachal adenocarcinoma. Lung lesion fine needle aspiration and TURBT pathology revealed inflammation but no evidence of malignancy. The patient underwent a partial cystectomy and umbilectomy with pathology demonstrating dense plasmacytic cells, a high rate of immunohistochemistry staining positive for IgG4 plasma cells, a storiform pattern of fibrosis, and an obliterative phlebitis. Furthermore, the patient had an elevated serum IgG4 level of 227 mg/dL (range 2.4-121 mg/dL). IgG4-related disease is a newly recognized fibroinflammatory disorder that can mimic neoplastic processes and a high index of suspicion and accurate tissue pathology is necessary for an accurate diagnosis. PMID:25202466

  4. Estimation of anti-D IgG in red blood cell eluates using the specific radioactivity of 125I-labeled IgG: effect of unlabeled, cytophilic IgG

    Energy Technology Data Exchange (ETDEWEB)

    Masouredis, S.P.; Mahan, L.C.; Sudora, E.J.; Langley, J.W.; Victoria, E.J.

    1981-01-01

    The specific radioactivity of conventionally prepared 125I IgG anti-D eluates is significantly less (from 1/5 to 1/20) than that of the 125I IgG fraction used to prepare the eluate. This discrepancy is due to the release of unlabeled, cytophilic IgG from normal red blood cells during eluate preparation and does not represent an underestimation of the eluate anti-D IgG content. Cytophilic IgG content of eluates plays an important role in reducing the nonimmunologic binding of labeled antibody IgG. The results justify the assumption used in numerous studies that the specific radioactivity of 125I IgG fractions can be used to provide a valid estimate of the anti-D IgG content of eluates.

  5. Increased IgG4-Positive Plasma Cells in Granulomatosis with Polyangiitis: A Diagnostic Pitfall of IgG4-Related Disease

    OpenAIRE

    Eunhee S. Yi; Ryu, Jay H.; Lewis, Jean E; Sing Yun Chang; Karina Keogh

    2012-01-01

    Granulomatosis with polyangiitis (Wegener's) (GPA) may mimic IgG4-related disease (IgG4-RD) on histologic examination of some biopsies, especially those from head and neck sites. IgG4 immunostain is often performed in this context for differential diagnosis with IgG4-RD. However, the prevalence of IgG4+ cells in GPA has not been explored. We examined the IgG4+ cells in 26 cases confirmed as GPA by a thorough clinical and pathologic assessment. Twenty-six biopsies consisted of 14 sinonasal/ora...

  6. Endothelial cells the site of the regulation of IgG LEVEL by salvaging and transcytosis of immunoglobulin

    International Nuclear Information System (INIS)

    ), transferrin (Tavassoli et al 1986), ceruloplasmin (Tarsio et al 1987), transcobalamin II (Soda et al 1985) the complex biochemical events taking place at the blood-vessel wall interface are not fully understood. This is the case of IgG transfer from mother to fetus. The process is thought to involve specific receptors that bind to the Fc region of the IgG molecule namely the MHC class I related receptor FcRn (Brambel 1970, Rodewald 1980). Until now, the reported data showed that FcRn was occasional (Kristofersen et al 1996) low level (Leach et al 1996) or not at all expressed (Simister et al 1996) in fetal endothelial cells. Taking advantage of the successful isolation and cultivation of microvascular endothelial cells from human term placenta (Jinga V et al 1999) we can now appropriately investigate the presence, distribution and function of FcRn in placental endothelial cells.Transfer of maternal gammaglobulin (IgG) to the fetus provides the neonate with humoral immunity during early lifetime. The mechanism of selective transport of IgG from the placental stroma to the lumen of the fetal blood vessels has not been elucidated, yet. It was postulated that the specific transport as well as the regulation of IgG concentration in the blood, involves the MHC class I related receptor - FcRn - for the Fc domain of IgG. We questioned whether, human placental endothelial cells (HPEC) express FcRn, and if present, whether it is in a functionally active form. The experiments were performed on cultured HPEC; as positive control, cultured human trophoblastic cells (JEG3) and mouse SV-40 transformed EC line (SVEC) shown to express mRNA for the human FcRn, were used. The double chamber system. The permeability coefficient expression of FcRn was tested by indirect immunofluorescence. The role of FcRn was assessed on HPEC grown on filters in a double chamber system by quantifying the transcytosis of [125 I]-human IgG or [125 I]-rF(ab')2 fragments (as control) from the apical to basolateral

  7. Membranous nephropathy with monoclonal IgG4 deposits and associated IgG4-related lung disease

    OpenAIRE

    Omokawa, Ayumi; Komatsuda, Atsushi; Hirokawa, Makoto; Wakui, Hideki

    2014-01-01

    A 62-year-old woman was admitted for nephrotic syndrome and lung tumor. A renal biopsy showed membranous features of the glomeruli. Immunofluorescence studies revealed granular IgG4-κ deposits along with the glomerular basement membrane. Electron microscopy revealed granular electron-dense deposits. Further study denied multiple myeloma. Light microscopy of the resected lung tumor revealed IgG4-related lung disease with no malignancy. Steroid therapy induced a remission of the nephrotic syndr...

  8. IgG and IgG subclasses antibody responses to rK39 in Leishmania donovani infections

    International Nuclear Information System (INIS)

    Leishmania donovani infection cause a wide spectrum of human diseases ranging from self-healing subclinical infections to severe visceral leishmaniasis, post kal-azar dermal leishmaiasis, and mucosal leishmaiasis. The infection associated with high levels of anti-leishmania antibodies which offer a potential parameter for the serological diagnosis of L. donovani infection replacing the invasive parasitological methods. rK39, a cloned antigen of L. chagasis was reported to have high levels of anti-leishmania antibodies in Sudanese and American visceral leishmaniasis patients. In an assessment of rK39-ELISA in detecting L. donovani infection we found that the antigen detected visceral leishmaniasis, post kala-azar dermal leishmaniasis, and mucosal leismaniasis with the sensitives of 96.6%, 95.91% and 90.91% respectively. The test has the specificity of 96.7%. Further investigation of 25 visceral leishmaniasis patients showed elevated anti-rK39 antibody responses of IgG subclasses with IgG1 and IgG3 significantly higher than IgG4. igG3 showed the highest sensitivity (84.00%) whereas IgG1 showed the highest sensitivity (100%). The dynamics of the serological reactivity to rK39 in l.donovani infections will be discussed in relation to exposure, infection, cure and relapse.(Author)

  9. In-depth analysis of subclass-specific conformational preferences of IgG antibodies

    DEFF Research Database (Denmark)

    Tian, Xinsheng; Vestergaard, Bente; Thorolfsson, Matthias; Yang, Zhiru; Rasmussen, Hanne B.; Langkilde, Annette Eva

    2015-01-01

    IgG subclass-specific differences in biological function and in vitro stability are often referred to variations in the conformational flexibility, while this flexibility has rarely been characterized. Here, small-angle X-ray scattering data from IgG1, IgG2 and IgG4 antibodies, which were designed...

  10. Neonatal diabetes mellitus.

    OpenAIRE

    Stewart, C.; Redmond, A

    2000-01-01

    An explosion of work over the last decade has produced insight into the multiple hereditary causes of a nonimmunological form of diabetes diagnosed most frequently within the first 6 months of life. These studies are providing increased understanding of genes involved in the entire chain of steps that control glucose homeostasis. Neonatal diabetes is now understood to arise from mutations in genes that play critical roles in the development of the pancreas, of β-cell apoptosis and insulin pro...

  11. Anorectal malformations in neonates

    Directory of Open Access Journals (Sweden)

    Bilal Mirza

    2011-01-01

    Full Text Available Background : Anorectal malformations (ARM are associated with congenital anomalies and other risk factors, yielding a poor prognosis, especially in neonatal life. Objectives: This study was performed to identify the congenital anomalies as a factor of poor prognosis (mortality in such patients. Settings: Department of Pediatric surgery, The Children′s Hospital and The Institute of Child Health, Lahore. Design: Prospective observational study, with statistical support. Materials and Methods: The information on the demography, clinical features, investigations, management performed, and outcome was entered in the designed proforma and analysed with the help of statistical software EpiInfo version 3.5.1. Statistical test: Chi-square test was used to determine statistical significance of the results. Results : Of 100 neonates with ARM, 77 were male and 23, female (3.4:1. The mean age at presentation was 3.4 days (range, 12 hrs to 28 days. In 60 patients (60%, the presentation was imperforate anus without a clinically identified fistula. In 28 patients (28%, associated anomalies were present. The common associated anomalies were urogenital (10%, cardiovascular (8%, and gastrointestinal (6%. Down′s syndrome was present in 8 (8% patients. A total of 15 (15% deaths occurred in this study. In patients having associated congenital anomalies, 11 deaths occurred, whereas, 4 deaths were in patients without associated anomalies (P < 0.5. Conclusion : The mortality is higher in neonates with ARM having associated congenital anomalies.

  12. Congenital hypothyroidism in neonates

    Directory of Open Access Journals (Sweden)

    Aneela Anjum

    2014-01-01

    Full Text Available Context: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation in children and it occurs in approximately 1:2,000-1:4,000 newborns. Aims and Objectives: The aim of this study is to determine the frequency of CH in neonates. Settings and Design: This cross-sectional study was conducted in neonatal units of the Department of Pediatrics Unit-I, King Edward Medical University/Mayo Hospital, Lahore and Lady Willington Hospital Lahore in 6 months (January-June 2011. Materials and Methods: Sample was collected by non-probability purposive sampling. After consent, 550 newborn were registered for the study. Demographic data and relevant history was recorded. After aseptic measures, 2-3 ml venous blood analyzed for thyroid-stimulating hormone (TSH level by immunoradiometric assay. Treatment was started according to the individual merit as per protocol. Statistical Analysis Used: Data was analyzed by SPSS 17 and Chi-square test was applied to find out the association of CH with different variables. Results: The study population consisted of 550 newborns. Among 550 newborns, 4 (0.8% newborns had elevated TSH level. CH had statistically significant association with mother′s hypothyroidism (P value 0.000 and mother′s drug intake during the pregnancy period (P value 0.013. Conclusion: CH is 0.8% in neonates. It has statistically significant association with mother′s hypothyroidism and mother′s drug intake during pregnancy.

  13. Neonatal euthanasia: The Groningen Protocol*

    OpenAIRE

    Vizcarrondo, Felipe E.

    2014-01-01

    For the past thirty years, voluntary euthanasia and physician-assisted suicide of adult patients have been common practice in the Netherlands. Neonatal euthanasia was recently legalized in the Netherlands and the Groningen Protocol (GP) was developed to regulate the practice. Supporters claim compliance with the GP criteria makes neonatal euthanasia ethically permissible. An examination of the criteria used by the Protocol to justify the euthanasia of seriously ill neonates reveals the criter...

  14. Potential Mechanisms for IgG4 Inhibition of Immediate Hypersensitivity Reactions

    OpenAIRE

    James, Louisa K.; Till, Stephen J.

    2016-01-01

    IgG4 is the least abundant IgG subclass in human serum, representing less than 5% of all IgG. Increases in IgG4 occur following chronic exposure to antigen and are generally associated with states of immune tolerance. In line with this, IgG4 is regarded as an anti-inflammatory antibody with a limited ability to elicit effective immune responses. Furthermore, IgG4 attenuates allergic responses by inhibiting the activity of IgE. The mechanism by which IgG4 inhibits IgE-mediated hypersensitivity...

  15. Immunohistochemical Characteristics of IgG4-Related Tubulointerstitial Nephritis: Detailed Analysis of 20 Japanese Cases

    OpenAIRE

    Mitsuhiro Kawano; Ichiro Mizushima; Yutaka Yamaguchi; Naofumi Imai; Hitoshi Nakashima; Shinichi Nishi; Satoshi Hisano; Nobuaki Yamanaka; Motohisa Yamamoto; Hiroki Takahashi; Hisanori Umehara; Takao Saito; Takako Saeki

    2012-01-01

    Although tubulointerstitial nephritis with IgG4+ plasma cell (PC) infiltration is a hallmark of IgG4-related kidney disease (IgG4-RKD), only a few studies are available about the minimum number of IgG4+ PC needed for diagnosis along with IgG4+/IgG+ PC ratio in the kidney. In addition, the significance of the deposition of IgG or complement as a reflection of humoral immunity involvement is still uncertain. In this study, we analyzed 20 Japanese patients with IgG4-RKD to evaluate the number of...

  16. Spectrum of Disorders Associated with Elevated Serum IgG4 Levels Encountered in Clinical Practice

    OpenAIRE

    Eunhee S. Yi; Tobias Peikert; Hiroshi Sekiguchi; Ryu, Jay H.; Ryohei Horie

    2012-01-01

    IgG4-related disease (IgG4-RD) is a recently described systemic fibroinflammatory disease associated with elevated circulating levels of IgG4 and manifests a wide spectrum of clinical presentations. Although serum IgG4 level has been described to be the most sensitive and specific laboratory test for the diagnosis of IgG4-RD, it is recognized that an elevated serum IgG4 level can be encountered in other diseases. In this study, we sought to identify the frequency of IgG4-RD and other disease ...

  17. Does the Maternal Serum IgG Level during Pregnancy in Primary Antibody Deficiency Influence the IgG Level in the Newborn?

    Directory of Open Access Journals (Sweden)

    Vasantha Nagendran

    2015-01-01

    Full Text Available Purpose. To find out if the serum IgG level in the newborn baby was affected by low maternal serum IgG during pregnancy in two newly diagnosed primary antibody deficient patients. Method. Infant cord blood IgG level was compared with maternal IgG level in 2 mothers with newly diagnosed primary antibody deficiency, who declined replacement IgG treatment during pregnancy. Results. Both mothers delivered healthy babies with normal IgG levels at birth. Conclusions. The normal IgG levels and sound health in these 2 babies in spite of low maternal IgG throughout pregnancy raise interesting discussion points about maternofoetal immunoglobulin transport mechanisms in primary antibody deficiency.

  18. Membranous nephropathy with repeated flares in IgG4-related disease

    OpenAIRE

    Kanda, Hiroko; Koya, Junji; Uozaki, Hiroshi; Tateishi, Shoko; Sato, Kojiro; Hagino, Noboru; Sawada, Tetsuji; Yamamoto, Kazuhiko

    2013-01-01

    IgG4-related disease (IgG4-RD) is associated with the infiltration of IgG4-positive plasma cells into various organs. Nephropathy of IgG4-RD is generally interstitial nephritis and glomerulonephritis is rare. We describe a case of membranous nephropathy (MN) without interstitial nephritis associated with IgG4-RD symptoms including lymphadenopathy and pulmonary and pleural lesions. Treatment with steroids improved these clinical symptoms, but withdrawal of steroids induced the repeated relapse...

  19. Orbital Pseudotumor: Uncommon Initial Presentation of IgG4-Related Disease

    OpenAIRE

    Teresa Carbone; Ricardo Azêdo Montes; Beatriz Andrade; Pedro Lanzieri; Luis Mocarzel

    2015-01-01

    IgG4-related disease (IgG4-RD) encompasses a group of fibroinflammatory conditions recognized in recent times. The main clinical features include variable degrees of tissue fibrosis, tumorlike expansions, perivascular lymphocytic infiltration rich in IgG4-positive plasma cells, and elevated serum IgG4. A case has been reported of an elderly patient with an unexplained unilateral exophthalmia; biopsy was performed and revealed lymphocytic infiltration, suggesting IgG4-RD. High serum levels of ...

  20. Maternal Antibodies Enhance or Prevent Cytomegalovirus Infection in the Placenta by Neonatal Fc Receptor-Mediated Transcytosis

    OpenAIRE

    Maidji, Ekaterina; McDonagh, Susan; Genbacev, Olga; Tabata, Takako; Pereira, Lenore

    2006-01-01

    How human cytomegalovirus (CMV) reaches the fetus across the placenta is unknown. The major viral cause of congenital disease, CMV infects the uterine-placental interface with varied outcomes depending on the strength of maternal humoral immunity and gestational age. Covering the surface of villi that float in blood, syncytiotrophoblasts express the neonatal Fc receptor (FcRn) that transports IgG for passive immunity. Immunohistochemical analysis of early-gestation biopsy specimens showed an ...

  1. Systemic IgG4-related disease with extensive peripheral nerve involvement that progressed from localized IgG4-related lymphadenopathy: an autopsy case

    OpenAIRE

    Fujii, Masayoshi; Sato, Yasuharu; Ohara, Nobuya; Hashimoto, Kenji; KOBASHI, HARUHIKO; Koyama, Yoshinobu; Yoshino, Tadashi

    2014-01-01

    A 77-year-old man, with a lengthy medical history of chronic dysuria, constipation, hypertension, myocardial infarction, and a submandibular lymphadenopathy that was excised 3 years ago, was hospitalized due to elevated liver enzyme levels. He demonstrated hypergammaglobulinemia, hyperproteinemia, high levels of IgG and IgG4, eosinophilia, sclerosing cholangitis, and retroperitoneal fibrosis. He was diagnosed with IgG4-related disease (IgG4-RD). While hospitalized, he had several episodes of ...

  2. Conformational destabilization of Immunoglobulin G increases the low pH-binding affinity with the Neonatal Fc Receptor

    DEFF Research Database (Denmark)

    Walters, Benjamin T; Jensen, Pernille Foged; Larraillet, Vincent;

    2016-01-01

    Crystallographic evidence suggests that the pH-dependent affinity of IgG molecules for the neonatal Fc receptor (FcRn) receptor primarily arises from salt bridges involving IgG histidine residues, resulting in moderate affinity at mildly acidic conditions. However, this view does not explain the...... diversity in affinity found in IgG variants, such as the YTE mutant (M252Y,S254T,T256E), which increases affinity to FcRn by up to 10×. Here we compare hydrogen exchange measurements at pH 7.0 and pH 5.5 with and without FcRn bound with surface plasmon resonance estimates of dissociation constants and Fc...

  3. Management Strategies for Neonatal Hypoglycemia

    OpenAIRE

    Sweet, Courtney B.; Grayson, Stephanie; Polak, Mark

    2013-01-01

    While hypoglycemia occurs commonly among neonates, treatment can be challenging if hypoglycemia persists beyond the first few days of life. This review discusses the available treatment options for both transient and persistent neonatal hypoglycemia. These treatment options include dextrose infusions, glucagon, glucocorticoids, diazoxide, octreotide, and nifedipine. A stepwise, practical approach to the management of these patients is offered.

  4. OXYTOCIN INDUCED NEONATAL HYPERBILIRUBINEMIA

    Directory of Open Access Journals (Sweden)

    Smita S.

    2015-05-01

    Full Text Available INTRODUCTION: Hyperbilirubinemia is one of the most common causes of health problems, observed in 60% of term and 80% of preterm infants in the first week of life . Hyperbilirubinemia leads to neurotoxicity in severe condition. Some studies suggests that liberal use of oxytocin for inducing labour is one of the factor which lead to neonatal hyperbilirubinemia. OBJECTIVE: To compare the effect of oxytocin and neonatal bilirubin levels with spontaneous vaginal delivery . MATERIALS AND METHOD S : 100 full term parturients were selected for this study. The subjects were divided into two groups. 50 healthy babies of women who had oxytocin induced labour and 50 healthy babies of women with normal vaginal delivery following spontaneous onset of labour formed the control group. Neon atal serum bilirubin was measured on day 1, 3 and 5 after delivery. Bilirubin was measured by spectrophotometry. Data was analysed in ms excel sheet using spss 19.0v. Statistical analysis was done by using unpaired‘t’ test. RESULTS: There was significant i ncrease in bilirubin level in oxytocin induced group compared to control group on day 1 and 3. There was insignificant increase in bilirubin level in oxytocin induced group on day 5. However the level of serum bilirubin is within normal limits as bilirubin level normally rises on till 4 th day and decreases thereafter. CONCLUSION: Neonatal hyperbilirubinemia may be due to oxytocin administration by continues IV infusion which results in erythrocyte swell and rupture. Increase in bilirubin level in oxytocin i nduced group is within physiological limits

  5. Probiotics and colostrum/milk differentially affect neonatal humoral immune responses to oral rotavirus vaccine.

    Science.gov (United States)

    Chattha, Kuldeep S; Vlasova, Anastasia N; Kandasamy, Sukumar; Esseili, Malak A; Siegismund, Christine; Rajashekara, Gireesh; Saif, Linda J

    2013-04-01

    Breast milk (colostrum [col]/milk) components and gut commensals play important roles in neonatal immune maturation, establishment of gut homeostasis and immune responses to enteric pathogens and oral vaccines. We investigated the impact of colonization by probiotics, Lactobacillus rhamnosus GG (LGG) and Bifidobacterium lactis Bb12 (Bb12) with/without col/milk (mimicking breast/formula fed infants) on B lymphocyte responses to an attenuated (Att) human rotavirus (HRV) Wa strain vaccine in a neonatal gnotobiotic pig model. Col/milk did not affect probiotic colonization in AttHRV vaccinated pigs. However, unvaccinated pigs fed col/milk shed higher numbers of probiotic bacteria in feces than non-col/milk fed colonized controls. In AttHRV vaccinated pigs, col/milk feeding with probiotic treatment resulted in higher mean serum IgA HRV antibody titers and intestinal IgA antibody secreting cell (ASC) numbers compared to col/milk fed, non-colonized vaccinated pigs. In vaccinated pigs without col/milk, probiotic colonization did not affect IgA HRV antibody titers, but serum IgG HRV antibody titers and gut IgG ASC numbers were lower, suggesting that certain probiotics differentially impact HRV vaccine responses. Our findings suggest that col/milk components (soluble mediators) affect initial probiotic colonization, and together, they modulate neonatal antibody responses to oral AttHRV vaccine in complex ways. PMID:23453730

  6. Hemolysis in Preterm Neonates.

    Science.gov (United States)

    Christensen, Robert D; Yaish, Hassan M

    2016-06-01

    Hemolysis can be an important cause of hyperbilirubinemia in premature and term neonates. It can result from genetic abnormalities intrinsic to or factors exogenous to normal to red blood cells (RBCs). Hemolysis can lead to a relatively rapid increase in total serum/plasma bilirubin, hyperbilirubinemia that is somewhat slow to fall with phototherapy, or hyperbilirubinemia that is likely to rebound after phototherapy. Laboratory methods for diagnosing hemolysis are more difficult to apply, or less conclusive, in preterm infants. Transfusion of donor RBCs can present a bilirubin load that must be metabolized. Genetic causes can be identified by next-generation sequencing panels. PMID:27235204

  7. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

    Garne, Kristina; Brødsgaard, Anne; Zachariassen, Gitte;

    2016-01-01

    visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. OBJECTIVE: To identify parental needs when wanting to provide neonatal home care supported by telemedicine. METHODS: The study used...... telemedicine support. A total of 9 parents with preterm infants assigned to a neonatal home care program and 10 parents with preterm infants admitted to a neonatal unit participated in individual interviews and focus group interviews, respectively. RESULTS: Three overall themes were identified: being a family......, parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a "bell cord" to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication with the...

  8. Potential Mechanisms for IgG4 Inhibition of Immediate Hypersensitivity Reactions.

    Science.gov (United States)

    James, Louisa K; Till, Stephen J

    2016-03-01

    IgG4 is the least abundant IgG subclass in human serum, representing less than 5 % of all IgG. Increases in IgG4 occur following chronic exposure to antigen and are generally associated with states of immune tolerance. In line with this, IgG4 is regarded as an anti-inflammatory antibody with a limited ability to elicit effective immune responses. Furthermore, IgG4 attenuates allergic responses by inhibiting the activity of IgE. The mechanism by which IgG4 inhibits IgE-mediated hypersensitivity has been investigated using a variety of model systems leading to two proposed mechanisms. First by sequestering antigen, IgG4 can function as a blocking antibody, preventing cross-linking of receptor bound IgE. Second IgG4 has been proposed to co-stimulate the inhibitory IgG receptor FcγRIIb, which can negatively regulate FcεRI signaling and in turn inhibit effector cell activation. Recent advances in our understanding of the structural features of human IgG4 have shed light on the unique functional and immunologic properties of IgG4. The aim of this review is to evaluate our current understanding of IgG4 biology and reassess the mechanisms by which IgG4 functions to inhibit IgE-mediated allergic responses. PMID:26892721

  9. Maternal immunization with ovalbumin prevents neonatal allergy development and up-regulates inhibitory receptor FcγRIIB expression on B cells

    Directory of Open Access Journals (Sweden)

    Duarte Alberto JS

    2010-03-01

    Full Text Available Abstract Background Preconception allergen immunization prevents neonatal allergen sensitization in mice by a complex interaction between regulatory cells/factors and antibodies. The present study assessed the influence of maternal immunization with ovalbumin (OVA on the immune response of 3 day-old and 3 week-old offspring immunized or non-immunized with OVA and evaluated the effect of IgG treatment during fetal development or neonatal period. Results Maternal immunization with OVA showed increased levels of FcγRIIb expression in splenic B cells of neonates, which were maintained for up to 3 weeks and not affected by additional postnatal OVA immunization. Maternal immunization also exerted a down-modulatory effect on both IL-4 and IFN-γ-secreting T cells and IL-4 and IL-12- secreting B cells. Furthermore, immunized neonates from immunized mothers showed a marked inhibition of antigen-specifc IgE Ab production and lowered Th2/Th1 cytokine levels, whereas displaying enhanced FcγRIIb expression on B cells. These offspring also showed reduced antigen-specific proliferative response and lowered B cell responsiveness. Moreover, in vitro evaluation revealed an impairment of B cell activation upon engagement of B cell antigen receptor by IgG from OVA-immunized mice. Finally, in vivo IgG transference during pregnancy or breastfeeding revealed that maternal Ab transference was able to increase regulatory cytokines, such as IL-10, in the prenatal stage; yet only the postnatal treatment prevented neonatal sensitization. None of the IgG treatments induced immunological changes in the offspring, as it was observed for those from OVA-immunized mothers. Conclusion Maternal immunization upregulates the inhibitory FcγRIIb expression on offspring B cells, avoiding skewed Th2 response and development of allergy. These findings contribute to the advancement of prophylactic strategies to prevent allergic diseases in early life.

  10. Overview of IgG4-Related Tubulointerstitial Nephritis and Its Mimickers

    OpenAIRE

    Jeong, Hyeon Joo; Shin, Su-Jin; Lim, Beom Jin

    2015-01-01

    Tubulointerstitial nephritis (TIN) is the most common form of renal involvement in IgG4-related disease. It is characterized by a dominant infiltrate of IgG4-positive plasma cells in the interstitium and storiform fibrosis. Demonstration of IgG4-positive plasma cells is essential for diagnosis, but the number of IgG4-positive cells and the ratio of IgG4-positive/IgG-positive plasma cells may vary from case to case and depending on the methods of tissue sampling even in the same case. IgG4-pos...

  11. Development of IgG4-related disease in a patient diagnosed with idiopathic membranous nephropathy

    OpenAIRE

    Wada, Yoko; Saeki, Takako; Yoshita, Kazuhiro; Ayalon, Rivka; Kamimura, Kenya; Nakano, Masaaki; Narita, Ichiei

    2013-01-01

    We report a case of IgG4-related disease (IgG4-RD) diagnosed after 3 years of follow-up for idiopathic membranous nephropathy (MN). MN has been considered as glomerular lesion of IgG4-related kidney diseases in recent years and was diagnosed simultaneously with or after a diagnosis of IgG4-RD in previously reported cases. In the present case, IgG4-RD developed 3 years after the diagnosis of idiopathic MN, indicating a possible relationship between idiopathic MN and IgG4-RD through common unde...

  12. Ocular adnexal marginal zone B cell lymphoma infiltrated by IgG4-positive plasma cells

    OpenAIRE

    KUBOTA, TOSHINOBU; Moritani, Suzuko; Yoshino, Tadashi; Nagai, Hirokazu; Terasaki, Hiroko

    2010-01-01

    Aims To report the clinicopathological characteristics of patients with ocular adnexal marginal zone B cell lymphoma (MZBL) with IgG4-positive plasma cells. Methods 114 biopsy samples of ocular adnexal MZBLs were analysed. MZBLs with IgG4-positive plasma cells were included when the IgG4:IgG ratio was >40% (IgG4-related group). The serum levels of each subclass of immunoglobulins and soluble interleukin-2 receptor in the IgG4-related group were compared with those in 61 consecutive patients h...

  13. Dermatopathic Lymphadenopathy With Increased IgG4-Positive Plasma Cells

    OpenAIRE

    Nakayama, Shoko; Yokote, Taiji; Akioka, Toshikazu; Miyoshi, Takuji; Hirata, Yuji; Hiraoka, Nobuya; Iwaki, Kazuki; Takayama, Ayami; Nishiwaki, Uta; Masuda, Yuki; Hanafusa, Toshiaki; Nishimura, Yasuichiro; Tsuji, Motomu

    2015-01-01

    Abstract Both dermatopathic lymphadenopathy (DL) and immunoglobulin G4-related disease (IgG4-RD) are frequently complicated with allergic diseases. However, the relationship between DL and IgG4-RD is not well known. To clarify this relationship on the basis of clinical and pathological findings, including IgG4-positive (IgG4+) plasma cell infiltration in lymph nodes (LNs) of DL patients, we analyzed LNs of 11 DL patients using immunostaining of IgG, IgG4, forkhead box P3 (FOXP3), transforming...

  14. EVALUATION OF NEONATAL CARDIAC MURMURS

    Directory of Open Access Journals (Sweden)

    Somaiah

    2014-09-01

    Full Text Available Cardiovascular malformations are the most common cause of congenital malformations, the diagnosis of which requires a close observation in the neonatal period. Early recognition of CHD is important in the neonatal period, as many of them may be fatal if undiagnosed and may require immediate intervention. The objectives of this study are to study the epidemiology of neonatal cardiac murmurs, to identify clinical characteristics which differentiate pathological murmur from functional murmurs and to assess the reliability of clinical evaluation in diagnosing CHD. Method of study included all neonates admitted to the NICU, postnatal ward, attending pediatric OPD or neonatal follow up clinic and were detected to have cardiac murmurs. It was a cross sectional study over a period of 16months. A clinical diagnosis was made based on history and clinical examination. Then Chest X-ray and ECG, Echocardiography was done in all neonates for confirmation of the diagnosis. These neonates were again examined daily till they were in hospital and during the follow-up visit at 6 weeks. The results of 70 neonates in this study conducted over a period of 24 months included the incidence of cardiac murmurs among intramural neonates which was 13.5 for 1000 live births. Most frequent symptom was fast breathing in 10(14.3% cases. VSD was the most common diagnosis clinically in 23 (33% babies. The most frequent Echo diagnosis was acyanotic complex congenital heart disease in 25(36% cases followed by 12(17% cases each of VSD and ASD respectively. Overall in our study 77.1% (54cases of the murmurs were diagnosed correctly and confirmed by Echocardiography The study concluded that it is possible to make clinical diagnosis in many cases of congenital heart diseases, the functional murmurs could be differentiated from those arising from structural heart disease and evaluation of the infants based only on murmurs, few congenital heart diseases can be missed.

  15. Neonate brain disorders

    International Nuclear Information System (INIS)

    Full text: Hypoxic-Ischemic insults in the brain of neonates constitute major cause of morbidity and mortality. A wide range of motor, sensory, and cognitive disabilities are observed in this population spanning from slight motor deficits, school difficulties and behavioral problems up to cerebral palsy and mental retardation. Pathologically involved areas characterized by high metabolic demands and therefore with enhanced vulnerability to any reduction or cessation of energy and oxygen supply. Watershed areas of the brain (vascular end zones and vascular border zones) are predominately affected in any adverse event. Radiologic and pathologic appearance of these lesions depends both on the severity of the insult and the maturity of the brain. The dominant pathology observed in preterm neonates is white matter lesions. There are three basic patterns of brain destruction in this population. Periventricular leukomalacia (PVL focal fPVL, diffuse dPVL), germinal matrix haemorrhage (GMH) associated with intraventricular haemorrhage (IVH), and parenchymal haemorrhage (PH). fPVL is characterized by focal necrosis of all cellular elements in the periventricular white matter, resulting in the formation of cysts, and dPVL is characterized by diffuse destruction of the premyelinating oligodendrocytes (pre-OLs) the precursors of mature oligodendroglia cells responsible for the formation of myelin in a later stage. GMH is located beneath germinal matrix layer surrounding the lateral ventricles and can extend into the ventricular system resulting thus to IVH. Finally, PH is located within the parenchyma adjacent to the ventricles and is believed to represent haemorrhagic infarcts following venous drainage compromise. In term or near-term neonates, the top-ographic pattern of injuries involves mainly gray matter structures. Most frequent predilection sites include the cerebral cortex (paracentral lobule, Rolandic area, visual cortex and hippocampus), basal ganglia, thalamus, and

  16. The Relationship between Neonatal Jaundice and Maternal and Neonatal Factors

    Directory of Open Access Journals (Sweden)

    Ehsan Garosi

    2016-03-01

    Conclusion: Since factors such as mode of delivery, oxytocin induction, and neonate's gender could contribute to jaundice, continuous assessment of newborns after birth could facilitate early diagnosis, promote disease management, and reduce the subsequent complications.

  17. The Design of New Adjuvants for Mucosal Immunity to Neisseria meningitidis B in Nasally Primed Neonatal Mice for Adult Immune Response

    Directory of Open Access Journals (Sweden)

    Tatiane Ferreira

    2012-01-01

    Full Text Available The aim of this study was to determine the value of detoxified Shiga toxins Stx1 and Stx2 (toxoids of Escherichia coli as mucosal adjuvants in neonatal mice for immunogenicity against the outer membrane proteins (OMPs of Neisseria meningitidis B. Mucosal immunization has been shown to be effective for the induction of antigen-specific immune responses in both the systemic and mucosal compartments. Systemic antibody levels (IgG, IgG1, IgG2a, IgG2b, IgM, and IgA and mucosal IgM and IgA were measured by ELISA using an N. meningitidis as an antigen. In addition, IFN-γ and IL-6 production were measured after stimulated proliferation of immune cells. Intranasal administration elicited a higher anti-OMP IgA response in both saliva and vaginal fluids. Our results suggest that both Stx1 and Stx2 toxoids are effective mucosal adjuvants for the induction of Ag-specific IgG, IgM, and IgA antibodies. The toxoids significantly enhanced the IgG and IgM response against OMPs with a potency equivalent to CT, with the response being characterized by both IgG1 and IgG2a isotypes, and increased IFN-gamma production. Additionally, bactericidal activity was induced with IgG and IgM antibodies of high avidity. These results support the use of the new toxoids as potent inducing adjuvants that are particularly suitable for mucosal immunization.

  18. Neonatal pulmonary hemosiderosis.

    Science.gov (United States)

    Limme, Boris; Nicolescu, Ramona; Misson, Jean-Paul

    2014-01-01

    Idiopathic pulmonary hemosiderosis (IPH) is a rare complex entity characterized clinically by acute or recurrent episodes of hemoptysis secondary to diffuse alveolar hemorrhage. The radiographic features are variable, including diffuse alveolar-type infiltrates, and interstitial reticular and micronodular patterns. We describe a 3-week-old infant presenting with hemoptysis and moderate respiratory distress. Idiopathic pulmonary hemosiderosis was the first working diagnosis at the Emergency Department and was confirmed, 2 weeks later, by histological studies (bronchoalveolar lavage). The immunosuppressive therapy by 1 mg/kg/d prednisone was immediately started, the baby returned home on steroid therapy at a dose of 0,5 mg/kg/d. The diagnosis of idiopathic pulmonary hemosiderosis should be evocated at any age, even in the neonate, when the clinical presentation (hemoptysis and abnormal radiological chest images) is strongly suggestive. PMID:25389504

  19. Neonatal Pulmonary Hemosiderosis

    Directory of Open Access Journals (Sweden)

    Boris Limme

    2014-01-01

    Full Text Available Idiopathic pulmonary hemosiderosis (IPH is a rare complex entity characterized clinically by acute or recurrent episodes of hemoptysis secondary to diffuse alveolar hemorrhage. The radiographic features are variable, including diffuse alveolar-type infiltrates, and interstitial reticular and micronodular patterns. We describe a 3-week-old infant presenting with hemoptysis and moderate respiratory distress. Idiopathic pulmonary hemosiderosis was the first working diagnosis at the Emergency Department and was confirmed, 2 weeks later, by histological studies (bronchoalveolar lavage. The immunosuppressive therapy by 1 mg/kg/d prednisone was immediately started, the baby returned home on steroid therapy at a dose of 0,5 mg/kg/d. The diagnosis of idiopathic pulmonary hemosiderosis should be evocated at any age, even in the neonate, when the clinical presentation (hemoptysis and abnormal radiological chest images is strongly suggestive.

  20. Neonatal bartter syndrome

    International Nuclear Information System (INIS)

    A pre-term baby girl was born following a pregnancy complicated by severe polyhydramnios at a gestational age of 36 weeks. She was initially suffering from respiratory distress consistent with idiopathic respiratory distress syndrome, and altered electrolyte imbalance with hyponatremia, hypokalemia and hypochloremic metabolic alkalosis. However, during the third week of life when she had dehydration along with significant electrolyte imbalance, Bartter's syndrome was considered which was supported by findings of high renin and aldosterone levels. Treatment was done by correction of electrolytes and dehydration along with indomethacin. The drug was well tolerated. The infant showed correction of electrolyte imbalance. The features of this case suggest an extreme form of Bartter's syndrome presenting from the early days of life. The syndrome is reported because of it's rarity and alerts pediatricians to the antenatal and neonatal variant of Bartter's syndrome. (author)

  1. The neonate in distress

    International Nuclear Information System (INIS)

    Respiratory distress is a very common and yet non-specific symptom in neonates and young infants. It may be manifested clinically in many ways, including tachypnea, apnea, periodic respiratory, grunting, retractions, nasal flaring, and cyanosis. In many instances, the chest radiograph is diagnostic or at least suggestive of the diagnosis. This fact is important in determining surgical or medical conditions that require emergency therapy. Even if the chest film is normal, valuable information can be gained. This initial normal radiograph can be used as a baseline film in the face of further developing symptoms which, likewise, may have developing radiographic findings. In any event, the chest radiograph gives the clinician ''direction'' in his or her search for the cause of the patient's respiratory distress

  2. Radiologic findings of neonatal sepsis

    International Nuclear Information System (INIS)

    To review the simple radiographic and sonographic findings in infants with neonatal sepsis. We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm : term=23 :13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18(50%), 9(25%), and 1(3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients(17%) radiologic examinations revealed no abnormality. In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment

  3. Neonatal euthanasia: The Groningen Protocol*

    Science.gov (United States)

    Vizcarrondo, Felipe E.

    2014-01-01

    For the past thirty years, voluntary euthanasia and physician-assisted suicide of adult patients have been common practice in the Netherlands. Neonatal euthanasia was recently legalized in the Netherlands and the Groningen Protocol (GP) was developed to regulate the practice. Supporters claim compliance with the GP criteria makes neonatal euthanasia ethically permissible. An examination of the criteria used by the Protocol to justify the euthanasia of seriously ill neonates reveals the criteria are not based on firm moral principles. The taking of the life of a seriously ill person is not the solution to the pain and suffering of the dying process. It is the role of the medical professional to care for the ailing patient with love and compassion, always preserving the person's dignity. Neonatal euthanasia is not ethically permissible. PMID:25473136

  4. Neonatal euthanasia: The Groningen Protocol.

    Science.gov (United States)

    Vizcarrondo, Felipe E

    2014-11-01

    For the past thirty years, voluntary euthanasia and physician-assisted suicide of adult patients have been common practice in the Netherlands. Neonatal euthanasia was recently legalized in the Netherlands and the Groningen Protocol (GP) was developed to regulate the practice. Supporters claim compliance with the GP criteria makes neonatal euthanasia ethically permissible. An examination of the criteria used by the Protocol to justify the euthanasia of seriously ill neonates reveals the criteria are not based on firm moral principles. The taking of the life of a seriously ill person is not the solution to the pain and suffering of the dying process. It is the role of the medical professional to care for the ailing patient with love and compassion, always preserving the person's dignity. Neonatal euthanasia is not ethically permissible. PMID:25473136

  5. Histological changes in neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Eleonora Obinu

    2014-06-01

    Full Text Available One of the most significant causes of neonatal morbidity and mortality is represented by neonatal sepsis that often manifests itself as a systemic inflammatory response syndrome (SIRS. The progression of SIRS usually leads to multiple organ dysfunction, occasionally culminating in multiple organ failure (MOF. The loss of endothelial barrier represents the unifying lesion of multiple organs in newborns affected by sepsis and the most important pathological change responsible for the evolution toward MOF in neonates. The aim of this study is to present the most important pathological changes occurring in neonatal sepsis.  Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  6. Radiologic findings of neonatal sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sam Soo; Han, Dae Hee; Choi, Guk Myeong; Jung, Hye Won [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Yoon, Hye Kyung; Han, Bokyung Kim; Lee, Nam Yong [Sansung Medical Center, Seoul (Korea, Republic of)

    1997-06-01

    To review the simple radiographic and sonographic findings in infants with neonatal sepsis. We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm : term=23 :13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18(50%), 9(25%), and 1(3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients(17%) radiologic examinations revealed no abnormality. In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment.

  7. Bilateral Vision Loss Secondary to Pachymeningitis in a Patient with IgG4-Related Disease

    OpenAIRE

    Ramirez, Lucas; D’Auria, Andrea; Popalzai, Adeel; Sanossian, Nerses

    2014-01-01

    IgG4-related disease (IgG4-RD) is a recently recognized fibroinflammatory condition associated with disease in nearly every organ, including the meninges. A proportion of idiopathic hypertrophic pachymeningitis cases may involve a component of meningeal IgG4-RD. We present a patient with severe bilateral vision loss found to have thickening of the dura mater on MRI, and subsequently diagnosed with IgG4-RD after dural biopsy.

  8. Membranous nephropathy as a rare renal manifestation of IgG4-related disease

    OpenAIRE

    Kurien, A. A.; RayChaudhury, A; Walker, P D

    2015-01-01

    IgG4-related disease, a newly described immune-mediated disorder with tissue infiltration of IgG4-positive plasma cells, has been reported in nearly every organ. In the kidney, it manifests as IgG4-related tubulointerstitial nephritis (TIN) but may also present as membranous nephropathy. We report a patient with IgG4 renal disease who had membranous nephropathy as well as TIN.

  9. IgG4-related chronic rhinosinusitis: A new clinical entity of nasal disease

    OpenAIRE

    Moteki, Hideaki; Yasuo, Masanori; Hamano, Hideaki; Uehara, Takeshi; Usami, Shin-Ichi

    2010-01-01

    Conclusion IgG4-related disease involves nasal manifestations with chronic rhinosinusitis (CRS). This type of sinusitis is a new clinical entity of nasal disease associated with a high level of serum IgG4 for which steroid therapy is effective. Objectives. To confirm whether IgG4-related disease has distinctive chronic rhinosinusitis. Methods: We compared serum IgG4 levels as well as nasal computed tomography (CT) and clinicopathological findings before and after glucocorticoid treatment in 3...

  10. Recurrent Mastoiditis Mimics IgG4 Related Disease: A Potential Diagnostic Pitfall.

    Science.gov (United States)

    Deshpande, Vikram; Zane, Nicolas A; Kraft, Stefan; Stone, John H; Faquin, William C

    2016-09-01

    IgG4-related disease (IgG4-RD) is a recently recognized entity that causes progressive fibrosis and formation of mass lesions. IgG4-RD can be diagnosed histologically by its hallmarks of storiform fibrosis, prominent lymphoplasmacytic infiltrate, and obliterative phlebitis, accompanied by the infiltration of excessive numbers of IgG4-positive plasma cells as well as elevations in serum IgG4 concentrations. A recent publication reported a case of IgG4-RD in the mastoid sinus, representing a new anatomic location for this disease. We report two additional cases of IgG4-RD occurring in the mastoid and causing clinical mastoiditis. The presenting symptoms were varied-tinnitus, hearing loss, and cranial nerve palsies. All three cases showed a dense lymphoplasmacytic infiltrate, storiform type fibrosis as well as elevated numbers of IgG4 positive plasma cells. The three patients responded to immunosuppressive therapy that included steroids and Rituximab. We further investigated 162 consecutive mastoiditis cases at our institution in order to determine the frequency of IgG4-RD as a previously unrecognized cause of mastoiditis. Within this latter cohort we identified nine cases of mastoiditis that had two of the histologic features of IgG4-RD, specifically storiform fibrosis and a dense lymphoplasmacytic infiltrate. Two of these cases showed >50 IgG4-positive plasma cells per high-power field with IgG4-IgG ratio of >40 %, thus fulfilling histological criteria for IgG4-RD. However, both were due to severe acute or chronic infection. In conclusion, we reaffirm IgG4 related mastoiditis as a distinct but uncommon cause of recurrent mastoiditis. The diagnosis of IgG4-related mastoiditis should be rendered with caution, and only after the exclusion of potential mimickers, particularly infection. PMID:27091207

  11. Neonatal varicella: A case report

    OpenAIRE

    Bhardwaj AK; Sharma PD; Sharma A

    2011-01-01

    Chicken pox is an infectious childhood disease. It is rare in infants and newborns due to passive immunity received from the mother. The characteristic skin eruptions in chicken pox are vesicular with erythematous base and accompanied with pruritus. The skin of the palms and soles is typically spared. We report a case of neonatal varicella where the mother was having skin eruptions at the time of delivery and the neonate contracted it during the perinatal period and developed clinical disease...

  12. IgG4-related tubulointerstitial nephritis associated with only lymphadenopathy and without elevated serum IgG4 or renal imaging abnormalities: a case report and literature review

    OpenAIRE

    Qiao, Xi; Wang, Lihua; Wang, Chen; Gao, Lifang; Yao, Shulei; Wu, Liran; Zhang, Xiaoqin

    2015-01-01

    IgG4-related tubulointerstitial nephritis (IgG4-TIN) is the most common renal manifestation of IgG4-related kidney disease (IgG4-RKD) and may cause acute or chronic renal dysfunction. Imaging often shows heterogeneous densities in the kidneys, such as a mass or multiple nodules. Serology usually demonstrates high levels of serum IgG4 and total IgG. Most patients have other organs involvement by IgG4 related disease. Although lymphadenopathy is frequently observed in patients with IgG4-TIN, it...

  13. Polyclonal hyperviscosity syndrome in IgG4-related disease and associated conditions

    OpenAIRE

    Chen, Luke YC; Wong, Patrick CW; Noda, Shinji; Collins, David R.; Sreenivasan, Gayatri M; Coupland, Robert C

    2015-01-01

    Key Clinical Message Polyclonal hyperviscosity syndrome (HVS) is rare and has been reported in various disorders of immune dysregulation and lymphoid hyperplasia. IgG4-Related Disease (IgG4-RD) is an emerging disorder often associated with exuberant hypergammaglobulinemia, and this review of seven cases establishes IgG4-RD as an important cause of polyclonal HVS.

  14. Molecular recognition of antibody (IgG) by cellular Fc receptor (FcRI).

    Science.gov (United States)

    Burton, D R; Jefferis, R; Partridge, L J; Woof, J M

    1988-11-01

    Earlier studies from this and other laboratories have provided indirect evidence for the involvement of the C gamma 2 domain of human IgG in the binding of IgG to the high affinity monocyte Fc receptor (FcRI). Two approaches have been used to extend these studies and to further localize the site of interaction on human IgG. Firstly, monoclonal antibodies (MAbs) directed against different epitopes on IgG were assayed for their capacity to inhibit the binding of radiolabelled IgG to human monocytes or U937 cells. The capacity of the MAbs to interact with their respective epitopes on FcR-bound IgG was also studied using indirect radiobinding and immunofluorescence assays. Secondly, a number of IgGs from several different species and fragments of human IgGs were assayed for their ability to inhibit the binding of radiolabelled IgG to human monocytes. The amino acid sequences of those IgGs exhibiting relatively tight, intermediate or weak binding to monocyte FcRs were compared. On the basis of these studies a possible monocyte FcR-binding site on human IgG is postulated, involving the lower hinge region of IgG (residues Leu 234-Ser 239) with possible involvement of the nearby N-proximal bend and two beta-strands (Gly 316-Lys 338). PMID:2975762

  15. Clinical and imaging features of neonatal chlamydial pneumonia

    International Nuclear Information System (INIS)

    Objective: To study the clinical and imaging features of chlamydial pneumonia in newborns. Methods: Medical records,chest X-Ray and CT findings of 17 neonates with chlamydia pneumonia were reviewed. The age was ranged from 9.0 to 28.0 days with mean of (16.8 ± 5.8) days. There were 11 males and 6 females. Sixteen were full term infants and one was born post term. All babies were examined with chest X-ray film, and 13 patients also underwent chest CT scan. Serologic test using immunofluorescence method for Chlamydia IgG and IgM antibodies were performed in all patients. Results: All newborns presented with cough but without fever. Positive results of the serologic tests were demonstrated. Chest films showed bilateral hyperventilation in 10 patients, diffuse reticular nodules in 10 patients including nodules mimicking military tuberculosis in 7 patients, and accompanying consolidation in 9 patients. CT features included interstitial reticular nodules in 13 patients with size, density, and distribution varied. Subpleural nodules (11 patients) and fusion of nodules (10 patients) predominated. Bilateral hyperinflation was found in 10 patients, which combined with infiltration in 12 patients, thickening of bronchovascular bundles in 10 patients, and ground glass sign in 5 patients. No pleural effusion and lymphadenopathy was detected in any patient. Conclusions: Bilateral hyperinflation and diffuse interstitial reticular nodules were the most common imaging features of neonatal chlamydial pneumonia. The main clinical characteristic of neonatal chlamydial pneumonia is respiratory symptoms without fever, which is helpful to its diagnosis. (authors)

  16. Genetic and infectious profiles influence cerebrospinal fluid IgG abnormality in Japanese multiple sclerosis patients.

    Directory of Open Access Journals (Sweden)

    Satoshi Yoshimura

    Full Text Available BACKGROUND: Abnormal intrathecal synthesis of IgG, reflected by cerebrospinal fluid (CSF oligoclonal IgG bands (OBs and increased IgG index, is much less frequently observed in Japanese multiple sclerosis (MS cohorts compared with Western cohorts. We aimed to clarify whether genetic and common infectious backgrounds influence CSF IgG abnormality in Japanese MS patients. METHODOLOGY: We analyzed HLA-DRB1 alleles, and IgG antibodies against Chlamydia pneumoniae, Helicobacter pylori, Epstein-Barr virus nuclear antigen (EBNA, and varicella zoster virus (VZV in 94 patients with MS and 367 unrelated healthy controls (HCs. We defined CSF IgG abnormality as the presence of CSF OBs and/or increased IgG index (>0.658. PRINCIPAL FINDINGS: CSF IgG abnormality was found in 59 of 94 (62.8% MS patients. CSF IgG abnormality-positive patients had a significantly higher frequency of brain MRI lesions meeting the Barkhof criteria compared with abnormality-negative patients. Compared with HCs, CSF IgG abnormality-positive MS patients showed a significantly higher frequency of DRB1 1501, whereas CSF IgG abnormality-negative patients had a significantly higher frequency of DRB1 0405. CSF IgG abnormality-positive MS patients had a significantly higher frequency of anti-C. pneumoniae IgG antibodies compared with CSF IgG abnormality-negative MS patients, although there was no difference in the frequency of anti-C. pneumoniae IgG antibodies between HCs and total MS patients. Compared with HCs, anti-H. pylori IgG antibodies were detected significantly less frequently in the total MS patients, especially in CSF IgG abnormality-negative MS patients. The frequencies of antibodies against EBNA and VZV did not differ significantly among the groups. CONCLUSIONS: CSF IgG abnormality is associated with Western MS-like brain MRI features. DRB1 1501 and C. pneumoniae infection confer CSF IgG abnormality, while DRB1 0405 and H. pylori infection are positively and negatively

  17. Performance Evaluation of the VIDAS(®) Measles IgG Assay and Its Diagnostic Value for Measuring IgG Antibody Avidity in Measles Virus Infection.

    Science.gov (United States)

    Dina, Julia; Creveuil, Christian; Gouarin, Stephanie; Viron, Florent; Hebert, Amelie; Freymuth, Francois; Vabret, Astrid

    2016-01-01

    The objective of this study is primarily to compare the performance of the VIDAS(®) Measles immunoglobulin (Ig)G assay to that of two other serological assays using an immunoassay technique, Enzygnost(®) Anti-measles Virus/IgG (Siemens) and Measles IgG CAPTURE EIA(®) (Microimmune). The sensitivity and the agreement of the VIDAS(®) Measles IgG assay compared to the Enzygnost(®) Anti-measles Virus/IgG assay and the Measles IgG CAPTURE EIA(®) assay are 100%, 97.2% and 99.0%, 98.4%, respectively. The very low number of negative sera for IgG antibodies does not allow calculation of specificity. As a secondary objective, we have evaluated the ability of the VIDAS(®) Measles IgG assay to measure anti-measles virus IgG antibody avidity with the help of the VIDAS(®) CMV IgG Avidity reagent, using 76 sera from subjects with measles and 238 other sera. Different groups of populations were analyzed. In the primary infection measles group, the mean IgG avidity index was 0.16 (range of 0.07 to 0.93) compared to 0.79 (range of 0.25 to 1) in the serum group positive for IgG antibodies and negative for IgM. These data allow to define a weak anti-measles virus IgG antibody avidity as an avidity index (AI) AI > 0.6. The VIDAS(®) Measles IgG assay has a performance equivalent to that of other available products. Its use, individual and quick, is well adapted to testing for anti-measles immunity in exposed subjects. PMID:27556477

  18. Performance Evaluation of the VIDAS® Measles IgG Assay and Its Diagnostic Value for Measuring IgG Antibody Avidity in Measles Virus Infection

    Science.gov (United States)

    Dina, Julia; Creveuil, Christian; Gouarin, Stephanie; Viron, Florent; Hebert, Amelie; Freymuth, Francois; Vabret, Astrid

    2016-01-01

    The objective of this study is primarily to compare the performance of the VIDAS® Measles immunoglobulin (Ig)G assay to that of two other serological assays using an immunoassay technique, Enzygnost® Anti-measles Virus/IgG (Siemens) and Measles IgG CAPTURE EIA® (Microimmune). The sensitivity and the agreement of the VIDAS® Measles IgG assay compared to the Enzygnost® Anti-measles Virus/IgG assay and the Measles IgG CAPTURE EIA® assay are 100%, 97.2% and 99.0%, 98.4%, respectively. The very low number of negative sera for IgG antibodies does not allow calculation of specificity. As a secondary objective, we have evaluated the ability of the VIDAS® Measles IgG assay to measure anti-measles virus IgG antibody avidity with the help of the VIDAS® CMV IgG Avidity reagent, using 76 sera from subjects with measles and 238 other sera. Different groups of populations were analyzed. In the primary infection measles group, the mean IgG avidity index was 0.16 (range of 0.07 to 0.93) compared to 0.79 (range of 0.25 to 1) in the serum group positive for IgG antibodies and negative for IgM. These data allow to define a weak anti-measles virus IgG antibody avidity as an avidity index (AI) AI > 0.6. The VIDAS® Measles IgG assay has a performance equivalent to that of other available products. Its use, individual and quick, is well adapted to testing for anti-measles immunity in exposed subjects. PMID:27556477

  19. Autoradiographic detection of IgG and viral antigens

    International Nuclear Information System (INIS)

    Autoradiographic methods can be used as an alternative to indirect immunofluorescence to detect viral antigen expression or the presence of IgG in tissue sections. Iodinated protein A isolated from Staphylococcus aureus detects an influx of IgG into the central nervous system of mice inoculated with the coronavirus SD. Antispecies antibody that has been iodinated detects coronavirus antigen expression for 24 days post-inoculation while it is only detectable for 10 days by immunofluorescence. A direct comparison of indirect fluorescence and autoradiographic methods indicates that the autoradiographic techniques are considerably more sensitive. This increased sensitivity is sufficient to permit the detection of viral antigen in formalin fixed paraffin embedded tissue sections. (Auth.)

  20. Serological IgG avidity test for ocular toxoplasmosis

    Directory of Open Access Journals (Sweden)

    Suresh S

    2012-01-01

    Full Text Available Subramaniam Suresh1, Saidin Nor-Masniwati1, Muhd Nor Nor-Idahriani1, Wan-Hitam Wan-Hazabbah1, Mohamed Zeehaida2, Embong Zunaina11Department of Ophthalmology, 2Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaBackground: The purpose of this study was to evaluate the immunoglobulin (Ig G avidity of serological toxoplasmosis testing in patients with ocular inflammation and to determine the clinical manifestations of ocular toxoplasmosis.Methods: A retrospective review of all patients presenting with ocular inflammation to the Hospital Universiti Sains Malaysia, Kelantan, Malaysia between 2005 and 2009 was undertaken. Visual acuity, clinical manifestations at presentation, toxoplasmosis antibody testing, and treatment records were analyzed.Results: A total of 130 patients with ocular inflammation were reviewed retrospectively. The patients had a mean age of 38.41 (standard deviation 19.24, range 6–83 years. Seventy-one patients (54.6% were found to be seropositive, of whom five (3.8% were both IgG and IgM positive (suggestive of recently acquired ocular toxoplasmosis while one (0.8% showed IgG avidity ≤40% (suggestive of recently acquired ocular toxoplasmosis and 65 patients (50.0% showed IgG avidity >40% (suggestive of reactivation of toxoplasmosis infection. Chorioretinal scarring as an ocular manifestation was significantly more common in patients with seropositive toxoplasmosis (P = 0.036. Eighteen patients (13.8% were diagnosed as having recent and/or active ocular toxoplasmosis based on clinical manifestations and serological testing.Conclusion: Ocular toxoplasmosis is a clinical diagnosis, but specific toxoplasmosis antibody testing helps to support the diagnosis and to differentiate between reactivation of infection and recently acquired ocular toxoplasmosis.Keywords: ocular toxoplasmosis, chorioretinal scar, toxoplasmosis antibody, IgG avidity test

  1. Perfil de isotipos de imunoglobulinas e subclasses de IgG na leishmaniose tegumentar americana Immunoglobulin isotype and IgG subclass profiles in american tegumentary leishmaniasis

    Directory of Open Access Journals (Sweden)

    Maria Aparecida de Souza

    2005-04-01

    Full Text Available O presente trabalho avaliou o perfil de anticorpos em amostras de soro de 37 pacientes com diagnóstico clínico confirmado ou compatível com leishmaniose tegumentar americana atendidos no Hospital de Clínicas da Universidade Federal de Uberlândia, MG. Os perfis das classes de imunoglobulinas e subclasses de IgG foram analisados pelo teste ELISA indireto, utilizando-se antígeno solúvel de Leishmania (Leishmania amazonensis. A avidez dos anticorpos foi determinada pelo tratamento com uréia a 6 M, após incubação dos soros com o antígeno. Observou-se que 97%, 94,6%, 57,5 e 21,5% das amostras testadas apresentaram anticorpos anti-Leishmania das classes IgE, IgG, IgA e IgM, respectivamente e, os perfis das subclasses de IgG demonstraram, IgG1>IgG3>IgG2>IgG4. Os anticorpos IgE anti-Leishmania de alta avidez corresponderam a 44,4%. Por outro lado, IgG e IgA anti-Leishmania foram em sua maioria (62,8 e 47,8%, respectivamente, de média avidez. A variação do perfil de isotipos, bem como a avidez das imunoglobulinas refletiu a complexidade da resposta imune humoral contra a leishmaniose tegumentar americana.The present work investigated the serum antibody profiles in 37 patients with American tegumentary leishmaniasis, who were attended at Hospital de Clinicas - Universidade Federal de Uberlandia, MG, Brazil. The immunoglobulin class and IgG subclass profiles were analyzed by indirect ELISA using Leishmania (Leishmania amazonensis soluble antigen. The antibody avidity was determined by 6 M urea treatment after incubation with immunoenzymatic conjugate. It was observed that 97% of the serum samples presented anti-Leishmania antibodies for IgE class, 94.6% IgG, 57.5% IgA and 21.5% IgM class. For IgG subclasses the profiles were in the following order of frequency: IgG1>IgG3>IgG2>IgG4. High avidity of anti-Leishmania IgE antibodies was found in 44.4% of the samples. On the other hand, moderate avidity of specific IgG and IgA was observed in 62

  2. Association between IgG4 Autoantibody and Complement Abnormalities in Systemic Lupus Erythematosus.

    Science.gov (United States)

    Pan, Qingjun; Guo, Linjie; Wu, Jing; Cai, Jun; Liao, Huanjin; Lan, Qiaofen; Peng, Yanxia; He, Yiming; Liu, Hua-Feng

    2016-01-01

    In order to investigate the association between IgG4 autoantibody and complement abnormalities in systemic lupus erythematosus (SLE), 72 newly diagnosed SLE patients, 67 rheumatoid arthritis (RA) patients, and 41 healthy normals were employed. Serum levels of antinuclear IgG4 and IgG4-specific IgM-rheumatoid factor (RF) were measured, and the correlations between serum levels of antinuclear IgG4 and several clinical parameters were analyzed. Also, the levels of IgG subclasses, C1q, and C3 deposition in lupus nephritis (LN) were detected. The results showed that serum levels of antinuclear IgG4 were higher in SLE patients relative to healthy normals (P < 0.01). Serum levels of antinuclear IgG4 in SLE patients were positively correlated with serum levels of total IgG4, albumin, and C3 (r = 0.61, P < 0.05; r = 0.40, P < 0.05; and r = 0.54, P < 0.05, resp.) and negatively correlated with 24-hour urinary protein (r = 0.49, P < 0.05). Serum levels of IgG4-specific IgM-RF were higher in RA patients than in SLE patients (P < 0.001). Also, the ratio of the deposition score for IgG4/(IgG1 + IgG2 + IgG3 + IgG4) was negatively correlated with the score for C1q and C3 deposition in LN (r = 0.34, P < 0.05; r = 0.51, P < 0.01, resp.). In summary, the IgG4 autoantibody may dampen the inflammatory response in SLE, thus maybe providing a novel therapeutic target for SLE. PMID:27597802

  3. Recombinant Human IgG antibodies against Human Cytomegalovirus

    Institute of Scientific and Technical Information of China (English)

    TAO DUAN; XIAO-FANG WANG; SHU-YUAN XIAO; SHU-YAN GU; MI-FANG LIANG

    2008-01-01

    Objective To study the passive immunization with human monoclonal antibodies as for prophylaxis of human eytomegalovirus (HCMV) infection. Methods Fab monochinal antibodies to HCMV were recovered by repertoire cloning of mRNA from a HCMV infected individual. Antigen binding specificity, CDR sequence of Vhand Vland neutralizing activity on HCMV AD169 stain were analyzed in vitro. The light and heavy chain Fd fragment genes of Fab antibodies were further cloned into a recombinant baculovirus expression vector pAC-κ-Fc to express intact IgG. Secreted products were purified with affinity chromatography using protein G. Results SDS-PAGE and Western blot confirmed the expression of the intact IgG. Immuno-blotting and -precipitation were used to identify HCMV proteins. One Fab monoclonal antibodyrecognized a conformational HCMV protein. Conclusion IgG antibodies can neutralize the HCMV AD169 strain efficiently at a titer of 2.5 μg/mL and may prove valuable for passive immunoprophylaxis against HCMV infection in humans.

  4. Granulocyte-associated IgG in neutropenic disorders

    International Nuclear Information System (INIS)

    We applied a radiolabeled antiglobulin test to a study of patients with a variety of neutropenic disorders. After defining the nature of the interaction of radiolabeled anti-IgG with the neutrophil, we studied 16 patients with neutropenia of uncertain etiology and adequate bone marrow granulocyte precursors. Twelve of these 16 patients had increased neutrophil-associated IgG (PMN-IgG). Patients with the highest levels of PMN-IgG had the lowest neutrophil counts. The majority of patients with neutropenia and increased PMN-IgG had an underlying immunologic disorder that included immune thrombocytopenic purpura in 5 patients and autoimmune hemolytic anemia in 1 patient. In some patients, elevated PMN-IgG preceded other evidence for immunologic disease. The direct antiglobulin test helped to distinguish neutropenic patients with increased PMN-IgG both from patients with neutropenia due to a known nonimmune disorder and from nonneutropenic patients with rheumatoid arthritis or systemic lupus erythematosis. Each of four patients with increased neutrophil-associated IgG treated with systemic corticosteroids responded clinically with an associated fall in neutrophil IgG and a rise in the circulating neutrophil count. The radiolabeled antiglobulin test appears useful in defining a subpopulation of patients with neutropenia due to an underlying immunologic disorder

  5. Quantitative analysis of the IgG and IgG subclass immune responses to chromosomal Pseudomonas aeruginosa beta-lactamase in serum from patients with cystic fibrosis by western blotting and laser scanning densitometry

    DEFF Research Database (Denmark)

    Petersen, T D; Ciofu, O; Pressler, T; Giwercman, B; Pedersen, S S; Høiby, N

    1996-01-01

    IgG1, 79% had IgG4, 56% IgG2, and only 16% of the patients had IgG3 a beta ab. The IgG1 and IgG4 a beta ab appeared first, and more than 50% of the patients were IgG1 and IgG4 a beta ab positive within 2-3 years of the onset of infection, but IgG2 positivity only appeared after seven years and IgG3...... remained absent from most of the patients. The median a beta ab levels increased during chronic infection: 100-fold for IgG1, 22-fold for IgG2, and 45-fold for IgG4. A 16-fold increase in the IgG3 a beta ab levels was detected in the six patients who developed IgG3 a beta ab. In the first four years of the...... chronic infection the a beta ab titres were higher in patients with good lung function than in those with poor lung function. CONCLUSIONS: The association of a weak IgG3 and a strong IgG4 a beta ab response suggests that the contribution of a beta ab antibodies to lung diseases mediated by immune...

  6. The Utility of Serum IgG4 Concentrations as a Biomarker

    OpenAIRE

    Takayuki Watanabe; Masahiro Maruyama; Hideaki Hamano; Masafumi Maruyama; Shigeyuki Kawa; Norikazu Arakura; Takashi Muraki; Tetsuya Ito

    2012-01-01

    IgG4-related disease is a new disease entity involving IgG4 in its clinical presentation and having 6 characteristic features: (1) systemic involvement; (2) solitary or multiple lesions showing diffuse or localized swelling, masses, nodules, and/or wall thickening on imaging; (3) high serum IgG4 concentration >135 mg/dL; (4) abundant infiltration of lymphoplasmacytes and IgG4-bearing plasma cells; (5) a positive response to corticosteroid therapy; and (6) complications of other IgG4-related d...

  7. A case of adenoid cystic carcinoma associated with IgG4-related disease

    OpenAIRE

    Tsuyoshi Shimo; Mayumi Yao; Yuichiro Takebe; Yuko Ono; Kyoichi Obata; Naito Kurio; Soichiro Ibaragi; Norie Yoshioka; Koji Kishimoto; Yoshinobu Yanagi; Hitoshi Nagatsuka; Akira Sasaki

    2015-01-01

    Introduction: Immunoglobulin G4-related disease (IgG4-RD) is an inflammatory condition associated with elevated serum IgG4 levels and tissue infiltration by IgG4-expressing plasma cells. We present a case of adenoid cystic carcinoma (ACC) of the submandibular gland with possible involvement of IgG4-RD. Presentation of case: The patient was a 59-year-old man presenting with a swollen right submandibular gland. Laboratory tests revealed IgG4 levels of 176 mg/dl (reference range: 4.8–105). An...

  8. Evaluation of diagnostic criteria for IgG4-related tubulointerstitial nephritis

    OpenAIRE

    Tang, Xuanli; Zhu, Bin; Chen, Riping; Hu, Yunqin; Zhang, Yinghua; Zhu, Xiaoling; Chen, Hongyu; Wang, Yongjun

    2015-01-01

    Background IgG4-TIN is the most common pattern of renal involvement in IgG4-related disease. There are several proposed diagnostic criteria of IgG4-TIN recently. Two of them proposed by the Mayo Clinic and JSN are predominant. However, histopathological criteria of the number of IgG4+ plasma cells and several histological features are still under discussion due to low amount of tissue in renal biopsy specimens and low frequency of this kind of specimens. We aimed to screen IgG4-TIN on archive...

  9. IgG4-related systemic disease mimicking renal pelvic cancer: a rare case

    OpenAIRE

    Wang, Yiwei; Chen, Xing; Luo, Rongkui; Wang, Hang; Wang, Guomin; Hou, Yingyong; Guo, Jianming

    2014-01-01

    Background Immunoglobulin G4–related disease (IgG4-RD) is a new clinical entity. Characteristic features of IgG4-RD are elevated serum IgG4 levels, infiltration of IgG4-positive cells, mass-forming lesions with fibrosis and good response to corticosteroids. The variable imaging features of IgG4-RD and the overlap with other differential diagnoses often pose a diagnostic challenge, as they frequently mimic malignant tumors or other inflammatory diseases in the abdomen. Case presentation A 54-y...

  10. INVISIBLE MURDERER: NEONATAL TETANUS

    Directory of Open Access Journals (Sweden)

    Yonca SONMEZ

    2006-06-01

    Full Text Available Neonatal tetanus (NNT has been secondary in the whole world in the death list of diseases which can be protected by the help of vaccine. It’s an important community health problem in the less-developed countries in which pre-birth care services are limited, assisting a mother at childbirth by uneducated people in dirty atmosphere and the immunity against tetanus is not enough. Studies have shown that minor part of the cases have been expressed in most of the countries. Because of that NNT have been called as “silent/invisible murderer”. In Turkey, in the year of 2003 it has been seen 15 cases, and 12 of them have been resulted in death. The methods which will be applied to carry out the elimination of NNT are; the vaccination of pregnant women with at least two doses tetanus toxoid and providing clean birth conditions for all of the pregnant women. However, in Turkey the proportion of the women who have two doses of tetanus vaccine is 41%. To eliminate NNT in our country, all the pregnant women must be attained, the ones who are attained must be presented with qualified pre-birth care service which also includes tetanus immunity and the births must be carried out under healty conditions. As smallpox and polio eradication, NNT elimination will also be accomplished by self-sacrificing works of personnel in primary health care. [TAF Prev Med Bull 2006; 5(3.000: 229-233

  11. Overview of IgG4-Related Tubulointerstitial Nephritis and Its Mimickers.

    Science.gov (United States)

    Jeong, Hyeon Joo; Shin, Su-Jin; Lim, Beom Jin

    2016-01-01

    Tubulointerstitial nephritis (TIN) is the most common form of renal involvement in IgG4-related disease. It is characterized by a dominant infiltrate of IgG4-positive plasma cells in the interstitium and storiform fibrosis. Demonstration of IgG4-positive plasma cells is essential for diagnosis, but the number of IgG4-positive cells and the ratio of IgG4-positive/IgG-positive plasma cells may vary from case to case and depending on the methods of tissue sampling even in the same case. IgG4-positive plasma cells can be seen in TIN associated with systemic lupus erythematosus, Sjögren syndrome, or anti-neutrophil cytoplasmic antibody-associated vasculitis, which further add diagnostic confusion and difficulties. To have a more clear view of IgG4-TIN and to delineate differential points from other TIN with IgG4-positive plasma cell infiltrates, clinical and histological features of IgG4-TIN and its mimickers were reviewed. In the rear part, cases suggesting overlap of IgG4-TIN and its mimickers and glomerulonephritis associated with IgG4-TIN were briefly described. PMID:26666884

  12. Bacterial Culture of Neonatal Sepsis

    Directory of Open Access Journals (Sweden)

    AH Movahedian

    2006-08-01

    Full Text Available Neonatal bacterial sepsis is one of the major cause of morbidity and mortality in neonates. This retrospective study was performed to determine the incidence of bacterial sepsis with focus on Gram negative organisms in neonates admitted at Beheshti Hospital in Kashan, during a 3-yr period, from September 2002 to September 2005. Blood culture was performed on all neonates with risk factors or signs of suggestive sepsis. Blood samples were cultured using brain heart infusion (BHI broth according to standard method. From the 1680 neonates 36% had positive blood culture for Pseudomans aeruginosa, 20.7% for Coagulase negative Staphylococci, and 17% for Klebsiella spp. Gram-negative organisms accounted for 72.1% of all positive cultures. The overall mortality rate was 19.8% (22 /111 of whom 63.6% (14 /22 were preterm. Pseudomona aeruginosa and Klebsiella spp. showed a high degree of resistance to commonly used antibiotics (ampicillin, gentamicin as well as third generation cephalosporins. Continued local surveillance studies are urged to monitor emerging antimicrobial resistance and to guide interventions to minimize its occurrence.

  13. Spontaneous Intestinal Perforation in Neonates

    Directory of Open Access Journals (Sweden)

    Charu Tiwari

    2015-03-01

    Full Text Available Background: The term Spontaneous Intestinal Perforation (SIP suggests a perforation in the gastrointestinal tract of a newborn with no demonstrable cause.Methods: Four neonates presenting with spontaneous bowel perforation were analyzed with respect to clinical presentation, management and outcome.Results: The mean age at presentation was 11.4 days. There were three males and one female. One of the neonates was preterm, very low birth weight and the other three were full term. Two neonates underwent emergency exploratory laparotomy and two were initially managed by peritoneal drainage in view of poor general condition; one of them improved and did not require further operative intervention. The preterm very low birth weight neonate was stabilized and explored after 48 hours. Intra-operatively, two of them had two ileal perforations each which required ileostomy; one had single perforation in the transverse colon which was primarily repaired. All four had an uneventful recovery.Conclusion: SIP is a distinct clinical entity and has better outcome than neonates with intestinal perforation secondary to Necrotizing Enterocolitis (NEC.

  14. SERUM SODIUM CHANGES IN NEONATES RECEIVING PHOTOTHERAPY FOR NEONATAL HYPERBILIRUBINEMIA

    Directory of Open Access Journals (Sweden)

    Sunil Kumar

    2015-07-01

    Full Text Available BACKGROUND : Neonates receiving phototherapy have side effects like hypocalcemia and electrolyte changes. Our study is hereby intended to study the serum sodium changes due to phototherapy. AIMS : To evaluate the serum sodium changes in neonates receiving phototherapy f or neonatal hyperbilirubinemia. SETTINGS AND DESIGN : A prospective hospital based comparative study conducted on neonates admitted in the Neonatal Intensive Care Unit receiving phototherapy. METHODS AND MATERIAL : A predesigned proforma has aided the enroll ment of 252 newborns into the study. Serum bilirubin and serum sodium were determined before and after termination of phototherapy. The first samples were considered as controls. A comparative study was made between before and after phototherapy groups to determine the incidence of serum sodium imbalances. STATISTICAL ANALYSIS USED : Proportions will be compared using chi - square test. All data of various groups will be tabulated and statistically analyzed using suitable statistical tests (Student's t test. RESULTS : Male to Female ratio was 1.45 : 1. Incidence of low birth weight babies was 23% and preterm was 20.2%. Mean birth weight and gestational age was 2.84±0.51 kg and 38.44±1.98 wks respectively. Mean duration of phototherapy was 37.65±11.06 hrs. The incidence of hyponatremia post phototherapy found to be 6% which was more in low birth weight (LBW babies (17.2% , p48 hrs (p<0.001. Even the decline in mean serum sodium values after phototherapy found to be statistically significant. CONCLUSION : Our study shows that neonates u nder phototherapy are at higher risk of hyponatremia. This risk is greater in premature and LBW babies and hence this group of babies should be closely monitored for changes in serum sodium and should be managed accordingly.

  15. Covariance structures of fat and protein influence the estimation of IgG in bovine colostrum.

    Science.gov (United States)

    Løkke, Mette Marie; Engelbrecht, Rikke; Wiking, Lars

    2016-02-01

    On-farm instruments for assessing colostrum quality are needed in order to ensure that the calf is supplied with enough IgG to avoid failure of passive transfer. The aim of this study was to evaluate methods for estimating the IgG concentration in cows' colostrum. This research included 126 colostrum samples from 21 Danish farms with different breeds, ensuring a broad variation pattern in IgG, total protein and fat concentration. Approximately one third of the samples did not fulfil the recommendation of >50 g IgG/l colostrum, and the IgG concentration decreased with time from calving to milking. The ratio of IgG to total protein varied from 6 to 61%, however IgG and total protein were correlated with r2 = 0.70. The variation in fat was independent of variations in protein and IgG. The IgG concentration was measured by ELISA and compared to fast measurements by specific gravity by colostrometer, Brix by refractometer and prediction from infrared spectroscopy. The three fast methods were all correlated to the total protein concentration of colostrum; however specific gravity was also influenced by the fat concentration. Furthermore, specific gravity generally overestimated the IgG concentration, and the cut-off level should be raised to 1050 in order to ensure adequate IgG in colostrum. None of the methods estimated IgG concentration better than the correlation of total protein and IgG, meaning that they all depended on the indirect correlation between total protein and IgG. The results suggest that using a refractometer for quality control of colostrum is an easy and feasible method, and a cut-off level of Brix 22 seems sufficient to assure adequate IgG concentration in colostrum fed to the calf. PMID:26869112

  16. Low Birth Weight Causes Survey in Neonates

    OpenAIRE

    F. Eghbalian

    2007-01-01

    Background: Neonatal mortality rate is one of the main health problems which is affected by prenatal status, maternal, fetal and perinatal conditions. Low birth weight (LBW) is one of the main causes of neonatal and infantile mortality. The aim of this study is an evaluation of the LBW causes in neonates. Methods: This descriptive cross sectional study was done on 1500 neonates, born in Fatemieh Hospital, Hamedan, 2004. Data such as birth weight, sex, maternal age, gestational age, birth inte...

  17. Determinants of neonatal mortality in Indonesia

    OpenAIRE

    Agho Kingsley; Dibley Michael J; Titaley Christiana R; Roberts Christine L; Hall John

    2008-01-01

    Abstract Background Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002. Methods The data source for the analysis was the 2002–20...

  18. Procalcitonin as a marker of neonatal sepsis

    OpenAIRE

    Nazeer Ahmad Jeergal; Rizwan-u-zama; Naushad Ali .N. Malagi; Faisal Farooqui; Sadashiva .B. Ukkali; Ravindra Naganoor; A.N. Thobbi

    2016-01-01

    Introduction: Neonatal sepsis is one of the commonest causes of neonatal mortality in the developing world. Procalcitonin (PCT) has emerged as the most studied and promising sepsis biomarker. Objective: To assess the role of procalcitonin (PCT) as a marker in the early diagnosis, treatment and follow-up of neonatal sepsis. Methods: Twenty five neonates with clinical (n=5), suspected (n=13) and proven sepsis (n=7) were evaluated. The PCT levels were measured by immunoluminoassay before and on ...

  19. Specific IgE, IgG and IgG4 antibodies against house dust mite in patients with bronchial asthma.

    Directory of Open Access Journals (Sweden)

    Okazaki,Morihiro

    1991-08-01

    Full Text Available Serum levels of total IgE, specific IgE, IgG and IgG4 against house dust mite were measured in mite-sensitive asthma patients receiving immunotherapy with house dust. Serum levels of total IgE, mite specific IgE and IgG did not significantly change during the course of hyposensitization. Increased levels of mite specific IgG4 were observed in patients during immunotherapy. The increase in specific IgG4 was dependent on the total dose of house dust administered in both children (r = 0.636, p less than 0.001 and adults (r = 0.629, p less than 0.01. However, the increase of specific IgG4 in adults was not as apparent as in children. These results might suggest that mite specific IgG4 is a useful immunological marker in the immunotherapy for allergic asthma, and that IgG4 antibody acts as a blocking antibody in atopic bronchial asthma.

  20. Are Classification Criteria for IgG4-RD Now Possible? The Concept of IgG4-Related Disease and Proposal of Comprehensive Diagnostic Criteria in Japan

    Directory of Open Access Journals (Sweden)

    Kazuichi Okazaki

    2012-01-01

    Full Text Available Recent studies suggest simultaneous or metachronous lesions in multiorgans characterized by elevated serum levels of IgG4 and abundant infiltration of IgG4-positive plasma cells with various degrees of fibrosis. Two Japanese research committees for IgG4-RD, one from fibrosclerosis (Okazaki team and the other from lymph proliferation (Umehara team supported by the “Research Program for Intractable Disease” of the Ministry of Health, Labor, and Welfare of Japan, have agreed with the unified nomenclature as “IgG4-RD” and proposed the comprehensive diagnostic criteria (CDC for IgG4-RD. Validation of the CDC demonstrated satisfactory sensitivity for the practical use of general physicians and nonspecialists but low sensitivity in the organs to be difficult in taking biopsy specimens such as type1 autoimmune pancreatitis (IgG4-related AIP, compared with IgG4-related sialadenitis/dacryoadenitis (Mikulicz's disease and IgG4-related kidney disease. Although the diagnostic criteria covering all IgG4-RD are hard to be established, combination with the CDC and organ-specific diagnostic criteria should improve sensitivity.

  1. Neonatal Jaundice Detection System.

    Science.gov (United States)

    Aydın, Mustafa; Hardalaç, Fırat; Ural, Berkan; Karap, Serhat

    2016-07-01

    Neonatal jaundice is a common condition that occurs in newborn infants in the first week of life. Today, techniques used for detection are required blood samples and other clinical testing with special equipment. The aim of this study is creating a non-invasive system to control and to detect the jaundice periodically and helping doctors for early diagnosis. In this work, first, a patient group which is consisted from jaundiced babies and a control group which is consisted from healthy babies are prepared, then between 24 and 48 h after birth, 40 jaundiced and 40 healthy newborns are chosen. Second, advanced image processing techniques are used on the images which are taken with a standard smartphone and the color calibration card. Segmentation, pixel similarity and white balancing methods are used as image processing techniques and RGB values and pixels' important information are obtained exactly. Third, during feature extraction stage, with using colormap transformations and feature calculation, comparisons are done in RGB plane between color change values and the 8-color calibration card which is specially designed. Finally, in the bilirubin level estimation stage, kNN and SVR machine learning regressions are used on the dataset which are obtained from feature extraction. At the end of the process, when the control group is based on for comparisons, jaundice is succesfully detected for 40 jaundiced infants and the success rate is 85 %. Obtained bilirubin estimation results are consisted with bilirubin results which are obtained from the standard blood test and the compliance rate is 85 %. PMID:27229489

  2. Fetal and neonatal thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    Chandar Mohan Batra

    2013-01-01

    Full Text Available Fetal thyrotoxicosis is a rare disease occurring in 1 out of 70 pregnancies with Grave′s disease or in 1 out of 4000-50,000 deliveries. The mortality is 12-20%, usually from heart failure, but other complications are tracheal compression, infections and thrombocytopenia. It results from transfer of thyroid stimulating immunoglobulins from mother to fetus through the placenta. This transplacental transfer begins around 20 th week of pregnancy and reaches its maximum by 30 th week. These autoantibodies bind to the fetal thyroid stimulating hormone (TSH receptors and increase the secretion of the thyroid hormones. The mother has an active autoimmune thyroid disease or has been treated for it in the past. She may be absolutely euthyroid due to past treatment by drugs, surgery or radioiodine ablation, but still have active TSH receptor stimulating autoantibodies, which can cause fetal thyrotoxicosis. The other features of this disease are fetal tachycardia, fetal goiter and history of spontaneous abortions and findings of goiter, ascites, craniosyntosis, fetal growth retardation, maceration and hydrops at fetal autopsy. If untreated, this disease can result in intrauterine death. The treatment for this disease consists of giving carbimazole to the mother, which is transferred through the placenta to the fetus. The dose of carbimazole is titrated with the fetal heart rate. If the mother becomes hypothyroid due to carbimazole, thyroxine is added taking advantage of the fact that very little of thyroxine is transferred across the placenta. Neonatal thyrotoxicosis patients are very sick and require emergency treatment. The goal of the treatment is to normalize thyroid functions as quickly as possible, to avoid iatrogenic hypothyroidism while providing management and supportive therapy for the infant′s specific signs and symptoms.

  3. Hypothyroidism in Filipino neonates

    International Nuclear Information System (INIS)

    Thyroid hormone determination (T4, T3, rT3, TSH) in cord blood of 3,897 newborns was carried out in Metro Manila (non-endemic) and central, Northern and Southern Luzon (endemic for goiter). The objective is to detect congenital hypothyroidism and establish its incidence in new born Filipinos. This was done by radioimmunoassay, using commercial kits from Abbott Laboratories. The results obtained as mean values for non-endemic regions are: T4: 10.96 +- 2.25 ug/dl; T3: 60-64 +- 13.82 ng/dl; rT3: 250.4 +- 64.9 ng/dl; and TSH 5.89 +- 2.58 uU/ml, n=200. Mean values in endemic regions (n = 205) are T4: 9.46 +- 2.18 ug/dl; T3: 67.8 +- 12.05 ng/dl; rT3: 184.3 +- 32.7 ng/dl and TSH: 6.65 +- 3.13 uU/ml. From the above data, nomograms were drawn where the values obtained from each case were plotted. From non-endemic regions 28 positive cases were recalled and in the endemic regions 16 positive cases were also recalled for re-examination but most of them turned out to be false positive. As of now, four positive cases were found in Metro Manila, i.e. 4/2, 441 births and five in endemic regions out of 1,456 births so the incidence of neonatal hypothyroidism is 9/3,897 births. This is 9 times higher than most reports abroad which is about 1/4000 births. (Auth.). 36 refs; 10 tabs; 10 figs

  4. CT of the neonatal head

    International Nuclear Information System (INIS)

    Computed tomography (CT) is used less often than other techniques on neonatal units. However, in the acute setting, CT can be invaluable in diagnosing or excluding potentially life-threatening conditions and guiding initial management in neonates. Common indications for scanning include trauma, suspected non-accidental injury, infection, or an acute hypoxic or metabolic event. The aim of this review is to provide an overview of the normal neonatal head at CT and compare this to the common pathological abnormalities. Several key features of each condition will be highlighted. It is important to note that some pathological conditions can have overlapping features at CT and, therefore, the clinical history and additional investigations are also of key importance in determining the diagnosis

  5. Diagnostic imaging in neonatal stroke

    International Nuclear Information System (INIS)

    A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in 4000 newborns. Since the course is often subclinical, the true incidence is probably higher. Diagnosis: Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Discussion: Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity. The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed. (orig.)

  6. Neonatal hemophilia: a rare presentation

    Directory of Open Access Journals (Sweden)

    Nuno Ferreira

    2015-12-01

    Full Text Available Hemophilia A is a X-linked hereditary condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased factor VIII activity leads to increased risk of bleeding events. During neonatal period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Subgaleal hemorrhage during neonatal period is a rare, severe extracranial bleeding with high mortality and usually related to traumatic labor or coagulation disorders. Subgaleal hemorrhage complications result from massive bleeding. We present a neonate with unremarkable family history and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe subgaleal bleeding at 52 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding.

  7. Permanent neonatal diabetes mellitus: clinical observation

    OpenAIRE

    Utts I.A.; Shabarov V.K.; Kravchenya A.R.; Ivanova S.B.; Novikova A.N.

    2015-01-01

    The aim is to study the characteristics of clinical and laboratory picture of neonatal diabetes mellitus in a premature baby; to analyze the course of the disease for 18 months, to determine the mechanisms of development of neonatal diabetes mellitus, to develop a differentiated approach in the treatment of neonatal diabetes mellitus.

  8. Permanent neonatal diabetes mellitus: clinical observation

    Directory of Open Access Journals (Sweden)

    Utts I.A.

    2015-06-01

    Full Text Available The aim is to study the characteristics of clinical and laboratory picture of neonatal diabetes mellitus in a premature baby; to analyze the course of the disease for 18 months, to determine the mechanisms of development of neonatal diabetes mellitus, to develop a differentiated approach in the treatment of neonatal diabetes mellitus.

  9. Neonatal tetanus mortality in coastal Kenya

    DEFF Research Database (Denmark)

    Bjerregaard, P; Steinglass, R; Mutie, D M;

    1993-01-01

    In a house-to-house survey in Kilifi District, Kenya, mothers of 2556 liveborn children were interviewed about neonatal mortality, especially from neonatal tetanus (NNT). The crude birth rate was 60.5 per 1000 population, the neonatal mortality rate 21.1 and the NNT mortality rate 3.1 per 1000...

  10. Increased IgG4 responses to multiple food and animal antigens indicate a polyclonal expansion and differentiation of pre-existing B cells in IgG4-related disease

    OpenAIRE

    2015-01-01

    Background IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory condition, characterised by an elevated serum IgG4 concentration and abundant IgG4-positive plasma cells in the involved organs. An important question is whether the elevated IgG4 response is causal or a reflection of immune-regulatory mechanisms of the disease. Objectives To investigate if the IgG4 response in IgG4-RD represents a generalised polyclonal amplification by examining the response to common environmental an...

  11. Neonatal varicella: A case report

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    Bhardwaj AK

    2011-06-01

    Full Text Available Chicken pox is an infectious childhood disease. It is rare ininfants and newborns due to passive immunity receivedfrom the mother. The characteristic skin eruptions inchicken pox are vesicular with erythematous base andaccompanied with pruritus. The skin of the palms and solesis typically spared. We report a case of neonatal varicellawhere the mother was having skin eruptions at the time ofdelivery and the neonate contracted it during the perinatalperiod and developed clinical disease on the day five of life.Specific anti-viral therapy was given to the mother and thebaby and the recovery was uneventful.

  12. Neonatal anesthesia with limited resources.

    Science.gov (United States)

    Bösenberg, Adrian T

    2014-01-01

    Neonates are the most vulnerable age group in terms of anesthetic risk and perioperative mortality, especially in the developing world. Prematurity, malnutrition, delays in presentation, and sepsis contribute to this risk. Lack of healthcare workers, poorly maintained equipment, limited drug supplies, absence of postoperative intensive care, unreliable water supplies, or electricity are further contributory factors. Trained anesthesiologists with the skills required for pediatric and neonatal anesthesia as well as basic monitoring equipment such as pulse oximetry will go a long way to improve the unacceptably high anesthetic mortality. PMID:24251423

  13. IgG and IgG4 antibodies in subjects with irritable bowel syndrome: a case control study in the general population

    Directory of Open Access Journals (Sweden)

    Ligaarden Solveig C

    2012-11-01

    Full Text Available Abstract Background Patients with Irritable Bowel Syndrome (IBS often relate their symptoms to the intake of food and modify their diet. IgE-mediated food allergy is uncommon in IBS, but the role of IgG-mediated food hypersensitivity remains inconclusive. The primary aim of this study was to compare food- and yeast-specific IgG and IgG4 antibodies in subjects with and without IBS. Methods This was a case control study in the general population for which subjects completed questionnaires about abdominal complaints and their intake of common food items. Blood samples were collected, and food- and yeast-specific IgG and IgG4 antibodies were measured. Antibodies were measured in mg/L. Results We included 269 subjects with IBS and 277 control subjects. After correction for subject characteristics and diet, there were no significant differences with regard to food- and yeast-specific IgG and IgG4 antibodies between subjects with IBS and controls. Lower values of IgG antibodies against egg (OR 0.99 (0.98 to 1.00, p = 0.002 and beef (OR 0.75 (0.60 to 0.94, p = 0.012 and higher values of IgG antibodies against chicken (OR 1.14 (1.03 to 1.27, p = 0.009 were associated with more severe symptoms. Conclusions Our findings suggest that IgG-and IgG4-mediated food and yeast hypersensitivity in IBS is unlikely. IgG antibodies against food and yeast may reflect the diet.

  14. IgG Conformer's Binding to Amyloidogenic Aggregates.

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    Monichan Phay

    Full Text Available Amyloid-reactive IgGs isolated from pooled blood of normal individuals (pAbs have demonstrated clinical utility for amyloid diseases by in vivo targeting and clearing amyloidogenic proteins and peptides. We now report the following three novel findings on pAb conformer's binding to amyloidogenic aggregates: 1 pAb aggregates have greater activity than monomers (HMW species > dimers > monomers, 2 pAbs interactions with amyloidogenic aggregates at least partially involves unconventional (non-CDR interactions of F(ab regions, and 3 pAb's activity can be easily modulated by trace aggregates generated during sample processing. Specifically, we show that HMW aggregates and dimeric pAbs present in commercial preparations of pAbs, intravenous immunoglobulin (IVIg, had up to ~200- and ~7-fold stronger binding to aggregates of Aβ and transthyretin (TTR than the monomeric antibody. Notably, HMW aggregates were primarily responsible for the enhanced anti-amyloid activities of Aβ- and Cibacron blue-isolated IVIg IgGs. Human pAb conformer's binding to amyloidogenic aggregates was retained in normal human sera, and mimicked by murine pAbs isolated from normal pooled plasmas. An unconventional (non-CDR component to pAb's activity was indicated from control human mAbs, generated against non-amyloid targets, binding to aggregated Aβ and TTR. Similar to pAbs, HMW and dimeric mAb conformers bound stronger than their monomeric forms to amyloidogenic aggregates. However, mAbs had lower maximum binding signals, indicating that pAbs were required to saturate a diverse collection of binding sites. Taken together, our findings strongly support further investigations on the physiological function and clinical utility of the inherent anti-amyloid activities of monomeric but not aggregated IgGs.

  15. Pancreatic cancer with a high serum IgG4 concentration

    Institute of Scientific and Technical Information of China (English)

    Terumi Kamisawa; Pong Yui Chen; Yuyang Tu; Hitoshi Nakajima; Naoto Egawa; Kouji Tsuruta; Atsutake Okamoto; Tsunekazu Hishima

    2006-01-01

    Differentiation between autoimmune pancreatitis and pancreatic cancer is sometimes difficult. It has been reported that serum IgG4 concentrations are significantly elevated and particularly high (>135 mg/dL) in autoimmune pancreatitis. Measurement of serum IgG4 has become a useful tool for differentiating between autoimmune pancreatitis and pancreatic cancer. However,we present a 74-year-old female with a markedly elevated serum IgG4 (433 mg/dL) who underwentpancreaticoduodenectomy for pancreatic cancer. Elevated serum IgG4 levels continued after the resection. On histology, adenocarcinoma of the pancreas accompanied with moderate lymphoplasmacytic infiltration infiltrated the lower bile duct and duodenum, but there were no findings of autoimmune pancreatitis. Although a small metastasis was detected in one parapancreatic lymph node, regional lymph nodes were swollen. Abundant IgG4-positive plasma cells infiltrated the cancerous areas of the pancreas, but only a few IgG4-positive plasma cells were detected in the noncancerous areas.Pancreatic cancer cells were not immunoreactive for IgG4. An abundant infiltration of IgG4-positive plasma cells was detected in the swollen regional lymph nodes and in the duodenal mucosa. We believe that the serum IgG4 level was elevated in this patient with pancreatic cancer as the result of an IgG4-related systemic disease that had no clinical manifestations other than lymphadenopathy.

  16. Erdheim-Chester Disease as a Mimic of IgG4-Related Disease

    Science.gov (United States)

    Gianfreda, Davide; Musetti, Claudio; Nicastro, Maria; Maritati, Federica; Cobelli, Rocco; Corradi, Domenico; Vaglio, Augusto

    2016-01-01

    Abstract Immunoglobulin-G4 (IgG4)-related disease (IgG4RD) is a fibro-inflammatory disorder characterized by tissue-infiltrating IgG4+ plasma cells, and, often, high serum IgG4. Several autoimmune, infectious, or proliferative conditions mimic IgG4RD. Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis, characterized by foamy histiocytic infiltration, fibrosis, and chronic inflammation. ECD and IgG4RD manifestations may overlap. A patient presented with huge fibrous retroperitoneal masses causing compression on neighboring structures; the case posed the challenge of the differential diagnosis between IgG4RD and ECD mainly because of a prominent serum and tissue IgG4 response. Retroperitoneal biopsy led to the diagnosis of ECD; the V600E BRAF mutation was found. Treatment with the BRAF inhibitor vemurafenib was started. Treatment failed to induce mass regression and the patient died after 3 months of therapy. Prompted by this case, we examined serum and tissue IgG4 in a series of 15 ECD patients evaluated at our center, and found that approximately one-fourth of the cases have increased IgG4 in the serum and often in the tissue. The differential diagnosis between IgG4RD and ECD can be challenging, as some ECD patients have prominent IgG4 responses. This suggests the possibility of common pathogenic mechanisms between ECD and IgG4RD. PMID:27227923

  17. IgG4 immunostaining and its implications in orbital inflammatory disease.

    Directory of Open Access Journals (Sweden)

    Amanda J Wong

    Full Text Available OBJECTIVE: IgG4-related disease is an emerging clinical entity which frequently involves tissue within the orbit. In order to appreciate the implications of IgG4 immunostaining, we analyzed gene expression and the prevalence of IgG4- immunostaining among subjects with orbital inflammatory diseases. METHODS: We organized an international consortium to collect orbital biopsies from 108 subjects including 22 with no known orbital disease, 42 with nonspecific orbital inflammatory disease (NSOI, 26 with thyroid eye disease (TED, 12 with sarcoidosis, and 6 with granulomatosis with polyangiitis (GPA. Lacrimal gland and orbital adipose tissue biopsies were immunostained for IgG4 or IgG secreting plasma cells. RNA transcripts were quantified by Affymetrix arrays. RESULTS: None of the healthy controls or subjects with TED had substantial IgG4 staining. Among the 63 others, the prevalence of significant IgG4-immunostaining ranged from 11 to 39% depending on the definition for significant. IgG4 staining was detectable in the majority of tissues from subjects with GPA and less commonly in tissue from subjects with sarcoidosis or NSOI. The detection of IgG4+ cells correlated with inflammation in the lacrimal gland based on histology. IgG4 staining tissue expressed an increase in transcripts associated with inflammation, especially B cell-related genes. Functional annotation analysis confirmed this. CONCLUSION: IgG4+ plasma cells are common in orbital tissue from patients with sarcoidosis, GPA, or NSOI. Even using the low threshold of 10 IgG4+ cells/high powered field, IgG4 staining correlates with increased inflammation in the lacrimal gland based on histology and gene expression.

  18. Contributions of Conventional and Heavy-Chain IgG to Immunity in Fetal, Neonatal, and Adult Alpacas▿

    OpenAIRE

    Daley-Bauer, L. P.; Purdy, S. R.; Smith, M. C.; Gagliardo, L. F.; Davis, W.C.; Appleton, J.A.

    2010-01-01

    In addition to conventional immunoglobulins, camelids produce antibodies that do not incorporate light chains into their structures. These so-called heavy-chain (HC) antibodies have incited great interest in the biomedical community, as they have considerable potential for biotechnological and therapeutic application. Recently, we have begun to elucidate the immunological functions of HC antibodies, yet little is known about their significance in maternal immunity or about the B lymphocytes t...

  19. A case of marginal zone B cell lymphoma mimicking IgG4-related dacryoadenitis and sialoadenitis

    OpenAIRE

    Ohta, Miho; Moriyama, Masafumi; Goto, Yuichi; Kawano, Shintaro; Tanaka, Akihiko; Maehara, Takashi; Furukawa, Sachiko; Hayashida, Jun-Nosuke; KIYOSHIMA, TAMOTSU; Shimizu, Mayumi; Arinobu, Yojiro; Nakamura, Seiji

    2015-01-01

    Background IgG4-related dacryoadenitis and sialoadenitis (IgG4-DS), so-called Mikulicz’s disease, is characterized by elevated serum IgG4 and infiltration of IgG4-positive plasma cells in glandular tissues. Recently, several studies reported both malignant lymphoma developed on the background of IgG4-associated conditions and IgG4-producing malignant lymphoma (non-IgG4-related disease). Case presentation We report on the case of a 70-year-old man who was strongly suspected IgG4-DS because of ...

  20. A subset of ocular adnexal marginal zone lymphomas may arise in association with IgG4-related disease

    OpenAIRE

    Kyotaro Ohno; Yasuharu Sato; Koh-ichi Ohshima; Katsuyoshi Takata; Tomoko Miyata-Takata; Mai Takeuchi; Yuka Gion; Tomoyasu Tachibana; Yorihisa Orita; Toshihiro Ito; Swerdlow, Steven H.; Tadashi Yoshino

    2015-01-01

    We previously suggested a relationship between ocular immunoglobulin (Ig)G4-related disease (IgG4-RD) and marginal zone lymphomas (MZLs). However, the cytokine background associated with these disorders and whether it differs between ocular adnexal MZLs with (IgG4-associated MZL) and without (IgG4-negative MZL) numerous IgG4+ plasma cells are unknown. In this study, we identified the mRNA expression pattern of Th2 and regulatory T-cell (Treg) cytokines in IgG4-RD and in IgG4-associated MZL an...

  1. WHERE SHOULD THE SURGICAL NEONATES BE NURSED?

    Directory of Open Access Journals (Sweden)

    Neelam Kler

    2012-04-01

    Full Text Available Surgical neonates need specialist medical and nursing care if their outcomes are to be improved. It needs a team of pediatric surgeons, neonatologists, pediatric anesthetists, and trained nurses. However, a key question in the management of these neonates is the place where they should be managed.One may ask since most of the pre-operative and post-operative care of surgical neonates are similar to the medical needs of sick neonate, why not manage them with medical neonatal ICUs with support from the surgeons?

  2. WHERE SHOULD THE SURGICAL NEONATES BE NURSED?

    OpenAIRE

    Neelam Kler; Siddarth Ramji; Avneet Kaur

    2012-01-01

    Surgical neonates need specialist medical and nursing care if their outcomes are to be improved. It needs a team of pediatric surgeons, neonatologists, pediatric anesthetists, and trained nurses. However, a key question in the management of these neonates is the place where they should be managed.One may ask since most of the pre-operative and post-operative care of surgical neonates are similar to the medical needs of sick neonate, why not manage them with medical neonatal ICUs with support ...

  3. The challenges of neonatal magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J.; Graves, Martin J.; Lomas, David J. [Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Edwards, Andrea [Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital, Department of Neonatology, Cambridge (United Kingdom); Austin, Topun [Addenbrooke' s Hospital, Department of Neonatology, Cambridge (United Kingdom)

    2012-10-15

    Improved neonatal survival rates and antenatal diagnostic imaging is generating a growing demand for postnatal MRI examinations. Neonatal brain MRI is now becoming standard clinical care in many settings, but with the exception of some research centres, the technique has not been optimised for imaging neonates and small children. Here, we review some of the challenges involved in neonatal MRI, including recent advances in overall MR practicality and nursing practice, to address some of the ways in which the MR experience could be made more neonate-friendly. (orig.)

  4. Neonatal nasopharyngeal teratomas: cross sectional imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, S. [Radiology Dept., Royal Children' s Hospital, Parkville, Melbourne (Australia); Dept. of Radiology, Royal Children' s Hospital, Univ. of Cape Town, Rondebosch (South Africa); Kumbla, S.; Fink, A.M. [Radiology Dept., Royal Children' s Hospital, Parkville, Melbourne (Australia)

    2003-04-01

    Background: Neonatal nasopharyngeal teratomas are extremely rare and there are few reports describing both CT and MRI features of these lesions. Objective: To describe the CT and MRI appearances of neonatal nasopharyngeal teratoma. Materials and methods: Three neonates with nasopharyngeal teratomas and severe respiratory distress were reviewed. Results: The nasopharyngeal mass resulted in severe respiratory compromise requiring urgent intervention. Characteristic mandibular and pterygoid plate abnormalities demonstrated by CT and MRI are described. Conclusions: Prenatal MRI enables the diagnosis, delineates tumour extent and allows planned delivery. CT and MRI play a key role in differentiating neonatal nasopharyngeal teratomas from other causes of a neonatal neck mass, thus optimising management. (orig.)

  5. STUDY OF HEMATOLOGICAL PARAMETERS AMONG NEONATES ADMITTED WITH NEONATAL JAUNDICE

    Directory of Open Access Journals (Sweden)

    Amar

    2012-09-01

    Full Text Available ABSTRACT: INTRODUCTION: Jaundice is most common problem faced by neonates in the first week of life. Although physiological jaundice is mor e frequent as compared to pathological jaundice it is very important to differentiate betwe en the two as pathological jaundice may lead to kernicterus and subsequently brain damage. There are various modalities of investigations e.g. Serum bilirubin, Direct and indirect coomb’s t est, Blood group, G-6PD deficiency, reticulocyte count by which we can reach at diagnos is. Treatment is also dependent upon the amount of serum bilirubin and various other laborat ory investigations. Thus laboratory workup is very important for diagnosis and prevention of ne onatal hyperbilirubinemia in newborn. With this background present study was conducted to study the clinico- pathological profile among infants with neonatal hyperbilirubinemia. METHODOLOGY: A prospective study was carried out for the duration of 1 year in one of th e teaching hospitals. RESULTS: Altogether 63 babies were enrolled in the study. Male babies out numbered the female (58.7% vs. 41.3%.Mean age of the study population was 2.97 da ys with standard deviation of 1.2 days. Percentage of Pre-term babies was 30.1. Neonates ha ving low birth weight were 17(26.9%. Physiological jaundice constituted (4062% cases of Neonatal hyperbilirubinemia. ABO incompatibility was the commonest cause of pathologic al jaundice followed by septicemia. Statistically significant rise in the serum bilirub in was noted in pathological jaundice as compared to physiological jaundice. C-reactive protei n (CRP was found to be positive in all the cases of septicemia. Direct and indirect Coomb’s te st was positive in all the cases with Rh incompatibility. CONCLUSION: Neonatal hyperbilirubinemia is associated with various other clinical morbidities. Causes of hyperbilirubinemia s hould be investigated comprehensively. ABO and Rh typing should be done along with Coombs Test

  6. Recent Advances in the Concept and Pathogenesis of IgG4-Related Disease in the Hepato-Bilio-Pancreatic System

    OpenAIRE

    Okazaki, Kazuichi; Yanagawa, Masahito; Mitsuyama, Toshiyuki; Uchida, Kazushige

    2014-01-01

    Recent studies have proposed nomenclatures of type 1 autoimmune pancreatitis (AIP) (IgG4-related pancreatitis), IgG4-related sclerosing cholangitis (IgG4-SC), IgG4-related cholecystitis, and IgG4-related hepatopathy as IgG4-related disease (IgG4-RD) in the hepato-bilio-pancreatic system. In IgG4-related hepatopathy, a novel concept of IgG4-related autoimmune hepatitis (AIH) with the same histopathological features as AIH has been proposed. Among organs involved in IgG4-RD, associations with p...

  7. Biomarkers for neonatal sepsis: recent developments

    Directory of Open Access Journals (Sweden)

    Mally P

    2014-09-01

    Full Text Available Pradeep Mally,1 Jie Xu,2 Karen D Hendricks-Muñoz2 1Department of Pediatrics, Division of Neonatology, New York University School of Medicine, New York, NY, USA; 2Department of Pediatrics, Division of Neonatal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA Abstract: As a leading cause of neonatal morbidity and mortality, neonatal sepsis remains a significant global health challenge. Despite recent advances in the management of neonatal sepsis, including use of more potent antibiotics, timely identification continues to be a frequent and challenging problem in the management of the newborn or high-risk neonate in the neonatal intensive care unit. Lack of specific early objective diagnostic evaluations or specific signs and symptoms, especially in the preterm infant, impedes early identification. However, emerging technologies linked with enhanced understanding of the immature and developing neonatal immune system responses to early infection provide an opportunity to develop critically needed biomarkers to improve early identification in this high-risk population. This review will focus on the field of neonatal sepsis biomarker development, identifying current promising biomarkers that have been investigated and widely utilized, as well as provide insight into recent advances and the rapidly evolving technologies that are being exploited in biomarker development to improve diagnosis, treatment, and prognosis in neonatal sepsis. Keywords: biomarker, cytokines, neonatal sepsis, recent developments, morbidity, mortality, neonates

  8. Investigating the Interaction between the Neonatal Fc Receptor and Monoclonal Antibody Variants by Hydrogen/Deuterium Exchange Mass Spectrometry

    DEFF Research Database (Denmark)

    Jensen, Pernille Foged; Larraillet, Vincent; Schlothauer, Tilman; Kettenberger, Hubert; Hilger, Maximiliane; Rand, Kasper D

    2015-01-01

    The recycling of immunoglobulins by the neonatal Fc receptor (FcRn) is of crucial importance in the maintenance of antibody levels in plasma and is responsible for the long half-lives of endogenous and recombinant monoclonal antibodies. From a therapeutic point of view there is great interest in...... understanding and modulating the IgG-FcRn interaction to optimize antibody pharmacokinetics and ultimately improve efficacy and safety. Here we studied the interaction between a full-length human IgG1 and human FcRn via hydrogen/deuterium exchange mass spectrometry and targeted electron transfer dissociation to...... wild-type glycosylated IgG. Our results provide new molecular insight into the IgG-FcRn interaction and illustrate the capability of hydrogen/deuterium exchange mass spectrometry to advance structural proteomics by providing detailed information on the conformation and dynamics of large protein...

  9. Neonatal withdrawal syndrome: Case report

    Directory of Open Access Journals (Sweden)

    Radunović-Gojković Tatjana

    2009-01-01

    Full Text Available Introduction. Maternal drug abuse has increased over the past decade. It has a multiple negative influence on a pregnant woman, as well as her newborn. Practically, every drug taken during pregnancy crosses the placenta, and the developing fetus may also be affected by the effects of a drug. After delivery, an infant of a drug-abusing mother may potentially develop neonatal withdrawal syndrome. Existing studies on the neonatal effects of drug exposure in utero are subject to many factors. Many studies have relied on the history obtained from the mother, which is innacurate. Urine testing for drug abuse does not reflect exposure to a drug through pregnancy and does not provide quantitative information. Social and economic deprivation is common among drug abusers, and this factor has a major effect on long term studies of infant outcome. The purpose of this article is to underline the problems during management of a neonatal withdrawal syndrom, and growing incidence of it in our society. Case report. A case of an infant of a heroin-abusing mother is reported. Conclusion. It is very important to take care of an infant with neonatal withdrawal syndrome, but it is also of a great importance to supervise these children for a long period of time.

  10. Photodegradation of riboflavin in neonates

    International Nuclear Information System (INIS)

    The biologically most important flavins are riboflavin and its related nucleotides, all highly sensitive to light. It is because of its photoreactivity and its presence in almost all body fluids and tissues that riboflavin assumes importance in phototherapy of neonatal jaundice. The absorption maxima of both bilirubin and riboflavin in the body are nearly identical: 445-450 (447) nm. In consequence, blue visible light will cause photoisomerization of bilirubin accompanied by photodegradation of riboflavin. This results in diminished erythrocyte glutathione reductase, which indicates generalized tissue riboflavin deficiency and red cell lysis. Single- and double-strand breaks in intracellular DNA have occurred with phototherapy. This light exposure of neonates may result also in alterations of bilirubin-albumin binding in the presence of both riboflavin and theophylline (the latter frequently given to prevent neonatal apnea). Many newborns, especially if premature, have low stores of riboflavin at birth. The absorptive capacity of premature infants for enteral riboflavin is likewise reduced. Consequently, inherently low stores and low intake of riboflavin plus phototherapy for neonatal jaundice will cause a deficiency of riboflavin at a critical period for the newborn. Supplementation to those infants most likely to develop riboflavin deficiency is useful, but dosage, time, and mode of administration to infants undergoing phototherapy must be carefully adjusted to avoid unwanted side effects

  11. Cerebral Palsy and Neonatal Encephalopathy

    OpenAIRE

    J Gordon Millichap

    2005-01-01

    The type and severity of cerebral palsy (CP) and pattern of associated disability in children with or without preceding neonatal encephalopathy (NE) were compared in a population-based case-control study of patients followed for 6 years at the Children’s Hospital, Westmead, Sydney, Australia.

  12. Pathophysiology of Equine Neonatal Septicemia

    Directory of Open Access Journals (Sweden)

    Juan Carlos Ospina Chirivi

    2014-07-01

    Full Text Available Neonatal septicemia is a major cause of mortality and morbidity in horses in their first seven days of life and within their pathophysiology. It is important to consider the extrinsic and intrinsic predisposing factors which make foals susceptible to agents of primarily bacterial etiology. However, other types of infectious etiology (viruses and fungi should be considered too, as well as noninfectious etiologies. The paper mentions a wide variety of mechanisms that produce different injuries that must be addressed with measures of critical neonatal care, so it is imperative for the veterinarian to know the pathogenic mechanisms of the disease, its clinical presentation and anatomo-pathological lesions. Thus, systemic inflammatory response syndrome (SIRS, multiple organ dysfunction syndrome (MODS, and peripheral circulatory collapse or shock are some of the elements defined as the pillars of the pathophysiology of neonatal septicemia, extensively studied in equine medicine. This paper presents a short review of the triggering mechanisms of neonatal septicemia highlighting the importance of epidemiological investigations in Colombia. It shows the need for retrospective and prospective studies and for divulgation of some of the preventive measures of the disease in horses.

  13. Microbiome Development in Neonatal Calves

    Science.gov (United States)

    The initial colonization of eukaryotic hosts by microbial populations is poorly understood, yet this remains a critical time for growth and development. The goals of this study were to characterize the microbiome of neonatal calves. Terminal restriction fragment length polymorphism (T-RFLP) analysis...

  14. Neonatal presentation of Caroli's disease

    OpenAIRE

    Keane, F; Wilkinson, M.; Qureshi, S; Reid, C; Baker, A.; MIELI-VERGANI, G

    1997-01-01

    A neonatal presentation of Caroli's disease with severe cardiac and progressive renal pathology is described. The availability of small paediatric endoscopes ensured early diagnosis. Despite aggressive medical management, the baby died with severe bleeding complications before potentially life saving multiple organ transplantation could take place.

 Keywords: Caroli's disease; endoscopic retrograde cholangiopancreatography; pulmonary artery stenosis

  15. Neonatal systemic candidiasis treated miconazole.

    OpenAIRE

    Tuck, S

    1980-01-01

    Two premature newborn infants with systemic candidiasis are reported; both were treated with miconazole. One died and the other made a complete recovery. Miconazole may be a useful addition to the drugs available for the treatment of systemic candidiasis in the neonate, but all of them have serious limitations.

  16. A New Nanogold-Labeled Immunoresonance Scattering Spectral Probe for Determination of Trace IgG

    Institute of Scientific and Technical Information of China (English)

    JIANG,Zhi-Liang; LI,Yan; SUN,Shuang-Jiao; CHEN,Bing

    2007-01-01

    A kind of 9 nm gold nanoparticles was prepared with the trisodium citrate and used to label goat anti-human IgG to obtain an IgG immunoresonance scattering spectral probe. In pH 5.8 buffer solution and in the presence of polyethylene glycol (PEG), the immune reaction between gold-labeled goat anti-human IgG and IgG took place,and the resonance scattering intensity at 580 nm (I580nm) was enhanced greatly. The enhanced intensity △IRS is proportional to the IgG concentration from 1.3 to 1.5 × 103 ng·mL 1, with a detection limit of 0.78 ng·mL-1. This assay showed high sensitivity and good selectivity for quantitative determination of IgG in human serum, with satisfactory results.

  17. Nontuberculous mycobacterial infection with concurrent IgG4-related lymphadenopathy.

    Science.gov (United States)

    Liu, Ting-Ting; Weng, Shao-Wen; Wang, Ming-Chung; Huang, Wan-Ting

    2016-03-01

    Disseminated nontuberculous mycobacteria (NTM) infection with concurrent IgG4-related lymphadenopathy has not been reported. We described a patient with neutralizing autoantibodies to interferon-gamma (IFN-γ) and elevated levels of serum IgG4 presenting with generalized lymphadenopathy and reactive dermatosis. Histologically, lymph nodes (LNs) showed effaced nodal architecture with polymorphic infiltrates, mimicking angioimmunoblastic T-cell lymphoma. Both the absolute number and the ratio of IgG4+ plasma cells to IgG+ plasma cells were increased. Mycobacterium abscessus was isolated from cultures of LNs, and demonstrated by polymerase chain reaction-restriction fragment length polymorphism. The skin biopsy showed neutrophilic dermatosis, consistent with Sweet syndrome. The patient met the criteria of both adult-onset immunodeficiency syndrome and IgG4-related lymphadenopathy. This case provides evidence of disseminated NTM infection with concurrent type III IgG4-related lymphadenopathy in the patient with anti-IFN-γ autoantibodies. PMID:26660641

  18. A three-layer immunoradiometric assay for determination of IgG subclass antibodies in Human Sera (''IgG subclass RAST'')

    International Nuclear Information System (INIS)

    We report the development of a three-layer immunoradiometric assay (TIRA) for measurement of IgG antibodies of all four subclasses in human sera. The first layer consists of diluted human serum, the second layer is monoclonal mouse antibodies to human IgG subclasses, and the third layer is 125I-labelled rabbit anti-mouse IgG. Monoclonal anti-IgGI, anti-IgG3 and anti-IgG4 reacted only with their complementary IgG subclass, whereas the anti-IgG2 showed slight cross-reactivity to immunoglobins of other subclasses and classes and to light chain proteins. The observed cross-reactivity was found to be without importance, when the TIRA was applied to measurement of IgG subclass antibodies. Equipotency was established by use of appropriate dilutions of the monoclonal antibodies, and the assay was calibrated by use of human reference serum. The TIRA therefore permits reliable inter-individual and intra-individual comparisons of the IgG antibody response in all four subclasses. Non-specific binding obtained with pooled normal human serum was below 0.33%. Inter-assay coefficient of variation was between 18 and 27%. The TIRA was applied to measurement of IgG subclass antibodies to timothy grass pollen in sera from grass pollen allergies undergoing immunotherapy. (author)

  19. In men at risk of HIV infection, IgM, IgG1, IgG3, and IgA reach the human foreskin epidermis.

    Science.gov (United States)

    Lemos, M P; Karuna, S T; Mize, G J; Fong, Y; Montano, S M; Ganoza, C; Lama, J R; Sanchez, J; McElrath, M J

    2016-05-01

    We profiled the humoral response in the penis, an area that has been minimally explored but may be relevant for protecting insertive men against HIV and other sexually acquired infections. Comparing paired tissue samples from 20 men at risk of HIV infection, foreskin contains less immunoglobulin A (IgA) and more IgG2 than colon. Using foreskin dermal and epidermal explants and paired plasma from 17 men, we examined Ig accumulation by normalizing Ig to human serum albumin (HSA) transudation. Dermal IgM, IgG2, IgA, and IgE ratios were greater than that in plasma, suggesting there is local antibody secretion at the dermis. Local Ig transcription was concentrated at the inner rather than the outer foreskin, and inner foreskin Ig ratios did not correlate with blood, indicating that localized production can contribute to the foreskin response. IgM, IgG1, IgG3, and IgA have preferential access to the foreskin epidermis, whereas IgG2, IgG4, and IgE are restricted to the dermis. Lastly, Ad5-specific IgA was selectively present in the colon, whereas foreskin Ad5 IgG was mainly derived from blood, and reached the inner epidermis at higher ratios than the outer (P<0.002). In summary, the foreskin antibody response combines local and systemic sources, and there is selective isotype accumulation in the epidermis. PMID:26509877

  20. High Serum IgG4 Concentrations in Patients with Hashimoto’s Thyroiditis

    OpenAIRE

    2015-01-01

    Purpose. Since recent reports suggest that Hashimoto thyroiditis (HT) may be associated with IgG4-related disease, we aimed to find out whether the measurement of serum IgG4 allows for the identification of distinct types of HT, with different clinical, sonographic, and serologic characteristics. Methods. The group studied consisted of 53 patients with HT and 28 healthy individuals who underwent thyroid ultrasonography and body composition analysis. Serum concentrations of IgG4, TSH, anti-per...

  1. Cavitating Lung Disease: A Novel Presentation of IgG4-Related Disease

    OpenAIRE

    Praveen K. Jinnur; Eunhee S. Yi; Ryu, Jay H.; Iyer, Vivek N.

    2015-01-01

    Patient: Male, 60 Final Diagnosis: IgG4 related disease Symptoms: Cough • hemoptysis Medication: — Clinical Procedure: None Specialty: Pulmonology Objective: Rare disease Background: Immunoglobulin (Ig) G4-related disease, previously referred to as IgG4-related sclerosing disease or hyper-IgG4 disease, may occur in the lung, involving alveolar parenchyma, airways, and pleura. Various pulmonary manifestations of IgG4-related disease have been reported, but to the best of our knowledge a cavita...

  2. IgG4-Related Disease Presenting as a Solitary Neck Mass

    OpenAIRE

    McKinnon, Tyler; Randazzo, William T; Kim, Brian D; Biddinger, Paul; Forseen, Scott

    2015-01-01

    IgG4-related disease is a newly recognized entity associated with autoimmune conditions involving almost every organ system. It is characterized by elevated serum IgG4 as well as mass like tissue infiltration by IgG4-positive plasma cells. Imaging findings are nonspecific, vary depending on the site of disease, and include mass like enlargement of the salivary or lacrimal glands and enlarged lymph nodes. Radiographic findings often mimic malignancy, necessitating tissue sampling to confirm th...

  3. IgG4-related tubulointerstitial nephritis accompanied with cystic formation

    OpenAIRE

    Fukuhara, Hideo; Taniguchi, Yoshinori; Matsumoto, Manabu; Kuroda, Naoto; Fukata, Satoshi; Inoue, Keiji; Fujimoto, Shimpei; Terada, Yoshio; Shuin, Taro

    2014-01-01

    Background An immunoglobulin G4 (IgG4)-related disease is important disease in differential diagnosis of tumors in kidney, pancreas, lung and other organs. The imaging findings of IgG4-related kidney diseases are usually expressed as defect contrast region, while cystic formation in kidney is extremely rare. Here, we report a case of IgG4-related tubulointerstitial nephritis with renal cystic change caused by the narrowing or obstruction of collecting duct in renal medulla. Case presentation ...

  4. Clinical and imaging diagnosis of IgG4-related disease in the head and neck

    International Nuclear Information System (INIS)

    IgG4-related disease in the head and neck is a newly recognized multi-organ system disease characterized by elevated serum IgG4, infiltration of numerous IgG4-positive plasma cells, tissue fibrosis, and dramatic response to corticosteroid treatment. IgG4-related disease of the head and neck has some relative characteristics on CT and MRI, which can provide valuable information for the diagnosis and differential diagnosis, and are helpful for the clinical treatment, evaluation of therapeutic effects and prediction of prognosis. (authors)

  5. IgG4-related disease: case report and literature review

    OpenAIRE

    Nizar, Abo-Helo; Toubi, Elias

    2015-01-01

    IgG4-related disease (IgG4-RD) is relatively a new growing entity of immune-mediated origin, characterized by a mass-forming lesion, the infiltration of IgG4-positive plasma cells and occasionally elevated serum IgG4. It is considered to be both a systemic inflammation and sclerosing disease. The most common manifestations are parotid and lacrimal swelling, lymphadenopathy and autoimmune pancreatitis. Sclerosing cholangitis and retroperitoneal fibrosis are among the other mentioned frequent m...

  6. IgG4-positive plasma cell infiltration in explanted livers for primary sclerosing cholangitis

    OpenAIRE

    Zen, Yoh; Quaglia, Alberto; Portmann, Bernard

    2011-01-01

    Abstract Aims: To explore whether IgG4-related sclerosing cholangitis (IgG4-SC) contributes to end-stage primary sclerosing cholangitis (PSC) in UK. Methods and Results: This study consisted of 41 patients who underwent liver transplantation for advanced PSC. Explanted livers were histologically examined with an emphasis on IgG4-positive plasma cell infiltration. Thirty-nine cases (95%) had minimal or mild infiltration of IgG4-positive plasma cells (? 30 cells/high power field)...

  7. A novel immunopathological association of IgG4-RD and vasculitis with Hashimoto's thyroiditis

    OpenAIRE

    Minamino, Hiroto; Inaba, Hidefumi; Ariyasu, Hiroyuki; Furuta, Hiroto; Nishi, Masahiro; Yoshimasu, Takashi; Nishikawa, Akinori; Nakanishi, Masanori; Tsuchihashi, Shigeki; Kojima, Fumiyoshi; Murata, Shin-ichi; Inoue, Gen; Akamizu, Takashi

    2016-01-01

    Summary A 73-year-old man with Hashimoto's thyroiditis (HT) suffered from purpura on the lower legs. He was diagnosed with IgG4-related disease (IgG4-RD) with serum IgG4 elevation and dacryo-sialadenitis confirmed histologically. Serum Th2 and Treg cytokines, interleukin 7 (IL7), IL8 and Th2 chemokine levels were elevated, while skewed Th1 balance was seen in fluorescence-activated cell sorting (FACS). Therefore, preferential Th1 balance in HT appeared to be followed by IgG4-RD characterized ...

  8. Prevalence of Atopy, Eosinophilia, and IgE Elevation in IgG4-Related Disease

    OpenAIRE

    Torre, Emanuel Della; Mattoo, Hamid; Mahajan, Vinay S; Carruthers, Mollie; Pillai, Shiv; John H. Stone

    2013-01-01

    IgG4-related disease (IgG4-RD) is a fibroinflammatory disorder that can affect virtually every organ system. T helper type 2 responses have been presumed to be pathogenic in this disease and a high proportion of IgG4-RD patients are reported to have longstanding allergies, peripheral blood eosinophilia, and serum IgE elevation. It has therefore been proposed that allergic mechanisms drive IgG4-RD. However, no epidemiological assessment of atopy, peripheral blood eosinophilia, serumIgEconcentr...

  9. The importance of IgG4 in the predictive model of thyroiditis

    OpenAIRE

    Pandrc, Milena S; Petrović, Stanko; Kostovski, Vanja; Petrović, Marijana; Zarić, Miloš

    2015-01-01

    Summary Immunoglobulin (Ig)G4-related sclerosing disease (IgG4-RSD) is a new disease entity first proposed with regard to autoimmune pancreatitis. A 67-year-old male patient was examined because of weight loss and an abdominal pain. Based on the clinical characteristics, laboratory parameters and ultrasound features, we identified the diagnosis of the IgG4-related systemic disease (IgG4-RSD), that was confirmed by the histopathological analysis after the biopsy of the head of pancreas. After ...

  10. Orbital IgG4-Related Disease: Clinical Features and Diagnosis

    OpenAIRE

    KUBOTA, TOSHINOBU; Moritani, Suzuko

    2012-01-01

    Orbital IgG4-related disease, which can occur in adults of any age, is characterized by IgG4-positive lymphoplasmacytic infiltrations in ocular adnexal tissues. The signs and symptoms include chronic noninflammatory lid swelling and proptosis. Patients often have a history of allergic disease and elevated serum levels of IgG4 and IgE as well as hypergammaglobulinemia. Orbital IgG4-related disease must be differentiated from idiopathic orbital inflammation and ocular adnexal marginal zone B-ce...

  11. Clinical relevance of Küttner tumour and IgG4-related dacryoadenitis and sialoadenitis

    OpenAIRE

    Furukawa, S.; Moriyama, M; Kawano, S; Tanaka, A; Maehara, T.; Hayashida, J-N; Goto, Y.; Kiyoshima, T; Shiratsuchi, H; Ohyama, Y.; Ohta, M.; Imabayashi, Y; Nakamura, S.

    2014-01-01

    Objectives Küttner tumour (KT), so-called chronic sclerosing sialoadenitis, is characterised by concomitant swelling of the submandibular glands secondary to strong lymphocytic infiltration and fibrosis independent of sialolith formation. However, recent studies have indicated that some patients with KT develop high serum levels of IgG4 and infiltration of IgG4-positive plasma cells, namely IgG4-related dacryoadenitis and sialoadenitis (IgG4-DS), so-called Mikulicz's disease. The aim of this ...

  12. IgG4 Related Disease of the Head and Neck

    OpenAIRE

    Deshpande, Vikram

    2015-01-01

    IgG4 related disease of the head and neck region represents one of the more common manifestations of IgG4 related disease. Involvement of the submandibular and parotid glands, the orbit and thyroid represent some of the more common sites involved by IgG4 related disease. Eosinophilic angiocentric fibrosis, Mikulicz disease and Riedel thyroiditis are also members of the family of IgG4 related disease. Clinically, the disease is characterized by tumefactive lesions, often multicentric, that sho...

  13. IgG4-Related Esophageal Disease Presenting as Esophagitis Dissecans Superficialis With Chronic Strictures

    OpenAIRE

    Dumas-Campagna, Myriam; Bouchard, Simon; Soucy, Genevieve; Bouin, Mickael

    2014-01-01

    IgG4-related disease is a recently recognized autoimmune systemic disorder that has been described in various organs. The disease is characterized histologically by a dense lymphoplasmocytic infiltrate of IgG4-positive cells, storiform fibrosis and can be associated with tumefactive lesions. IgG4-related disease involving the upper gastrointestinal tract is rare and only two previous case reports have reported IgG4-related esophageal disease. We report the case of a 63-year-old female patient...

  14. IgG1 Fc N-glycan galactosylation as a biomarker for immune activation.

    Science.gov (United States)

    de Jong, Sanne E; Selman, Maurice H J; Adegnika, Ayola A; Amoah, Abena S; van Riet, Elly; Kruize, Yvonne C M; Raynes, John G; Rodriguez, Alejandro; Boakye, Daniel; von Mutius, Erika; Knulst, André C; Genuneit, Jon; Cooper, Philip J; Hokke, Cornelis H; Wuhrer, Manfred; Yazdanbakhsh, Maria

    2016-01-01

    Immunoglobulin G (IgG) Fc N-glycosylation affects antibody-mediated effector functions and varies with inflammation rooted in both communicable and non-communicable diseases. Worldwide, communicable and non-communicable diseases tend to segregate geographically. Therefore, we studied whether IgG Fc N-glycosylation varies in populations with different environmental exposures in different parts of the world. IgG Fc N-glycosylation was analysed in serum/plasma of 700 school-age children from different communities of Gabon, Ghana, Ecuador, the Netherlands and Germany. IgG1 galactosylation levels were generally higher in more affluent countries and in more urban communities. High IgG1 galactosylation levels correlated with low total IgE levels, low C-reactive protein levels and low prevalence of parasitic infections. Linear mixed modelling showed that only positivity for parasitic infections was a significant predictor of reduced IgG1 galactosylation levels. That IgG1 galactosylation is a predictor of immune activation is supported by the observation that asthmatic children seemed to have reduced IgG1 galactosylation levels as well. This indicates that IgG1 galactosylation levels could be used as a biomarker for immune activation of populations, providing a valuable tool for studies examining the epidemiological transition from communicable to non-communicable diseases. PMID:27306703

  15. Maternofetal transplacental transport of recombinant IgG antibodies lacking effector functions

    DEFF Research Database (Denmark)

    Mathiesen, Line; Nielsen, Leif K; Andersen, Jan Terje;

    2013-01-01

    alloimmunity, which may be lethal. A novel strategy to control pathogenic antibodies would be administration of a non-destructive IgG antibody blocking antigen binding while retaining binding to FcRn. We report on two human IgG3 antibodies with a hinge deletion and a C131S point mutation (IgG3ΔHinge) that...... transported efficiently from the maternal to the fetal placental compartment. Thus, IgG3ΔHinge:R435H may be a good candidate for transplacental delivery of a non-destructive antibody to the fetus to combat pathogenic antibodies....

  16. Biochemical and biophysical characterization of humanized IgG1 produced in Pichia pastoris

    OpenAIRE

    Ha, Sha; Wang, Yang; Richard R. Rustandi

    2011-01-01

    The first full length IgG produced in Pichia pastoris was reported in late 1980. However, use of a wild-type Pichia expression system to produce IgGs with human-like N-linked glycans was not possible until recently. Advances in glycoengineering have enabled organisms such as Pichia to mimic human N-glycan biosynthesis and produce IgGs with human glycans on an industrial scale. Since there are only a few reports of the analytical characterization of Pichia-produced IgG, we summarize the result...

  17. IgG1 Fc N-glycan galactosylation as a biomarker for immune activation

    Science.gov (United States)

    de Jong, Sanne E.; Selman, Maurice H. J.; Adegnika, Ayola A.; Amoah, Abena S.; van Riet, Elly; Kruize, Yvonne C. M.; Raynes, John G.; Rodriguez, Alejandro; Boakye, Daniel; von Mutius, Erika; Knulst, André C.; Genuneit, Jon; Cooper, Philip J.; Hokke, Cornelis H.; Wuhrer, Manfred; Yazdanbakhsh, Maria

    2016-01-01

    Immunoglobulin G (IgG) Fc N-glycosylation affects antibody-mediated effector functions and varies with inflammation rooted in both communicable and non-communicable diseases. Worldwide, communicable and non-communicable diseases tend to segregate geographically. Therefore, we studied whether IgG Fc N-glycosylation varies in populations with different environmental exposures in different parts of the world. IgG Fc N-glycosylation was analysed in serum/plasma of 700 school-age children from different communities of Gabon, Ghana, Ecuador, the Netherlands and Germany. IgG1 galactosylation levels were generally higher in more affluent countries and in more urban communities. High IgG1 galactosylation levels correlated with low total IgE levels, low C-reactive protein levels and low prevalence of parasitic infections. Linear mixed modelling showed that only positivity for parasitic infections was a significant predictor of reduced IgG1 galactosylation levels. That IgG1 galactosylation is a predictor of immune activation is supported by the observation that asthmatic children seemed to have reduced IgG1 galactosylation levels as well. This indicates that IgG1 galactosylation levels could be used as a biomarker for immune activation of populations, providing a valuable tool for studies examining the epidemiological transition from communicable to non-communicable diseases. PMID:27306703

  18. Are Classification Criteria for IgG4-RD Now Possible? The Concept of IgG4-Related Disease and Proposal of Comprehensive Diagnostic Criteria in Japan

    OpenAIRE

    Hisanori Umehara; Kazuichi Okazaki

    2012-01-01

    Recent studies suggest simultaneous or metachronous lesions in multiorgans characterized by elevated serum levels of IgG4 and abundant infiltration of IgG4-positive plasma cells with various degrees of fibrosis. Two Japanese research committees for IgG4-RD, one from fibrosclerosis (Okazaki team) and the other from lymph proliferation (Umehara team) supported by the “Research Program for Intractable Disease” of the Ministry of Health, Labor, and Welfare of Japan, have agreed with the unified n...

  19. Purification of rabbit IgG, obtention of sheep anti rabbit IgG and their use in radioimmunoassay of avian leukosis virus p15

    Energy Technology Data Exchange (ETDEWEB)

    Higuchi, Tomoko; Ogata, Hiroe; Veiga, Silvio Sanches; Nogueira, Zelia Maria [Instituto de Quimica, Sao Paulo, SP (Brazil); Souza Felippe, Julia Maria Martins de [Instituto Adolfo Lutz, Sao Paulo, SP (Brazil). Div. de Virus

    1988-01-01

    Immunoglobulin from rabbit serum was purified by ammonium sulphate precipitation followed by chromatography on DEA-cellulose and gel filtration in Sephadex G-200. The efficiency of all steps was followed by protein determination and profiles in sodium dodecyl-sulphate polyacrylamide gel electrophoresis. Sheeps were immunized with purified IgG. The deep anti-rabbit IgG titre was evaluated by double immuno diffusion gel plates. The system rabbit serum vs sheep anti-rabbit IgG serum was used as precipitating system in radioimmunoassay of the retrovirus immunogens, in this case, p15 of avian leukosis virus. (author). 19 refs., 4 figs., 3 tabs.

  20. Purification of rabbit IgG, obtention of sheep anti rabbit IgG and their use in radioimmunoassay of avian leukosis virus p15

    International Nuclear Information System (INIS)

    Immunoglobulin from rabbit serum was purified by ammonium sulphate precipitation followed by chromatography on DEA-cellulose and gel filtration in Sephadex G-200. The efficiency of all steps was followed by protein determination and profiles in sodium dodecyl-sulphate polyacrylamide gel electrophoresis. Sheeps were immunized with purified IgG. The deep anti-rabbit IgG titre was evaluated by double immuno diffusion gel plates. The system rabbit serum vs sheep anti-rabbit IgG serum was used as precipitating system in radioimmunoassay of the retrovirus immunogens, in this case, p15 of avian leukosis virus. (author). 19 refs., 4 figs., 3 tabs

  1. Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico.

    Science.gov (United States)

    Fargas-Berríos, N; García-Fragoso, L; García-García, I; Valcárcel, M

    2015-01-01

    Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM) is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor feeding tolerance and vomiting associated with hyperglycemia (385 mg/dL), glycosuria, and metabolic acidosis within the first 12 hours of life. The neonate was treated with intravenous insulin, obtaining a slight control of hyperglycemia. An adequate glycemia was achieved at 5 weeks of life. The molecular studies showed complete loss of maternal methylation at the TND differentially methylated region on chromosome 6q24. The etiology of this neonate's hyperglycemia was a hypomethylation of the maternal TND locus. A rare cause of neonatal diabetes mellitus must be considered if a neonate presents refractory hyperglycemia. To our knowledge, this is the first case reported in Puerto Rico of transient neonatal mellitus due to the uncommon mechanism of maternal hypomethylation of the TND locus. Its prevalence in Puerto Rico is unknown. PMID:26576310

  2. Avidity of Antibodies against HSV-2 and Risk to Neonatal Transmission among Mexican Pregnant Women

    Directory of Open Access Journals (Sweden)

    Antonia Herrera-Ortiz

    2013-01-01

    Full Text Available Objective. To determine HSV-2 seroprevalence, risk factors, and antibody avidity among a sample of Mexican pregnant women. Material and Methods. The avidity test was standardized with different urea concentrations and incubation times; the cut-off point was calculated to determine the low avidity (early infection. IgG antibodies against HSV-2 were detected from pregnant and postpartum women from Morelos, Mexico, and the avidity test was performed to positive samples. Multivariate regression logistic analysis was employed to evaluate demographic and sexual behavior characteristics associated with HSV-2 infection. Results. HSV-2 seroprevalence among Mexican women analyzed was 14.5% (333/2300, demographic factors (location of General Hospital, age, education level, and civil status, and risky sexual behaviors (STI self-report and number of sexual partners during last year were associated with HSV-2 infection. Seventeen women were detected with low avidity antibodies (early infection with a cut-off point of 66.1%. Conclusions. HSV-2 infection was common among this group of women from Mexico; the avidity test detected women with recent infections, and these women were more likely to transmit HSV-2 to their neonates. Neonatal herpes has no epidemiological surveillance, the disease could be overlooked, and so more studies are needed to estimate the magnitude of neonatal infection.

  3. Safety and immunogenicity of neonatal pneumococcal conjugate vaccination in Papua New Guinean children: a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    William S Pomat

    Full Text Available BACKGROUND: Approximately 826,000 children, mostly young infants, die annually from invasive pneumococcal disease. A 6-10-14-week schedule of pneumococcal conjugate vaccine (PCV is efficacious but neonatal PCV may provide earlier protection and better coverage. We conducted an open randomized controlled trial in Papua New Guinea to compare safety, immunogenicity and priming for memory of 7-valent PCV (PCV7 given in a 0-1-2-month (neonatal schedule with that of the routine 1-2-3-month (infant schedule. METHODS: We randomized 318 infants at birth to receive PCV7 in the neonatal or infant schedule or no PCV7. All infants received 23-valent pneumococcal polysaccharide vaccine (PPV at age 9 months. Serotype-specific serum IgG for PCV7 (VT serotypes and non-VT serotypes 2, 5 and 7F were measured at birth and 2, 3, 4, 9, 10 and 18 months of age. Primary outcomes were geometric mean concentrations (GMCs and proportions with concentration ≥ 0.35 µg/ml of VT serotype-specific pneumococcal IgG at age 2 months and one month post-PPV. RESULTS: We enrolled 101, 105 and 106 infants, respectively, into neonatal, infant and control groups. Despite high background levels of maternally derived antibody, both PCV7 groups had higher GMCs than controls at age 2 months for serotypes 4 (p<0.001 and 9V (p<0.05 and at age 3 months for all VTs except 6B. GMCs for serotypes 4, 9V, 18C and 19F were significantly higher (p<0.001 at age 2 months in the neonatal (one month post-dose2 PCV7 than in the infant group (one month post-dose1 PCV7. PPV induced significantly higher VT antibody responses in PCV7-primed than unprimed infants, with neonatal and infant groups equivalent. High VT and non-VT antibody concentrations generally persisted to age 18 months. CONCLUSIONS: PCV7 is well-tolerated and immunogenic in PNG neonates and young infants and induces immunologic memory to PPV booster at age 9 months with antibody levels maintained to age 18 months. TRIAL REGISTRATION

  4. Contactin-1 IgG4 antibodies cause paranode dismantling and conduction defects.

    Science.gov (United States)

    Manso, Constance; Querol, Luis; Mekaouche, Mourad; Illa, Isabel; Devaux, Jérôme J

    2016-06-01

    Paranodal axoglial junctions formed by the association of contactin-1, contactin-associated protein 1, and neurofascin-155, play important functions in nerve impulse propagation along myelinated axons. Autoantibodies to contactin-1 and neurofascin-155 define chronic inflammatory demyelinating polyradiculoneuropathy subsets of patients with specific clinical features. These autoantibodies are mostly of the IgG4 isotype, but their pathogenicity has not been proven. Here, we investigated the mechanisms how IgG subclasses to contactin-1 affect conduction. We show that purified anti-contactin-1 IgG1 and IgG4 bind to paranodes. To determine whether these isotypes can pass the paranodal barrier, we incubated isolated sciatic nerves with the purified antibody or performed intraneural injections. We found that IgG4 diffused into the paranodal regions in vitro or after intraneural injections. IgG4 infiltration was slow and progressive. In 24 h, IgG4 accessed the paranode borders near the nodal lumen, and completely fill the paranodal segments by 3 days. By contrast, control IgG, anti-contactin-1 IgG1, or even anti-contactin-associated-protein-2 IgG4 did not pass the paranodal barrier. To determine whether chronic exposure to these antibodies is pathogenic, we passively transferred anti-contactin-1 IgG1 and IgG4 into Lewis rats immunized with P2 peptide. IgG4 to contactin-1, but not IgG1, induced progressive clinical deteriorations combined with gait ataxia. No demyelination, axonal degeneration, or immune infiltration were observed. Instead, these animals presented a selective loss of the paranodal specialization in motor neurons characterized by the disappearance of the contactin-associated protein 1/contactin-1/neurofascin-155 complex at paranodes. Paranode destruction did not affect nodal specialization, but resulted in a moderate node lengthening. The sensory nerves and dorsal root ganglion were not affected in these animals. Electrophysiological examination further

  5. IgG subclass deficiency and sinopulmonary bacterial infections in patients with alcoholic liver disease.

    Science.gov (United States)

    Spinozzi, F; Cimignoli, E; Gerli, R; Agea, E; Bertotto, A; Rondoni, F; Grignani, F

    1992-01-01

    Abnormalities in IgG subclass distribution were sought in serum samples and bronchoalveolar lavage fluid from 15 patients with alcoholic liver disease to explain their increased susceptibility to bacterial respiratory infections. Serum IgG4 deficiency alone or in association with low IgG2 levels was revealed in approximately 30% of patients with alcoholic liver disease. This fact prompted us to further investigate the immunoglobulin concentrations in broncho-alveolar lavage fluid, paying special attention to the distribution of IgA and IgG subclasses. IgA levels were found to be normal or slightly elevated. However, there were substantial defects in total IgG and IgG1 concentrations, often associated with reduced IgG2 and IgG4 levels, in approximately 70% of patients with alcoholic liver disease, which proved to be closely correlated with the number and type (pneumonia) of bacterial respiratory infections. A prospective study of intravenous immunoglobulin substitutive therapy involving two patients with recurrent pneumonia and very low serum IgG2 values demonstrated a reduction in the number of respiratory infectious episodes as well as an increase in both serum and, to a lesser extent, bronchoalveolar lavage fluid IgG1 and IgG2 levels. We identified immune defects that may represent an important pathogenetic mechanism that, when considered together with the alcohol-related suppression of alveolar macrophage and ciliary functions and the inhibition of leukocyte migration into the lungs, should help clarify the complex relationships between alcohol and immune defense. PMID:1728935

  6. The blocking activity of birch pollen-specific immunotherapy-induced IgG4 is not qualitatively superior to that of other IgG subclasses

    DEFF Research Database (Denmark)

    Ejrnaes, Anne M; Bødtger, Uffe; Larsen, Jørgen N; Svenson, Morten

    2004-01-01

    for the clinical efficacy of SIT. In this study, fractionated serum samples from 14 SIT-treated birch pollen allergic individuals enabled determination of the inhibitory capacity of IgG4 alone versus non-IgG4 IgG. Allergen-binding activities of IgG and the IgG-mediated inhibition of allergen binding...... to autologous IgE were detected using 125I-labelled rBet v 1.2801, a recombinant variant of the major allergen of Betula verrucosa pollen. Results show that IgG4-depletion resulted in equivalent reductions in binding and blocking activities. In contrast, a significant but less than two-fold higher...

  7. Simultaneous occurrence of fetal and neonatal alloimmune thrombocytopenia and neonatal neutropenia due to maternal neutrophilic autoantibodies

    DEFF Research Database (Denmark)

    Taaning, Ellen; Jensen, Lise; Varming, Kim

    2012-01-01

    Foetal and neonatal alloimmune thrombocytopenia (FNAIT) and neonatal neutropenia caused by maternal autoantibodies against neutrophils are rare disorders. We describe a newborn with severe thrombocytopenia and intracerebral bleeding caused by maternal anti-HPA-3a alloantibodies and mild neutropenia...

  8. Regional variation in neonatal and post-neonatal mortality in Kenya

    Directory of Open Access Journals (Sweden)

    Lawrence D.E. Ikamari

    2013-04-01

    Full Text Available This paper seeks to establish the effect of region of residence on neonatal and post-neonatal mortality inKenya, using the 2003 Kenya Demographic and Health Survey data. The results show significant regionalvariation in neonatal and post-neonatal mortality. Both neonatal and post-neonatal mortality were alsofound to vary significantly according to household wealth status, household water supply, and toilet facility,maternal age at birth, preceding birth interval; antenatal visits and type of place of delivery. It was only postneonatalmortality that also varied significantly according to maternal education.The study recommends that concerted efforts be made to reduce high neonatal and post-neonatal mortalityin the high mortality areas. These could entail strengthening existing family planning, child survival and HIV/AIDS programmes alongside improving households’ access to piped water supply and household hygiene practices.

  9. CT findings in neonatal hypothermia

    Energy Technology Data Exchange (ETDEWEB)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y. [Department of Radiology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, P. O. Box 151, Beer-Sheva 84101 (Israel); Hershkowitz, E.; Berenstein, T.; Sofer, S. [Pediatric Intensive Care Unit, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel); Maor, E. [Department of Pathology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel)

    1998-06-01

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the `reversal sign`. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The `reversal sign` has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.) With 6 figs., 1 tab., 13 refs.

  10. Neonatal haemochromatosis associated with gastroschisis.

    Science.gov (United States)

    Thornton, M P; Marven, S S; Tanner, M S; Gürtl-Lackner, B

    2008-05-01

    We describe, to our knowledge, the first case of progressive neonatal liver failure due to neonatal haemochromatosis (NH) occurring in an infant with a gastroschisis and review the literature regarding these two conditions. A 1,665 g male infant with antenatally diagnosed gastroschisis was born with a severe coagulopathy, anaemia, thrombocytopenia, hypoglycaemia and jaundice. He developed progressive liver failure, complicated by necrotising enterocolitis. Serum ferritin was elevated at 1,459 microg/L. He died on day 40 and a limited post-mortem examination confirmed significant hepatic siderosis with fibrosis and cholestasis, and siderosis of the pancreas. Although no genetic aetiology for gastroschisis has been identified, an occasional inherited tendency has been observed. There is also evidence to support an autosomal recessive inheritance in NH. PMID:18338135

  11. CT findings in neonatal hypothermia

    International Nuclear Information System (INIS)

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the 'reversal sign'. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The 'reversal sign' has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.)

  12. CLINICO BACTERIOLOGICAL STUDY ON NEONATAL SEPTICEMIA

    Directory of Open Access Journals (Sweden)

    Krishna Prasad

    2015-09-01

    Full Text Available Neonatal septicemia remains a significant cause of morbidity and mortality in the new born, more so in developing countries like India due to delivery and post natal follow up in an unclean environment having more chances of contamination with infective organisms. Infection is more common in the neonatal period than at any other time in life . 1 This is partly attributable to exposure to large number of organisms, but is also due to a relative failure of the neonatal host defenses to clear microorganisms from blood and tissues. The rate of infection and type of organism causing sepsis in a neonate vary with demography. In India, the incidence of neonatal septicemia is 10 - 30/1000 live births , 2 whereas in western countries it is 1 - 8/1000 live births . 3 KEYWORDS: Neonatal, Sepsis, Staphylococcus, CRP, Bandemia

  13. Standaarde vir die interhospitaalvervoer van siek neonate

    Directory of Open Access Journals (Sweden)

    M.E. Muller

    1989-09-01

    Full Text Available The transport o f ill neonates between hospitals and/or health care centres, plays an important role in the mortality rate o f these seriously ill neonates. It is therefore important that the ill neonate is transported under optimal conditions. A lack o f standards in this regard hampers the evaluation o f the quality o f inter hospital transport o f ill neonates. The purpose o f this study is to formulate valid standards fo r the transport o f seriously ill neonates between hospitals (and/or other health care institutions to form the basis fo r the evaluation o f the quality o f this service. Factors that need to be considered in the transport o f ill neonates include the ambulance, equipment and stock, the transport personnel and communication. These factors were systematically explored and described and standards were formulated accordingly.

  14. RISK FACTORS IN NEONATAL ANAEROBIC INFECTIONS

    Directory of Open Access Journals (Sweden)

    M. S. Tabib

    2008-06-01

    Full Text Available Anaerobic bacteria are well known causes of sepsis in adults but there are few studies regarding their role in neonatal sepsis. In an attempt to define the incidence of neonatal anaerobic infections a prospective study was performed during one year period. A total number of 400 neonates under sepsis study were entered this investigation. Anaerobic as well as aerobic cultures were sent. The patients were subjected to comparison in two groups: anaerobic culture positive and anaerobic culture negative and this comparison were analyzed statistically. There were 7 neonates with positive anaerobic culture and 35 neonates with positive aerobic culture. A significant statistical relationship was found between anaerobic infections and abdominal distention and pneumonia. It is recommended for those neonates with abdominal distention and pneumonia refractory to antibiotic treatment to be started on antibiotics with anaerobic coverage.

  15. Factors modulating neonatal pain responssiveness

    OpenAIRE

    Bergqvist, Lena L

    2008-01-01

    To relieve pain in newborn infants particularly preterm infants is essential in modern neonatology. However, there are a number of innate difficulties related to pain assessment and pharmacological treatment, which includes in this thesis work. It emanated from our participation in an international team that designed and conducted the NEOPAIN multicenter trials, testing the effects of morphine analgesia in 898 preterm mechanically ventilated neonates. Primary neurological ou...

  16. Pain Perception in the Neonate

    OpenAIRE

    Midmer, Deana K.

    1989-01-01

    Pain expression in both pre-term and term infants is a little understood phenomenon. Recent research has generated data documenting that the newborn can feel pain, can act to avoid the pain, and may form memory traces of the experience. ”Nociceptive activity” or ”noxious stimuli” are better terms to use when addressing aversive stimulation of the neonate because they encourage scrutiny of the behavioural and physiologic responses of the newborn without placing emphasis on the emotional and su...

  17. Cerebral palsy and neonatal encephalopathy.

    OpenAIRE

    Gaffney, G; Flavell, V; Johnson, A; Squier, M.; Sellers, S

    1994-01-01

    A retrospective cohort study was carried out to test the hypothesis that children born at term with cerebral palsy with signs of neurological dysfunction preceded by depression at birth (termed neonatal encephalopathy) differ from those without such signs in the frequency of antenatal and perinatal factors, and in the severity and characteristics of their impairment and disability. The study was carried out in the area covered by Oxford Regional Health Authority. Antenatal, intrapartum, neona...

  18. Neonatal jaundice: the surgical viewpoint.

    OpenAIRE

    Kling, S.

    1980-01-01

    There is good evidence that neonatal hepatitis, biliary hypoplasia, biliary atresia and choledochal cyst are different stages of one disease process for which the term infantile obstructive cholangiopathy has been suggested. Thanks to the work of Kasai and the operation of hepatic portoenterostomy the surgical outlook has greatly improved, although in North America it still leaves much to be desired. One cannot procrastinate too long in the hope that the patient's condition will improve spont...

  19. Neonatal cranial ultrasound: current perspectives

    Directory of Open Access Journals (Sweden)

    Franco A

    2013-09-01

    Full Text Available Arie Franco, Kristopher Neal Lewis Department of Radiology, Medical College of Georgia at Georgia Regents University, Augusta, GA, USA Abstract: Ultrasound is the most common imaging tool used in the neonatal intensive care unit. It is portable, readily available, and can be used at bedside. It is the least expensive cross sectional imaging modality and the safest imaging device used in the pediatric population due to its lack of ionizing radiation. There are well established indications for cranial ultrasound in many neonatal patient groups including preterm infants and term infants with birth asphyxia, seizures, congenital infections, etc. Cranial ultrasound is performed with basic grayscale imaging, using a linear array or sector transducer via the anterior fontanel in the coronal and sagittal planes. Additional images can be obtained through the posterior fontanel in preterm newborns. The mastoid fontanel can be used for assessment of the posterior fossa. Doppler images may be obtained for screening of the vascular structures. The normal sonographic neonatal cranial anatomy and normal variants are discussed. The most common pathological findings in preterm newborns, such as germinal matrix-intraventricular hemorrhage and periventricular leukomalacia, are described as well as congenital abnormalities such as holoprosencephaly and agenesis of the corpus callosum. New advances in sonographic equipment enable high-resolution and three-dimensional images, which facilitate obtaining very accurate measurements of various anatomic structures such as the ventricles, the corpus callosum, and the cerebellar vermis. Limited studies have been performed to predict that longitudinal measurements of these anatomic structures might predict the clinical outcome of high-risk preterm newborns. Hemodynamic Doppler studies may offer the potential for early intervention and treatment to counter the hazards of developmental delay and a moribund clinical outcome

  20. [A neonate with ambiguous genitalia].

    Science.gov (United States)

    Jansen, Burgo J; van Rijn, Rick R; van Trotsenburg, A S P Paul

    2015-01-01

    In a neonate with ambiguous genitalia, physical examination revealed a phallus. Ultrasonography showed a vagina and uterus, but no gonads. Because of severe undervirilisation in the presence of a uterus, probably due to 46,XY gonadal dysgenesis, parents were advised female sex assignment. When after a few weeks the phallus had increased in size, abdominal laparoscopy showed an underdeveloped uterus. Gonadal biopsy confirmed gonadal dysgenesis. Sex assignment was reconsidered and changed into the male gender. PMID:26200425

  1. Myasis occuring in a neonate

    Directory of Open Access Journals (Sweden)

    Temitope O. Obasa

    2012-12-01

    Full Text Available Myasis is the infestation of skin by larvae or maggots of a variety of flies. It is a condition that occurs more commonly in adults who are living and/or have visited tropical countries. It rarely occurs in neonates, and even when seen, only few larvae are extracted. This case report describes myasis occurring in an 11-day-old female who had 47 larvae in her skin.

  2. Hepatobiliary scan in neonatal Jaundice

    International Nuclear Information System (INIS)

    Jaundice is more or less common in newborn babies. Through physiological jaundice is most common cause of neonatal jaundice, possibility of obstructive jaundice especially biliary atresia should be kept in mind. Early diagnosis of biliary atresia followed by surgical treatment can save baby's life. Otherwise death is inevitable due to liver failure. Hepatobiliary scan is the imaging study of choice in neonatal jaundice especially when there is persistent conjugated hyperbilirubinaemia. Total 27 newborn babies of suspected biliary atresia, aged 14 days to 4 months were referred to Institute of Nuclear Medicine for Hepatobiliary scan. All of them had high serum bilirubin ranged from 6.0 mg/dl with an average of 9.35 ng/dl serum bilirubin level. Ultrasonography of hepatobiliary system was performed in 14 cases showing normal sized liver in 4 cases and hepatomegaly in 10 cases. Hepatobiliary scan was done with 99mTc-Mebrofenin (Br IDA) after preparing the baby with phenobarbitone for 3-5 days. 20 (67%) cases were scan positive suggesting biliary atresia (BA) and 7(27%) cases were scan negative. In BA there will be increased hepatic uptake of the radionuclide without any significant excretion even in 24 hours delayed images. Presence of radiotracer in the bowel exclude the diagnosis of BA. Early diagnosis of biliary atresia is very important because in this condition surgery should be performed early (within 60 days of life). Studies suggest that hepatobiliary scan after hepatic stimulation with phenobarbitone for a period of 3-5 days is highly accurate for differentiating biliary atresia from other causes of neonatal jaundice. It is very important to perform hepatobiliary scan in a case of neonatal jaundice to exclude biliary atresia for the sake of baby's life.(author)

  3. A Monosaccharide Residue Is Sufficient to Maintain Mouse and Human IgG Subclass Activity and Directs IgG Effector Functions to Cellular Fc Receptors

    Directory of Open Access Journals (Sweden)

    Daniela Kao

    2015-12-01

    Full Text Available Immunoglobulin G (IgG glycosylation modulates antibody activity and represents a major source of heterogeneity within antibody preparations. Depending on their glycosylation pattern, individual IgG glycovariants present in recombinant antibody preparations may trigger effects ranging from enhanced pro-inflammatory activity to increased anti-inflammatory activity. In contrast, reduction of IgG glycosylation beyond the central mannose core is generally believed to result in impaired IgG activity. However, this study reveals that a mono- or disaccharide structure consisting of one N-acetylglucosamine with or without a branching fucose residue is sufficient to retain the activity of the most active human and mouse IgG subclasses in vivo and further directs antibody activity to cellular Fcγ receptors. Notably, the activity of minimally glycosylated antibodies is not predicted by in vitro assays based on a monomeric antibody-Fcγ-receptor interaction analysis, whereas in vitro assay systems using immune complexes are more suitable to predict IgG activity in vivo.

  4. IgG subclass and light chain distribution of anticardiolipin and anti-DNA antibodies in systemic lupus erythematosus.

    OpenAIRE

    Gharavi, A E; Harris, E N; Lockshin, M D; Hughes, G R; Elkon, K B

    1988-01-01

    The IgG subclass and light chain distribution of anticardiolipin and anti-DNA antibodies were determined in serum samples from patients with systemic lupus erythematosus. With an enzyme linked immunosorbent assay (ELISA) and mouse monoclonal antibodies to individual subclasses, significant differences in the distributions of IgG2, IgG3, and IgG4 subclasses were observed between anticardiolipin and anti-DNA antibodies. Whereas anti-DNA antibodies were predominantly IgG1 and IgG3, all subclasse...

  5. Is IgG4-Related Disease a Cause of Xerostomia? A Cohort Study of 60 Patients

    OpenAIRE

    Hermet, M.; M. André; J. L. Kémény; Le Guenno, G.; P. Déchelotte; G. Guettrot-Imbert; A. Tridon; I. Delèvaux; Soubrier, M; O. Aumaître

    2012-01-01

    Objective. Immunoglobulin-G4-(IgG4-) related disease (IgG4 RD) is a fibrosing process characterized by a significant infiltration of IgG4-secreting plasma cells. IgG4 RD can affect almost all organs including salivary glands. Whether IgG4 RD plays a role in the development of sicca syndrome and particularly dry mouth syndrome remains to be investigated. Methods. We conducted a monocentric cohort study for two years to search for IgG4 RD features in patients with dry mouth syndrome using immun...

  6. IgG4-related disease and its pathogenesis—cross-talk between innate and acquired immunity

    OpenAIRE

    Umehara, Hisanori; Nakajima, Akio; Nakamura, Takuji; Kawanami, Takafumi; Tanaka, Masao; Dong, Lingli; Kawano, Mitsuhiro

    2014-01-01

    IgG4-related disease (IgG4-RD) is a novel clinical entity proposed in Japan in the 21th century and is attracting strong attention over the world. The characteristic manifestations of IgG4-RD are increased serum IgG4 concentration and tumefaction by IgG4+ plasma cells. Although the clinical manifestations in various organs have been established, the pathogenesis of IgG4-RD is still unknown. Recently, many reports of aberrant acquired immunity such as Th2-diminated immune responses have been p...

  7. Rethinking Ormond’s Disease: “Idiopathic” Retroperitoneal Fibrosis in the Era of IgG4-Related Disease

    OpenAIRE

    Khosroshahi, Arezou; Carruthers, Mollie N.; John H. Stone; Shinagare, Shweta; Sainani, Nisha; Hasserjian, Robert P.; Deshpande, Vikram

    2013-01-01

    Abstract Idiopathic retroperitoneal fibrosis (RPF) is a periaortic sclerotic disease that encases adjacent retroperitoneal structures, particularly the ureters. A subset of idiopathic RPF cases can be associated with IgG4-related disease, but the frequency of this association is not clear. We selected 23 cases of idiopathic RPF and identified IgG4-related RPF cases based on the presence of IgG4+ plasma cells in the tissue, using an IgG4/IgG ratio cutoff of >40%. We then compared the IgG4-rela...

  8. Neonatal hip dysplasia: Differental diagnosis

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2010-01-01

    Full Text Available Introduction. Hip dysplasia is the elementary form of the developmental dysplasia of the hip (DDH. The diagnosis may be made by the ultrasound examination (types II a-, II b. Objective. The aim of the authors was to define the congenital structural neonatal hip dysplasia, and to differentiate hip hypoplasia, hip dysplasia and teratogenic anomalies. Methods. In all the cases, the uniform clinical and ultrasound tests were performed. All the patients were examined in the neonatal period of life (the first six weeks. The following clinical tests were used: Le Damany-Ortolany, Coleman-Barlow-Palmen and Weissman-Strinović. For the ultrasound examination, the Graph’s method was used. Results. The investigation was performed in the period 2007- 2008. 2,878 neonates were included. The distribution of the sonotypes, according to Graph, was as follows: Ia in 16.17%. Ib in 65.08%; IIa+ in 18.17%, IIc in 0.28%, IId in 0.19%; IIIa in 0.009%, IIIb in 0.02%; and IV in 0.01%. It was found that DDH was 8 times more frequent in girls; located more frequently at the left side than bilaterally. Conclusion. Hip sonoscreening has to be performed in all newborns in the first 72 hours. The suggested follow-up period is six weeks: for the diagnosis - the first three weeks, and for the prevention and treatment - all six weeks.

  9. Neonatal Hearing screening in tafila

    International Nuclear Information System (INIS)

    To measure the true prevalence of hearing impairment in neonates in Tafila, Jordan. This retrospective study was carried out at Prince Zeid Hospital, Taflia, Jordan through analysis of data of all births from January 2005 and January 2006. Transient evoked otoacoustic emissions (TEOAE) were measured via the application of echoprobe to both ears. There were two groups of births that were analysed statistically. Hearing impaired neonates were those with two fails or more in each ear. Normal ones were those with 3 pass or more. Of the 1788 babies in the study group, 1622 (90.7%) were enrolled in the study with 9.3% loss rate. 1512 babies were examined on the 2 day of birth, 2 of them had hearing impairment with a rate of 1.2/1000. 110 babies were screened on the day of discharge from the nursery, one of them with hearing defect with a rate of 5.9/1000. Thus, true prevalence of hearing impaiment or failure was 1.7/1000. We conclude that screening for hearing impairment in the neonatal period is easy, informative and the true prevalence of hearing impairment in Tafila is similar to that in different parts of the world. (author)

  10. Bacteriological Profile and Antibiogram of Neonatal Septicemia

    OpenAIRE

    Bhatt Sima K; Patel Disha A; Gupta Praveg; Patel Kiran; Joshi Gurudutt

    2012-01-01

    Background: Early diagnosis and proper management of neonatal septicemia can bring down the morbidity and mortality substantially.4 Hence the aim of this study was to study the bacteriological profile of neonatal septicemia cases and their antibiogram for planning strategy for the management of these cases. Methodology: A retrospective study of bacterial isolates from cases of neonatal septicemia was undertaken over a period of 13 months from January 2006 to February 2007 at B.J.Medical Colle...

  11. Morphine Enhances HIV Infection of Neonatal Macrophages

    OpenAIRE

    Li, Yuan; MERRILL, JEFFREY D.; Mooney, Kathy; Song, Li; Wang, Xu; GUO, CHANG-JIANG; Savani, Rashmin C; Metzger, David S.; Douglas, Steven D.; Ho, Wen-Zhe

    2003-01-01

    Perinatal transmission of HIV accounts for almost all new HIV infections in children. There is an increased risk of perinatal transmission of HIV with maternal illicit substance abuse. Little is known about neonatal immune system alteration and subsequent susceptibility to HIV infection after morphine exposure. We investigated the effects of morphine on HIV infection of neonatal monocyte-derived macrophages (MDM). Morphine significantly enhanced HIV infection of neonatal MDM. Morphine-induced...

  12. A Swine Model of Neonatal Asphyxia

    OpenAIRE

    Cheung, Po-Yin; Gill, Richdeep S.; Bigam, David L.

    2011-01-01

    Annually more than 1 million neonates die worldwide as related to asphyxia. Asphyxiated neonates commonly have multi-organ failure including hypotension, perfusion deficit, hypoxic-ischemic encephalopathy, pulmonary hypertension, vasculopathic enterocolitis, renal failure and thrombo-embolic complications. Animal models are developed to help us understand the patho-physiology and pharmacology of neonatal asphyxia. In comparison to rodents and newborn lambs, the newborn piglet has been proven ...

  13. Neonatal Sludge: A finding of congenital hypothyroidism

    OpenAIRE

    Kurtoğlu, Selim; Çoban, Dilek; Akın, Mustafa Ali; Akın, Leyla; Yıkılmaz, Ali

    2010-01-01

    Congenital hypothyroidism is one of the most urgent diseases of the neonate. When diagnosed and treated at an early stage, its most important complication, mental retardation, is preventable. The signs of congenital hypothyroidism are nonspecific in neonates. Only 5% of the cases have characteristic clinical findings. One of the most important and earliest signs is prolonged jaundice during the neonatal period. We report herein a case of congenital hypothyroidism, who presented with icterus a...

  14. The Neonatal Connectome During Preterm Brain Development

    OpenAIRE

    van den Heuvel, Martijn P.; Kersbergen, Karina J.; de Reus, Marcel A.; Keunen, Kristin; Kahn, René S.; Groenendaal, Floris; de Vries, Linda S.; Benders, Manon J. N. L.

    2014-01-01

    The human connectome is the result of an elaborate developmental trajectory. Acquiring diffusion-weighted imaging and resting-state fMRI, we studied connectome formation during the preterm phase of macroscopic connectome genesis. In total, 27 neonates were scanned at week 30 and/or week 40 gestational age (GA). Examining the architecture of the neonatal anatomical brain network revealed a clear presence of a small-world modular organization before term birth. Analysis of neonatal functional c...

  15. Antibody isotypes, including IgG subclasses, in Ecuadorian patients with pulmonary Paragonimiasis

    Directory of Open Access Journals (Sweden)

    Angel Guevara E.

    1995-08-01

    Full Text Available An ELISA test was developed to detect Paragonimus-specific antibodies, including IgG subclasses, using P. mexicanus crude water-soluble antigens. The test was standardized to detect antibodies in sera of Ecuadorian patients with pulmonary paragonimiasis and negative controls from the endemic area. The detected mean levels of IgG (0.753, SEM: 0.074 and IgM (0.303, SEM: 0.033 were significantly elevated (P<0.05. Within the IgG subclasses, IgG4 showed the highest detected mean level (0.365, SEM: 0.116 and the other three subclasses showed considerably lower mean levels (IgG1, 0.186 SEM: 0.06; IgG2, 0.046 SEM: 0.01; IgG3, 0.123 SEM: 0.047. The number of P. mexicanus eggs found in sputum of infected individuals showed a positive correlation with the level of antibodies detected for IgM, IgG and its subclasses (P<0.001. The relevance of these findings in Ecuadorian patients suffering from pulmonary paragonimiasis is discussed.

  16. IgG4 related renal disease: A wolf in sheep's clothing

    OpenAIRE

    Rohan, A.; Ravishankar, B.; Vishwanath, S; Vankalakunti, M.; Kishore, B.; Ballal, H. S.

    2014-01-01

    IgG4 related disease is a fibro-inflammatory condition with involvement of renal and extra renal organs, characterized by lymphoplasmacytic infiltration with organ dysfunction. We describe three cases of IgG4 related renal disease from a tertiary care hospital in south India.

  17. The first case of IgG4-related disease in Italy

    OpenAIRE

    Rolla, Davide; Bellino, Diego; Peloso, Giancarlo; Pia Rastaldi, Maria; Simonini, Paola; Louis Ravetti, Jean

    2013-01-01

    Background:Recently, Mikulicz’s disease has been defined as an IgG-4 related disease, a systemic condition, where the hallmark pathology findings are lymphoplasmacytic infiltrates, immunoglobulin (Ig)G4-positive plasma cells, modest tissue eosinophilia, and intense fibrosis.

  18. Salivary IgG assay to detect Helicobacter pylori infection in an Indian adult population

    Directory of Open Access Journals (Sweden)

    Ramya Thirumala Krishnaswamy

    2012-01-01

    Conclusion: EIAgen H. pylori IgG assay is a noninvasive, moderately accurate, and sensitive method for the detection of H. pylori infection in saliva. Salivary anti H. pylori IgG test prior to endoscopy is a useful screening test for seroepidemiological studies.

  19. Intrathecal IgG synthesis and autoantibody-secreting cells in multiple sclerosis

    DEFF Research Database (Denmark)

    Sellebjerg, Finn; Jensen, Claus V; Christiansen, Michael

    We studied intrathecal IgG synthesis and autoantibody-secreting cells in 148 patients with possible onset symptoms of MS (POSMS) or clinically definite MS (CDMS). In POSMS intrathecal synthesis of IgG oligoclonal bands and abnormalities on T2-weighted magnetic resonance imaging were associated bu...

  20. Protease inhibitors decrease IgG shedding from Staphylococcus aureus, increasing complement activation and phagocytosis efficiency.

    Science.gov (United States)

    Fernandez Falcon, Maria F; Echague, Charlene G; Hair, Pamela S; Nyalwidhe, Julius O; Cunnion, Kenji M

    2011-10-01

    Staphylococcus aureus is a major pathogen for immunologically intact humans and its pathogenesis is a model system for evasion of host defences. Antibodies and complement are essential elements of the humoral immune system for prevention and control of S. aureus infections. The specific hypothesis for the proposed research is that S. aureus modifies humoral host defences by cleaving IgG that has bound to the bacterial surface, thereby inhibiting opsonophagocytosis. S. aureus was coated with pooled, purified human IgG and assayed for the shedding of cleaved IgG fragments using ELISA and Western blot analysis. Surface-bound IgG was shed efficiently from S. aureus in the absence of host blood proteins. Broad-spectrum protease inhibitors prevented cleavage of IgG from the S. aureus surface, suggesting that staphylococcal proteases are responsible for IgG cleavage. Serine protease inhibitors and cysteine protease inhibitors decreased the cleavage of surface-bound IgG; however, a metalloprotease inhibitor had no effect. Using protease inhibitors to prevent the cleavage of surface-bound IgG increased the binding of complement C3 fragments on the surface of S. aureus, increased the association with human neutrophils and increased phagocytosis by human neutrophils. PMID:21636671

  1. Peroxynitrite-induced structural perturbations in human IgG: A physicochemical study.

    Science.gov (United States)

    Arfat, Mir Yasir; Arif, Zarina; Chaturvedi, Sumit Kumar; Moinuddin; Alam, Khursheed

    2016-08-01

    IgG is an important defence protein. To exhibit optimum function the molecule must maintain its native structure. Peroxynitrite is a potent oxidizing and nitrating agent produced in vivo under pathophysiological conditions. It can oxidize and/or nitrate various amino acids causing changes in the structure and function of proteins. Such proteins may be involved in the pathogenesis of many inflammatory diseases, including rheumatoid arthritis. In the present work, peroxynitrite-induced structural changes in IgG have been studied by UV-visible, fluorescence, CD, FT-IR, DLS spectroscopy and DSC as well as by SDS-PAGE. Peroxynitrite-modified IgG exhibited hyperchromicity at 280 nm, quenching of tryptophan fluorescence, increase in ANS fluorescence, loss of β-sheet, shift in the positions of amide I and amide II bands, appearance of new peak in FT-IR, attachment of nitro residues and increase in melting temperature, compared to native IgG. Furthermore, peroxynitrite-modified IgG exhibited an additional peak at 420 nm, quenching in tyrosine fluorescence and enhancement in dityrosine fluorescence compared to native IgG. Generation of nitrotyrosine, dityrosine and nitrotryptophan was also observed in peroxynitrite-modified IgG. Gross structural changes in IgG caused by peroxynitrite and observed in vitro may favour autoantibodies induction in vivo under similar conditions. PMID:27210739

  2. Enhanced HIV-1 neutralization by a CD4-VH3-IgG1 fusion protein

    International Nuclear Information System (INIS)

    HIV-1 gp120 is an alleged B cell superantigen, binding certain VH3+ human antibodies. We reasoned that a CD4-VH3 fusion protein could possess higher affinity for gp120 and improved HIV-1 inhibitory capacity. To test this we produced several human IgG1 immunoligands harboring VH3. Unlike VH3-IgG1 or VH3-CD4-IgG1, CD4-VH3-IgG1 bound gp120 considerably stronger than CD4-IgG1. CD4-VH3-IgG1 exhibited ∼1.5-2.5-fold increase in neutralization of two T-cell laboratory-adapted strains when compared to CD4-IgG1. CD4-VH3-IgG1 improved neutralization of 7/10 clade B primary isolates or pseudoviruses, exceeding 20-fold for JR-FL and 13-fold for Ba-L. It enhanced neutralization of 4/8 clade C viruses, and had negligible effect on 1/4 clade A pseudoviruses. We attribute this improvement to possible pairing of VH3 with CD4 D1 and stabilization of an Ig Fv-like structure, rather than to superantigen interactions. These novel findings support the current notion that CD4 fusion proteins can act as better HIV-1 entry inhibitors with potential clinical implications.

  3. Experiences in the measurement of RBC-bound IgG as markers of cell age.

    Science.gov (United States)

    Paleari, Renata; Ceriotti, Ferruccio; Azzario, Franco; Maccioni, Liliana; Galanello, Renzo; Mosca, Andrea

    2004-05-01

    An immunologically mediated pathway has been largely accepted to be one of the mechanisms involved in the clearance of senescent or prematurely damaged RBC. According to this pathway, RBC removal is mediated by binding of naturally occurring IgG to clustered integral membrane proteins, followed by complement deposition. The validation of an immunoenzymatic method for the detection of RBC-bound autologous IgG is presented. The use of RBC-bound IgG as an index related to red cell age was evaluated by measuring IgG binding in RBC treated with the clustering agent ZnCl2, in density fractionated RBC and in a selected group of patients expected to have an altered RBC life span. The immunoenzymatic method for IgG detection resulted to be reproducible (CV = 3.4%). IgG binding to in vitro clustered RBC was found to be enhanced to a very great extent, about 20 times higher with respect to untreated RBC. A slight but significant increase (about 1.8-fold) in membrane-bound IgG was observed in the highest density fraction of normal RBC, which constituted 1% of the total cells. A significantly greater number of RBC-bound IgG was measured in splenectomized beta-thalassemia intermedia patients and in subjects with secondary decreases in the C3 complement fraction concentration. PMID:15039023

  4. Low avidity IgG antibodies in diagnosis of recent human schistosomiasis.

    Science.gov (United States)

    Mostafa, Nahed E; Awad, Adel; Shalaby, Mohsen

    2002-12-01

    One hundred thirty school children from a schistosomiasis endemic area in Sharkia Governorate, were selected on parasitological findings. Seventy persons were negative on the first screen and turned positive after 3 months of the screening (recently infected). Stool examination, ELISA (IgG & IgM), low avid IgG, and circulating antigens were performed for all patients and controls. ELISA detected IgM in all cases. IgG and circulating antigens in 90% of schistosomiasis patients. Low avidity IgG were detected in 85.71% of recent cases. The specificity of ELISA appeared to be >99%. The IgM/IgG ratio was >1 in patients with recent infection. The percentage of fall of O.D. readings of IgG after addition of 6 molar urea was high among cases with recent infection. Low avid lgG appears to be good and valuable in diagnosis of recent schistosomiasis in man. PMID:12512829

  5. Characteristics, diagnosis and therapeutic strategies for IgG4-related orbital disease.

    Science.gov (United States)

    Oles, Krzysztof; Sładzień, Jacek; Bartuś, Krzysztof; Leszczyńska, Joanna; Bojanowska, Emila; Krakowczyk, Łukasz; Mika, Joanna

    2016-06-01

    Thanks to detailed studies conducted in recent years, a new disease syndrome was identified in 2001. It is known as a IgG4-related disease and its differentiation is based on the analysis of IgG4 levels in the affected tissues. The IgG4-related disease is considered to be a generalized pathological process involving a wide spectrum of various disorders that may affect distant organs. Orbital IgG4-related disease is a recently reported issue that may prove important for the elucidation of the etiology of idiopathic, lymphoplasmacytic or fibrotic disorders of various organs, including the orbits. In this article, we are describing epidemiology and differential diagnostics of IgG4-related orbital disease with particular focus on pseudotumors, MALT lymphomas and lymphocyte/plasma cell infiltrations of the orbit. We are also discussing therapeutic possibilities currently available in the management of the disease. PMID:27116895

  6. A case of refractory IgG4-related peripheral neuropathy with severe axonal damage.

    Science.gov (United States)

    Suzuki, Yu; Shiraishi, Makoto; Yamada, Koji; Doi, Masatomo; Kato, Masayuki; Hasegawa, Yasuhiro

    2016-05-31

    A 78-year-old man presented complaining of tingling and pain. Neurological examination revealed dysesthesia and hypothermesthesia below both knees and areflexia in the lower extremities. Laboratory data revealed elevated serum levels of immunoglobulin IgG4 and para-aortic, and mesenteric lymphadenopathy was evident on plain computed tomography of the abdomen. Microscopic findings of a bone marrow biopsy specimen showed occlusion of blood vessels with IgG4-positive plasma cells. IgG4-related disease was diagnosed because the bone marrow biopsy exhibited > 10 IgG4-positive plasma cells per high-power field. Treatment was initiated with prednisolone starting at 30 mg/day, but no improvement in neurological symptoms was achieved. Sural nerve biopsy demonstrated obstructive thromboangiitis with severe loss of myelin and axons. Further investigations are needed to elucidate the relationship between obstructive thromboangiitis and steroid-resistant IgG4-related peripheral neuropathy. PMID:27098901

  7. IgG Adhesion on Hydrophobic Surfaces: Theory, Modelling, and Application to ELISA

    CERN Document Server

    de Thier, P

    2016-01-01

    Enzyme-Linked ImmunoSorbent Assays (ELISA) are a range of widely used analytical methods whose implementation requires to build antibodies (IgG) thin films onto surfaces predominantly made of polystyrene. The high hydrophobicity of polystyrene ensures a spontaneous and strong adhesion of proteins allowing to easily build IgG monolayers. Since the ELISA improvements definitely lie in the comprehension of physico-chemical mechanisms on which IgG immobilization on hydrophobic surfaces are relied, this work develops a theorization essay (thermodynamics of the so-called hydrophobic effect and of thin films building) emphasized by numerical modelling (random sequential additions model, i.e. RSA) and experimental estimations by atomic force microscopy (AFM) and ELISA. Keeping in mind the hydrophobic effect, thermodynamics (of irreversible processes) allows to explain why IgG adhesion on polystyrene occurs whereas numerical modelling approaches show a way of surface saturation leading to promote IgG orientations expe...

  8. The Study of IgG Subclass Profiles of Anti-HBc in Populations with Different Status of HBV Infection

    Institute of Scientific and Technical Information of China (English)

    Yu-Yen Yang; Chi-Chiang Yang; Chien-Fu Huang; James Cheng-Chung Wei; Mei-Shang Ho; Lina Wang; Shyh-Jye Lin; Wei-Yu Tsai; Chien-Chou Lin; Fangling Xu

    2005-01-01

    To study IgG subclasses for the hepatitis B virus (HBV) core antigen (anti-HBc) in different populations, a comparison was made between 104 chronic carriers (60 male and 44 female) and 434 recovered individuals (247 male and 192 female). Biochemistry analyses of AST (aspartate aminotransferase) and ALT (alanine aminotransferase) were also performed. Among the 104 chronic carriers, 21 patients were found to be ALT and AST abnormal (> 25 IU/ml). After comparing these ALT and AST abnormal patients with other ALT and AST normal chronic carriers, no statistical difference was observed in the OD values of the anti-HBe (p > 0.05). The ELISA results showed the anti-HBc IgG subclass pattern was IgG1 > IgG3 > IgG4 in chronic carriers and IgG3 > IgG1 > IgG4 in recovered individuals (p < 0.05). This result suggests the IgG1/IgG3 ratio may be related with HBV status. However, in spite of the different anti-HBc IgG1/IgG3 patterns demonstrated in different populations, both anti-HBc IgG1 and IgG3 concentrations were significantly higher in chronic carriers (p < 0.05). Therefore, both the anti-HBc IgG1/IgG3 ratio and their amounts differed. They may play a significant role in chronic carriers and recovered individuals. The anti-HBc IgG subclass profiles of chronic carriers were not changed regardless of liver inflammation, and were independent of sex and age. Cellular & Molecular Immunology.

  9. Protective role of mouse IgG1 in cryoglobulinaemia; insights from an animal model and relevance to human pathology.

    Science.gov (United States)

    Chemouny, Jonathan Maurice; Hurtado-Nedelec, Margarita; Flament, Héloïse; Ben Mkaddem, Sanae; Daugas, Eric; Vrtovsnik, François; Berthelot, Laureline; Monteiro, Renato C

    2016-08-01

    Strait et al. described a novel mouse model of cryoglobulinaemia by challenging mice deficient in the immunoglobulin (Ig)G1 subclass (γ1(-) mice) with goat anti-mouse IgD [5]. The phenotype of wild-type mice was not remarkable, whereas γ1(-) mice developed IgG3 anti-goat IgG cryoglobulins as well as severe and lethal glomerulonephritis. Renal phenotype could not be rescued in γ1(-) mice by the deletion of C3, fragment crystalline γ receptor (FcγR) or J chain. On the other hand, early injection of IgG1, IgG2a or IgG2b inhibited the pathogenic effects of IgG3 in an antigen-dependent manner even in the absence of the FcγRIIb, an anti-inflammatory receptor. The authors concluded that the pathogenic role of IgG3 and the protective characteristic of IgG1 in this model were not explained by their abilities to bind to FcRs or effector molecules but are rather due to structural discrepancies enhancing the precipitation properties/solubility of IgG3/IgG1-containing immune complexes. The present article aims to discuss the current knowledge on IgG biology and the properties of IgGs explaining their differential propensity to acquire cryoglobulin activity. PMID:26410885

  10. IgG4-related disease simulating Hodgkin lymphoma in a child

    Directory of Open Access Journals (Sweden)

    D. Eric Ewing, MD

    2016-06-01

    Full Text Available Immunoglobulin (Ig G4-related disease is a recently described syndrome characterized by mass forming lymphoplasmacytic tissue infiltration and elevated serum IgG4 concentrations usually affecting middle-aged or older individuals. Lymphadenopathy is frequently observed and is sometimes the first or only manifestation of the disease. We report a case of IgG4-related disease mimicking Hodgkin lymphoma in a 13-year-old girl. The patient presented with progressive unilateral cervical lymphadenopathy of several months duration. Biopsy showed follicular hyperplasia with progressive transformation of germinal centers. Interfollicular areas were expanded by small lymphocytes, histiocytes, eosinophils and fibrosis with occasional CD30 positive cells initially concerning for interfollicular Hodgkin lymphoma. Immunohistochemical analysis revealed an intrafollicular plasmacytosis with an IgG4-positive/IgG-positive plasma cell ratio of 50% supporting a diagnosis of IgG4-related lymphadenopathy, progressively transformed germinal centers type. Laboratory studies were supportive with elevated serum IgG4 (178 mg/dL and IgE (30.40 kU/L levels along with an elevated serum IgG4/IgG ratio (0.16. Very few cases of IgG4-related disease have been described in children. Within this age group, there is considerable clinical overlap between IgG4-related disease associated lymphadenopathy and Hodgkin lymphoma. In addition, lymphadenopathy secondary to IgG4-related disease demonstrates substantial histologic diversity with the potential to simulate the inflammatory background and fibrosis of Hodgkin lymphoma. The importance of accurate diagnosis is underscored by the prognostic implications considering the marked response of the syndrome to steroid therapy. In addition, appropriate follow up is critical to monitor for relapse and additional organ involvement.

  11. Acute kidney injury in asphyxiated neonates

    Directory of Open Access Journals (Sweden)

    Roy Amardiyanto

    2013-07-01

    Full Text Available Background Asphyxia neonatorum may result in multiorgan dysfunction including renal involvement. There is no consensus on the determination of acute kidney injury (AKI in neonates making establishment of the diagnosis and its management becomes difficult. The Acute Kidney Injury Network (AKIN recommends AKI criteria based on increased serum creatinine level and reduced urine output. Objectives To identify the prevalence of AKI in asphyxiated neonates using the AKIN criteria, to compare the difference of AKI stages, and the glomerular filtration rates (GFR between moderate and severe asphyxia. Methods This was a cross-sectional analytical study conducted between July 2012 and January 2013. Subjects were all asphyxiated neonates (Apgar score 35 weeks delivered and hospitalized in Cipto Mangunkusumo Hospital and Koja District Hospital, Jakarta, Indonesia. Glomerular filtration rate was calculated using the components of urine creatinine, serum creatinine, and urine output; while AKI stages were determined according to AKIN criteria. Urinary output was measured via urethral catheterization. Results Of 94 subjects, there were 70 neonates with moderate and 24 neonates with severe asphyxia, with the prevalence of AKI was 63%. Twenty one out of 24 neonates with severe asphyxia experienced AKI, while neonates with moderate asphyxia who experienced AKI was 38 out of 70 subjects (54%. Two third of neonates with severe asphyxia who experienced AKI had stage 3 of AKI. More severe AKI stages and lower median GFR were found in neonates with severe compared to moderate asphyxia (P<0.001. Conclusion The prevalence of AKI in neonatal asphyxia is high (63%. The more severe degree of neonatal asphyxia, the more severe AKI stage and the lower median GFR. [Paediatr Indones. 2013;53:232-8.].

  12. Toxoplasma-SPECIFIC IgG SUBCLASS ANTIBODY RESPONSE IN CEREBROSPINAL FLUID SAMPLES FROM PATIENTS WITH CEREBRAL TOXOPLASMOSIS

    Directory of Open Access Journals (Sweden)

    Fernanda S. NASCIMENTO

    2015-10-01

    Full Text Available SUMMARY Cerebral toxoplasmosis can be highly debilitating and occasionally fatal in persons with immune system deficiencies. In this study, we evaluated the Toxoplasma gondii-specific IgG subclass antibody response in 19 cerebrospinal fluid (CSF samples from patients with cerebral toxoplasmosis who had a positive IgG anti-T. gondii ELISA standardized with a cyst antigen preparation. There were no significant differences between the rates of positivity and the antibody concentrations (arithmetic means of the ELISA absorbances, MEA for IgG1 and IgG2, but the rates of positivity and MEA values for these two IgG subclasses were significantly higher than those for IgG3 and IgG4. The marked IgG2 response in CSF from patients with cerebral toxoplasmosis merits further investigation.

  13. Prognostic value of intrathecal IgG synthesis in multiple sclerosis: a study in 54 patients

    Directory of Open Access Journals (Sweden)

    Aghamohammadi A

    2008-06-01

    Full Text Available Background: Multiple sclerosis (MS is an inflammatory disease of the central nervous system with multifocal areas of demyelination. Despite an increased understanding of the mechanisms causing MS, immunological factors that indicate disease activity are only starting to be discovered. Chronic brain inflammation is often associated with an increase in production of IgG in the CSF as determined by the IgG index (normal ≤0.77 and oligoclonal bands (OCBs. Different studies have found variable correlations between these two factors and disease progression. We herein evaluate the correlation of IgG index and OCB with disease progression in Iranian MS patients.Methods: The IgG index was measured in 54 patients with multiple sclerosis. The progression index (PI, type of disease course and the presence of OCBs were compared in patients with normal, high and very high IgG index.Results: PI was higher in patients with very high IgG indexes (0.10±0.13 vs. patients with high (0.06±0.05 and normal IgG indexes (0.05±0.07; p>0.05. Secondary progressive (SP patients had higher IgG indexes than those with relapsing-remitting (RR courses (2.04±1.24 for SP vs. 1.78±1.45 for RR; p>0.05. The PI was higher in OCB-positive MS patients (0.08±0.10 vs. OCB-negative patients (0.05±0.04 (p>0.05.Conclusion: Although the findings of this study need to be treated with some caution since this is not a prospective evaluation, the results indicate a trend toward better prognosis of the disease in patients with lower IgG index values. We think that the IgG index is a useful marker of disease activity in MS. Patients with IgG indexes above 1.1 could have an increased risk of progression and they would benefit from early treatment with immunomodulator agents. Our results did not reveal statistically significant prognostic value for IgG index in patients with multiple sclerosis. Thus the results warrant prospective studies to verify the prognostic value of intrathecal IgG

  14. Neonatal aerosol exposure to Bermuda grass allergen prevents subsequent induction of experimental allergic feline asthma: evidence for establishing early immunologic tolerance.

    Science.gov (United States)

    Heller, M C; Lee-Fowler, T M; Liu, H; Cohn, L A; Reinero, C R

    2014-07-15

    Allergic asthma is increasing in industrialized countries, especially in children. Rodent and human studies suggest an opportunity to "prevent" asthma in the perinatal period. The aims of this study were to create a more "natural" model of feline asthma by exposing offspring of asthmatic queens to Bermuda grass allergen (BGA) by inhalation only, and to investigate maternal-fetal-infant interactions in the development of asthma. Kittens from asthmatic queens were divided into four groups: maternal exposure to aerosolized BGA during the third trimester, neonatal exposure to aerosolized BGA in the first three months of life, both maternal and neonatal exposure, or saline control. Kittens failing to achieve an asthmatic phenotype based on bronchoalveolar lavage fluid (BALF) analysis by 6 months underwent traditional sensitization: adjuvanted allergen injection, intranasal allergen, and aerosol challenges. BALF was collected at 3, 4 and 6 months, and after sensitization at 8 months, and analyzed for eosinophil counts and BGA-specific IgG and IgA. Intradermal testing (IDT) was performed at 6 and 7 months. At six months none of the kittens had airway eosinophilia, BGA-specific IgG or IgA, and were non-responsive to IDT. After sensitization, kittens receiving neonatal aerosolization failed to develop airway eosinophilia as seen in the controls. Kittens exposed to BGA aerosols, either in-utero or neonatally, continued to lack IDT response. Chronic exposure to BGA aerosols failed to induce asthma in kittens, and instead tolerized the kittens to BGA. This is the first evidence that neonatal intervention could potentially "prevent" allergic asthma in cats. PMID:24704287

  15. Serum Concentrations of IgG4 in the Spanish Adult Population: Relationship with Age, Gender, and Atopy

    Science.gov (United States)

    Carballo, Iago; Alvela, Lucía; Pérez, Luis-Fernando; Gude, Francisco; Vidal, Carmen; Alonso, Manuela; Sopeña, Bernardo; Gonzalez-Quintela, Arturo

    2016-01-01

    Background and Aim Serum IgG4 concentrations are commonly measured in clinical practice. The aim of this study was to investigate serum IgG4 concentrations in adults and their potential relationship with demographic, lifestyle, metabolic, and allergy-related factors. Methods Serum IgG4 concentrations were measured with a commercial assay in 413 individuals (median age 55 years, 45% males) who were randomly selected from a general adult population. Results Median IgG4 concentration was 26.8 mg/dL. Five out of the 413 individuals (1.2%) exhibited IgG4 concentrations >135 mg/dL, and 17 out of 411 (4.1%) exhibited an IgG4/total IgG ratio >8%. Serum IgG4 concentrations were significantly higher in males than in females and decreased with age. After adjusting for age and sex, serum IgG4 concentrations were not significantly influenced by alcohol consumption, smoking or common metabolic abnormalities (obesity and the related metabolic syndrome). Serum IgG4 concentrations were not significantly correlated with serum concentrations of proinflammatory cytokines and inflammation markers. Serum IgG4 concentrations were significantly correlated with IgE concentrations. Serum IgG4 concentrations tended to be higher in atopics (individuals with IgE-mediated sensitization to aeroallergens) than in non-atopics, particularly among atopics without respiratory symptoms. Serum IgG4 concentrations were not significantly correlated with total eosinophil blood count. Cases of IgG4-related disease were neither present at baseline nor detected after a median of 11 years of follow-up. Conclusions Studies aimed at defining reference IgG4 values should consider partitioning by age and sex. Further studies are needed to confirm the potential influence of atopy status on serum IgG4 concentrations. PMID:26910567

  16. IgG4-Related Disease Is Not Associated with Antibody to the Phospholipase A2 Receptor

    OpenAIRE

    Beck, Laurence H.; Salant, David J.; Arezou Khosroshahi; John H. Stone; Bloch, Donald B.; Rivka Ayalon

    2012-01-01

    Patients with IgG4-related disease (IgG4-RD) share histopathological characteristics that are similar across affected organs. The finding of infiltration with IgG4+ plasma cells in the proper clinical and histopathological contexts connects a large number of clinical entities that were viewed previously as separate conditions. The renal involvement in IgG4-RD is usually characterized by tubulointerstitial nephritis, but membranous nephropathy has also been reported to be one of the renal comp...

  17. Haemodynamics of intravenous paracetamol in neonates

    OpenAIRE

    Allegaert, Karel; Naulaers, Gunnar

    2010-01-01

    Abstract Introduction Reports on the haemodynamics of intravenous (iv) paracetamol in adult intensive care were recently published. We therefore wanted to explore the haemodynamics of iv paracetamol in neonates. Methods Retrospective, pooled analysis of heart rate (bpm) and blood pressure (mean, systolic, diastolic) observations collected during iv paracetamol pharmacokinetic studies in neonates. Heart rat...

  18. Teamwork in the Neonatal Intensive Care Unit

    Science.gov (United States)

    Barbosa, Vanessa Maziero

    2013-01-01

    Medical and technological advances in neonatology have prompted the initiation and expansion of developmentally supportive services for newborns and have incorporated rehabilitation professionals into the neonatal intensive care unit (NICU) multidisciplinary team. Availability of therapists specialized in the care of neonates, the roles of…

  19. Neonatal Salmonella Typhi Meningitis: A Rare Entity

    OpenAIRE

    Singhal, Vikram; EK, Saleem; SM, Rajesh; Coutinho, Anita

    2012-01-01

    Salmonella meningitis is rarely seen in neonates and if it is present, it is associated with complications like subdural collections and abscesses. We are presenting a case of Salmonella meningitis in a 28 days old neonate who developed complications like extensive subdural collections and ventriculitis. The child responded well to prolonged systemic antibiotics and other supportive measures.

  20. Neonatal maxillary orthopedics: past to present

    NARCIS (Netherlands)

    A.M. Kuijpers-Jagtman; C. Prahl

    2013-01-01

    Neonatal maxillary orthopedics was introduced in the treatment protocol for cleft lip and palate in the 1950s of the last century. A wide range of appliances has been designed with pin-retained active appliances at one end of the spectrum and passive appliances at the other. Although neonatal maxill

  1. Neonate with hypoglycemia for pancreatectomy: Anesthetic challenge

    OpenAIRE

    Gupta, Alka; Kohli, Jasvinder Kaur; Senapati, Nihar Nalini; Sharma, Sanjeev

    2016-01-01

    Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is rare and an important cause of hypoglycemia in neonates. It can lead to brain damage or death secondary to severe hypoglycemia. We present the anesthetic management in a diagnosed case of PHHI in an 8-day-old male neonate for total pancreatectomy.

  2. Analytical validation of anti-toxoplasma IgG immunoassays

    Directory of Open Access Journals (Sweden)

    Guenael Freire de Souza

    2012-12-01

    Full Text Available There are often discrepancies when using different methods to measure anti-Toxoplasma gondii IgG levels in patient samples. The diagnostic performance of a chemiluminescent immunoassay (CLIA and an enzyme-linked fluorescent assay (ELFA used as confirmatory tests for samples identified as positive or equivocal by an electrochemiluminescent immunoassay (ECLIA were examined. Cut-off values were those stated by the manufacturer, and Western blot was used to confirm the results of all methods. All samples identified as positive by ECLIA (n = 93 were confirmed as positive by Western blot, as were 14 of the 28 samples identified as equivocal. When these 121 samples were retested, the sensitivities of CLIA and ELFA were 64.4% and 73.8%, respectively. Both methods exhibited a specificity of 100%. This study confirms that the results obtained from the different immunoassays are not comparable, and neither CLIA nor ELFA should be used to confirm ECLIA results, which should instead be confirmed by methods such as Western blot or Sabin-Feldman dye test.

  3. Sepsis neonatal por Estreptococos Pyogenes

    Directory of Open Access Journals (Sweden)

    Gilberto Rodríguez-Herrera

    2009-09-01

    Full Text Available Se presenta el caso de un paciente masculino, recién nacido a término adecuado para la edad gestacional, quien nace por parto vaginal, con el antecedente de fiebre en la madre durante el periodo de postparto inmediato. Los padres consultan a los 2 días de vida pues le notan dificultad respiratoria, hipoactividad y rechazo a la leche materna. El paciente se interna y se aborda como una sepsis. Durante su estancia en el servicio de neonatología del Hospital Nacional de Niños asocia fallo respiratorio que amerita ventilación mecánica asistida por varios días en diferentes ocasiones, derrame pleural exudativo, convulsiones de origen hipóxico isquémico. Con reporte de hemocultivos positivos por Estreptococos pyogenes. El Estreptococos pyogenes o estreptococo β-hemolνtico del grupo A, fue un problema en los comienzos del siglo pasado, siendo frecuente en las infecciones puerperales y del reciιn nacido. En la actualidad es un germen sumamente raro en los procesos de sepsis neonatal.2 La gravedad de la enfermedad causada por este microorganismo en el periodo neonatal varνa desde una onfalitis crónica de bajo grado a una septicemia, una meningitis fulminante y la muerte.1 El presente artículo pretende hacer un resumen del paciente, con su evolución clínica, radiológica y además ejemplificar todas las complicaciones que tuvimos con este germen tan poco frecuente en la actualidad en sepsis neonatal.

  4. Evaluation of Neonates with Ventriculitis

    Directory of Open Access Journals (Sweden)

    Ferda Ozlu

    2013-08-01

    Full Text Available Backgroud: Neonatal meningitis and ventriculitis still remain a problem with high mortality in spite of systemic and intraventricular antibiotics. Ventriculitis due to repeated taps is a serious problem of posthemorragic hydrocephalus in preterm infants. Methods: In this study, we evaluated 16 infants with ventriculitis followed at Cukurova University Faculty of Medicine Neonatal Intensive Care Unit between January 1999-December 2004. Results: Mean gestational week was 33± 5 (25-40 weeks and mean birth weight was 2096 ± 912 (980-3500 grams. Venticulitis was diagnosed at 38 ± 22 days. Eleven of the infants had intraventricular hemorrhage and 15 had hydrocephalus, 5 of whom had congenital hydrocephalus. Drainage of CSF was performed by taps in 13 infants. Gram negative microorganisms (Klebsiella pneumonia, Pseudomonas aeruginosa were predominating in cultures. Both intravenous and intraventricular antibiotic treatment was performed according to the cerebrospinal fluid cultures. Vancomycine and amicasine as intraventricular therapy were performed for 28 ±17 days. Cerebrospinal fluid protein levels increased significantly at 8 infant during intraventricular therapy. Mean cerebrospinal fluid protein at the begining of intraventricular treatment was 624.1± 429.1 (109-1330 mg/dl while on 14th day of treatment it was 993.7± 582.2 (89-1750 mg/dl. Seven of the infants were ventriculoperitoneal shunted 6 of them were reinfected. Seven of the infants were died during treatment, 1 infant with ventriculoperitoneal shunt was treated and 8 infants were discharged during treatment because of parents’ refusal of therapy. Conclusion: Despite the new treatment regimens, the ventriculitis still remains a problem because of nonstandardized practice in neonatal care. [Cukurova Med J 2013; 38(4.000: 553-558

  5. Optimization of the cutoff value for a commercial anti-dengue virus IgG immunoassay.

    Science.gov (United States)

    Marrero-Santos, Karla M; Beltrán, Manuela; Carrión-Lebrón, Jessica; Sanchez-Vegas, Carolina; Hamer, Davidson H; Barnett, Elizabeth D; Santiago, Luis M; Hunsperger, Elizabeth A

    2013-03-01

    A commercial anti-dengue virus (anti-DENV) indirect IgG enzyme-linked immunosorbent assay (ELISA) for serological diagnosis was evaluated for its utility in determining previous DENV exposure in U.S. travelers. The Boston Area Travel Medicine Network clinics used Focus Diagnostics anti-DENV IgG ELISA to measure anti-DENV IgG antibodies in 591 pretravel specimens from U.S. residents who had traveled to countries where dengue is endemic. When using the manufacturer's index cutoff value for this ELISA, false-positive results were observed that overestimated the perceived past DENV exposure in U.S. travelers. Validation of 121 of these anti-DENV IgG results by plaque reduction neutralization test (PRNT) was used for receiver operating characteristic (ROC) curve optimization of the index cutoff value from 1 to 3.0, improving the specificity of the anti-DENV IgG ELISA from 24% to 95.7%. Additionally, previous vaccination with yellow fever virus contributed to 52.8% of the false-positive rate in the anti-DENV IgG ELISA results. Optimization of the cutoff value of the anti-DENV IgG ELISA provided better interpretation and confidence in the results and eliminated the need for confirmation by PRNT. The travel history of U.S. travelers was also useful for categorizing these travelers into groups for analysis of previous DENV exposure. PMID:23302742

  6. Changes in Healthy Human IgG Fc-Glycosylation after Birth and during Early Childhood.

    Science.gov (United States)

    de Haan, Noortje; Reiding, Karli R; Driessen, Gertjan; van der Burg, Mirjam; Wuhrer, Manfred

    2016-06-01

    Glycosylation on the fragment crystallizable (Fc) region of immunoglobulin G (IgG) has a large influence on the interaction of the antibody with Fc gamma receptors (FcγRs). IgG consists of four subclasses that all have distinct affinities for the different FcγRs. Knowledge about the Fc-glycosylation in healthy human is valuable as reference for new biomarkers and in the design of biopharmaceuticals that rely on IgG Fc-glycosylation. Previously, subclass-specific characterization of IgG Fc-glycosylation was performed for healthy adults, pregnant women, and newborns. For young healthy children, however, the subclass-specific description of IgG Fc-glycosylation is still lacking. Therefore, we performed the IgG subclass-specific analysis of the Fc-glycosylation of 130 healthy humans between birth and 40 years of age, including 22 samples derived from the umbilical cords of newborns. The analysis was performed by a previously published matrix-assisted laser desorption/ionization (MALDI)-time-of-flight (TOF)-mass spectrometry (MS) workflow, including a derivatization step for the linkage-specific stabilization of sialic acids. The characterization revealed that when children start to produce their own IgG they have a decreased galactosylation, sialylation, and bisection and an increased fucosylation compared with newborns. During childhood, the fucosylation and sialylation decrease, whereas bisection increases and galactosylation stays constant. PMID:27161864

  7. Human IgG subclasses against enterovirus Type 71: neutralization versus antibody dependent enhancement of infection.

    Directory of Open Access Journals (Sweden)

    Rui-Yuan Cao

    Full Text Available The emerging human enterovirus 71 (EV71 represents a growing threat to public health, and no vaccine or specific antiviral is currently available. Human intravenous immunoglobulin (IVIG is clinical used in treating severe EV71 infections. However, the discovery of antibody dependent enhancement (ADE of EV71 infection illustrates the complex roles of antibody in controlling EV71 infection. In this study, to identify the distinct role of each IgG subclass on neutralization and enhancement of EV71 infection, different lots of pharmaceutical IVIG preparations manufactured from Chinese donors were used for IgG subclass fractionation by pH gradient elution with the protein A-conjugated affinity column. The neutralization and ADE capacities on EV71 infection of each purified IgG subclass were then assayed, respectively. The neutralizing activity of human IVIG is mainly mediated by IgG1 subclass and to less extent by IgG2 subclass. Interestingly, IgG3 fraction did not have neutralizing activity but enhanced EV71 infection in vitro. These results revealed the different roles of human IgG subclasses on EV71 infection, which is of critical importance for the rational design of immunotherapy and vaccines against severe EV71 diseases.

  8. Aminoglycoside trough levels in neonates

    Directory of Open Access Journals (Sweden)

    Pejović Biljana

    2010-01-01

    Full Text Available Introduction. Drug safety depends on trough levels. Objective. Objective of the study was to measure gentamicin and amikacin trough levels in neonates and to identify risk groups by gestational and postnatal age. Methods. Gentamicin and amikacin were applied according to the clinical practice guidelines. Trough levels (mg/l were deter- mined using fluorescence polarization immunoassay methodology. Target trough levels were <2 mg/l for gentamicin, and <10 mg/l for amikacin. Patients were divided in 3 groups by gestational age: I ≤32, II 33-36, and III ≥37 gestational weeks and, by postnatal age, in 2 groups: ≤7 and >7 days. Results. Out of 163 neonates, 111 were receiving gentamicin and 52 amikacin. Mean amikacin trough level was 7.8±4.8 mg/l and, in group I 10.5±4.9 mg/l, which was above the target range and significantly higher than in group II (LSD, p<0.05. In the amikacin group, 26 patients were 7 and less, and 26 more than 7 days old, without significant differences in trough levels between the groups. In the gentamicin group, 52.3% of neonates had trough values within the target range. Gentamicin trough level in group I was above the trough range, 3.7±1.8, 2.3±1.5 in group II and, 1.8±1.4 mg/l in group III. The difference in trough levels among the groups was highly significant (F=9.015, p<0.001, χ2=17. 576, p<0.001. Further analysis revealed that differences between groups I and II (LSD, p=0.002 and between I and III (LSD, p=0.000 were highly significant. Conclusion. Obtained gentamicin and amikacin trough levels are high. Inverse correlation has been confirmed between trough level and gestational age, with highly significant difference, and the risk group has been identified. There is obviously a need to change the dosing regimen in terms of those with extended intervals, particularly for neonates of the lowest gestational age, along with pharmacokinetic measurements.

  9. Morphine glucuronidation in premature neonates.

    OpenAIRE

    Hartley, R.; Quinn, M; Green, M; Levene, M I

    1993-01-01

    The glucuronidation of morphine was investigated in 10 premature neonates (postnatal age < 24 h at initiation of treatment) following 24 h of therapy (2 h loading infusion, followed by a constant rate infusion). Morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) were measured in plasma obtained at 24 h in all babies. Plasma concentrations of M3G and M6G correlated significantly with morphine concentration (P < 0.01 in both cases), and with each other (P < 0.001), suggesti...

  10. A Rapid Method to Characterize Mouse IgG Antibodies and Isolate Native Antigen Binding IgG B Cell Hybridomas.

    Directory of Open Access Journals (Sweden)

    Haolin Liu

    Full Text Available B cell hybridomas are an important source of monoclonal antibodies. In this paper, we developed a high-throughput method to characterize mouse IgG antibodies using surface plasmon resonance technology. This assay rapidly determines their sub-isotypes, whether they bind native antigen and their approximate affinities for the antigen using only 50 μl of hybridoma cell culture supernatant. Moreover, we found that mouse hybridomas secreting IgG antibodies also have membrane form IgG expression without Igα. Based on this surface IgG, we used flow cytometry to isolate rare γ2a isotype switched variants from a γ2b antibody secreting hybridoma cell line. Also, we used fluorescent antigen to single cell sort antigen binding hybridoma cells from bulk mixture of fused hybridoma cells instead of the traditional multi-microwell plate screening and limiting dilution sub-cloning thus saving time and labor. The IgG monoclonal antibodies specific for the native antigen identified with these methods are suitable for in vivo therapeutic uses, but also for sandwich ELISA assays, histology, flow cytometry, immune precipitation and x-ray crystallography.

  11. Imaging approach to persistent neonatal jaundice

    International Nuclear Information System (INIS)

    Fifteen patients with persistent neonatal jaundice were evaluated by sonography and radionuclide scintigraphy. The sonographic features of both neonatal hepatitis and biliary atresia are nonspecific. Hepatobiliary scintigraphy after phenobarbital pretreatment in patients with neonatal hepatitis demonstrates normal hepatic extraction and delayed tracer excretion into the gastrointestinal tract. If there is neonatal hepatitis with severe hepatocellular damage, the hepatic extraction of tracer activity is decreased and excretion may be delayed or absent. Patients under 3 months of age with biliary atresia have normal hepatic extraction of tracer with no excretion into the gastrointestinal tract. Sonography in patients with a choledochal cyst shows a cystic mass in the porta hepatis with associated bile-duct dilatation. Hepatobiliary scintigraphy confirms that the choledochal cyst communicates with the biliary system. Initial sonography demonstrates hepatobiliary anatomy; subsequent phenobarbital-enhanced radionuclide scintigraphy determines hepatobiliary function. An expedient diagnostic approach is recommended for the evaluation of persistent neonatal jaundice

  12. Sepsis neonatal por Estreptococos Pyogenes Neonatal Sepsis by Streptococcus pyogenes

    Directory of Open Access Journals (Sweden)

    Gilberto Rodríguez-Herrera

    2009-09-01

    Full Text Available Se presenta el caso de un paciente masculino, recién nacido a término adecuado para la edad gestacional, quien nace por parto vaginal, con el antecedente de fiebre en la madre durante el periodo de postparto inmediato. Los padres consultan a los 2 días de vida pues le notan dificultad respiratoria, hipoactividad y rechazo a la leche materna. El paciente se interna y se aborda como una sepsis. Durante su estancia en el servicio de neonatología del Hospital Nacional de Niños asocia fallo respiratorio que amerita ventilación mecánica asistida por varios días en diferentes ocasiones, derrame pleural exudativo, convulsiones de origen hipóxico isquémico. Con reporte de hemocultivos positivos por Estreptococos pyogenes. El Estreptococos pyogenes o estreptococo β-hemolνtico del grupo A, fue un problema en los comienzos del siglo pasado, siendo frecuente en las infecciones puerperales y del reciιn nacido. En la actualidad es un germen sumamente raro en los procesos de sepsis neonatal.2 La gravedad de la enfermedad causada por este microorganismo en el periodo neonatal varνa desde una onfalitis crónica de bajo grado a una septicemia, una meningitis fulminante y la muerte.1 El presente artículo pretende hacer un resumen del paciente, con su evolución clínica, radiológica y además ejemplificar todas las complicaciones que tuvimos con este germen tan poco frecuente en la actualidad en sepsis neonatal.We present herein the case of a newborn patient of appropriate gestational age weight ( 3700 grams, born by vaginal delivery, from a mother that had had 2 previous pregnancies (2 normal deliveries. During the immediate puerperium she had fever. The parents consulted at the age of 2 days, stating that they had noticed difficult breathing since his birth, hipoactivity and poor appetite. He was admitted to the hospital and underwent several studies searching for the origin and germ causing the sepsis. He developed respiratory failure and needed

  13. Distribution of Cytomegalovirus Genotypes among Neonates Born to Infected Mothers in Islamabad, Pakistan

    Science.gov (United States)

    Mujtaba, Ghulam; Khurshid, Adnan; Sharif, Salmaan; Alam, Muhammad Masroor; Aamir, Uzma Bashir; Shaukat, Shahzad; Angez, Mehar; Rana, Muhammad Suleman; Umair, Massab; Shah, Aamer Ali; Zaidi, Syed Sohail Zahoor

    2016-01-01

    Background Congenital cytomegalovirus (cCMV) infection contributes to considerable long-term sequelae in neonates and children all over the world. The association between viral genotypes and severity of clinical cytomegalovirus (CMV) infection is yet to be defined. The objective of this study was to find the impact of active CMV infection during pregnancy and the clinical significance of genotypes in neonates with congenital cytomegalovirus infections in Pakistan. Methods A total of 409 blood samples from pregnant women seeking health care services at the two antenatal hospitals of Islamabad during January to December 2012 were tested by ELISA and nested-PCR. Pregnant women with active infection (detected as IgM positive, PCR positive or positive on both assays) were followed until delivery, to detect the outcome of overt cCMV infection in neonates. Genetic characterization of CMV strains was performed by sequence analysis of envelope glycoproteins: gB, gN and gH to detect the contributing CMV genotypes. Results The seroprevalence of anti-CMV IgG and IgM was 97.5% (399 out of 409) and 12.7% (52 out of 409), respectively, while 20% (82/409) pregnant women were found positive for CMV DNA by PCR. Logistic regression analysis showed a significant association of active infection with parity [OR = 2.56, 95% CI = 1.82–2.62, p = 0.04], febrile illness [OR = 1.84, 95% CI = 1.76–3.65, p = 0.01] and jaundice [OR = 22.5, 95% CI = 4.53–85.02, p = 0.002]. We were able to isolate virus in 41 out of 70 neonates; 36.6% (15 out of 41) of them were symptomatic at birth while 63.4% (26 out of 41) were asymptomatic. The most prominent clinical feature observed in symptomatic neonates was hepatosplenomegaly (26.6%; 4 out of 15). All three genotypes gB, gN and gH were found with the highest frequency of gB1 genotype, found in 75% infants with hepatic damage. Phylogenetic analysis of Pakistani strains showed 96%-100% homology to their prototype strains. Conclusions Active CMV

  14. IgG4-related tubulointerstitial nephritis associated with only lymphadenopathy and without elevated serum IgG4 or renal imaging abnormalities: a case report and literature review.

    Science.gov (United States)

    Qiao, Xi; Wang, Lihua; Wang, Chen; Gao, Lifang; Yao, Shulei; Wu, Liran; Zhang, Xiaoqin

    2015-01-01

    IgG4-related tubulointerstitial nephritis (IgG4-TIN) is the most common renal manifestation of IgG4-related kidney disease (IgG4-RKD) and may cause acute or chronic renal dysfunction. Imaging often shows heterogeneous densities in the kidneys, such as a mass or multiple nodules. Serology usually demonstrates high levels of serum IgG4 and total IgG. Most patients have other organs involvement by IgG4 related disease. Although lymphadenopathy is frequently observed in patients with IgG4-TIN, it is rarely presented as the only extrarenal lesion. Herein, we present a rare case of IgG4-TIN associated with only lymphadenopathy and without elevated serum IgG4 or renal imaging abnormalities. A 61-year-old Chinese man was admitted to our hospital with seven months history of generalized lymphadenopathy and five months history of renal dysfunction. His renal imaging was normal. He had no current or previous clinical, radiographic, and/or histologic evidence of other organ involvement except for the lymphadenopathy. Renal biopsy indicated plasma cell-rich TIN with an increased number of IgG4-positive plasma cells and storiform fibrosis. Repeated lymph nodes biopsy revealed IgG4-related lymphadenopathy. However, he did not have elevated serum IgG4 or total IgG levels. Oral prednisone therapy improved his renal function and lymphadenopathy. These findings supported our final diagnosis of IgG4-TIN. Clinicians should be aware of this condition and steroid therapy should be considered for such patients. An early diagnosis and appropriate therapy can induce remission and preserve renal function. PMID:26770608

  15. Prevalence of IgG4-Related Disease in Japan Based on Nationwide Survey in 2009

    OpenAIRE

    Kazushige Uchida; Atsushi Masamune; Tooru Shimosegawa; Kazuichi Okazaki

    2012-01-01

    The number of patients with autoimmune pancreatitis who visited hospitals in Japan in 2007 was approximately 2709 (95% confidence interval; range 2540–3040). Because IgG4-related disease is a new clinical entity, there are no data with regard to its prevalence. To estimate the number of patients with IgG4-related disease in Japan, we randomly selected hospitals using stratification and asked them how many patients they had with IgG4-related disease in 2009. The number of patients with Mikulic...

  16. Intracranial spread of IgG4-related disease via skull base foramina.

    Science.gov (United States)

    Rice, C M; Spencer, T; Bunea, G; Scolding, N J; Sloan, P; Nath, U

    2016-06-01

    IgG4-related disease (IgG4-RD) is a newly recognised, multiorgan, inflammatory disease, and its full clinical spectrum remains undefined. We present a biopsy-proven case of IgG4-RD presenting with a parapharyngeal mass with intracranial extension and possible involvement of the brain parenchyma. We highlight the importance of considering the diagnosis in those presenting with tumefactive lesions, leptomeningitis or pachymeningitis and emphasise the value of securing a tissue diagnosis so that appropriate long-term treatment can be instigated and complications avoided. PMID:26856357

  17. IgG4 subclass antibodies impair antitumor immunity in melanoma

    OpenAIRE

    Karagiannis, Panagiotis; Gilbert, Amy E.; Josephs, Debra H; Ali, Niwa; Dodev, Tihomir; Saul, Louise; Correa, Isabel; Roberts, Luke; Beddowes, Emma; Koers, Alexander; Hobbs, Carl; Ferreira, Silvia; Geh, Jenny L.C.; Healy, Ciaran; Harries, Mark

    2013-01-01

    Host-induced antibodies and their contributions to cancer inflammation are largely unexplored. IgG4 subclass antibodies are present in IL-10–driven Th2 immune responses in some inflammatory conditions. Since Th2-biased inflammation is a hallmark of tumor microenvironments, we investigated the presence and functional implications of IgG4 in malignant melanoma. Consistent with Th2 inflammation, CD22+ B cells and IgG4+-infiltrating cells accumulated in tumors, and IL-10, IL-4, and tumor-reactive...

  18. IgG4- related disease: an orphan disease with many faces

    OpenAIRE

    Pieringer, Herwig; Parzer, Ilse; Wöhrer, Adelheid; Reis, Petra; Oppl, Bastian; Zwerina, Jochen

    2014-01-01

    Immunoglobulin G4- related disease (IgG4-RD) is a rare systemic fibro-inflammatory disorder (ORPHA284264). Although patients have been described more than 100 years ago, the systemic nature of this disease has been recognized in the 21st century only. Type 1 autoimmune pancreatitis is the most frequent manifestation of IgG4-RD. However, IgG4-RD can affect any organ such as salivary glands, orbits, retroperitoneum and many others. Recent research enabled a clear clinical and histopathological ...

  19. Severe IgG4-Related Disease in a Young Child: A Diagnosis Challenge

    OpenAIRE

    Susana Corujeira; Catarina Ferraz; Teresa Nunes; Elsa Fonseca; Luísa Guedes Vaz

    2015-01-01

    Immunoglobulin G4-related disease (IgG4-RD) is an increasingly recognized syndrome that can appear with multiple organ involvement, typically with tumor-like swelling, lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, and elevated serum IgG4 concentrations. We report the case of a 22-month-old female child with failure to thrive and recurrent respiratory tract infections since 8 months of age. Physical examination was normal except for pulmonary auscultation with bilateral crac...

  20. Immunoglobulin G4-related disease with scant tissue IgG4

    OpenAIRE

    Makiishi, Tetsuya; Shirase, Tomoyuki; Hieda, Nobuhiro; Maeda, Sayako

    2013-01-01

    A 56-year-old man was admitted to our hospital for renal dysfunction and symmetrical swelling of submandibular glands. Laboratory and imaging findings were consistent with immunoglobulin G4-related disease (IgG4RD). Histological findings of the submandibular gland and the kidney were also consistent with IgG4RD. However, the patient did not have elevated serum or tissue IgG4 levels. Oral prednisolone therapy, initially 50 mg/day and gradually tapered over 12 months, improved his laboratory ab...

  1. Optimization of the Cutoff Value for a Commercial Anti-Dengue Virus IgG Immunoassay

    OpenAIRE

    Marrero-Santos, Karla M.; Beltrán, Manuela; Carrión-Lebrón, Jessica; Sanchez-Vegas, Carolina; Hamer, Davidson H; Barnett, Elizabeth D.; Luis M Santiago; Hunsperger, Elizabeth A.

    2013-01-01

    A commercial anti-dengue virus (anti-DENV) indirect IgG enzyme-linked immunosorbent assay (ELISA) for serological diagnosis was evaluated for its utility in determining previous DENV exposure in U.S. travelers. The Boston Area Travel Medicine Network clinics used Focus Diagnostics anti-DENV IgG ELISA to measure anti-DENV IgG antibodies in 591 pretravel specimens from U.S. residents who had traveled to countries where dengue is endemic. When using the manufacturer's index cutoff value for this...

  2. IgG4-related lung disease manifested as pneumonia in puerperium: a case report

    OpenAIRE

    Wang, Jinlin; Zeng, Yunxiang; Gu, Yingying; Li, Shiyue

    2015-01-01

    IgG4-related lung disease (IgG4-RLD) is recently emerging entity. Several reports concerned with the clinicopathologic feature have been described, but this disease in puerperium has not been reported previously. Here, we report a 24-year-old woman diagnosed as IgG4-RLD in puerperium, who developed dry cough, low fever and exertional dyspnea following the delivery. The inflammatory markers and pulmonary lesions of the patient suggested pneumonia. However, there was no improvement after antibi...

  3. Serum immunoglobulins, IgG subclasses, isohemagglutinins and complement-3 levels in patients with thalassemia major.

    Science.gov (United States)

    Vergin, C; Kutukculer, N; Cetingul, N; Nisli, G; Caglayan, S; Oztop, S

    1997-01-01

    Serum IgG, IgM, IgA, IgG subclasses (IgG1, G2, G3, G4), isohemagglutinins and complement-3 concentrations were measured in 23 beta-thalassemic patients suffering from recurrent infections. No significant abnormalities were found in these humoral immunity investigations, both in splenectomized and non-splenectomized patients. On the other hand, iron overload or repeated blood transfusions were not found to down-regulate the humoral immune system of thalassemic patients. PMID:10771839

  4. The Neonate with Abdominal Mass

    Directory of Open Access Journals (Sweden)

    M. Bajoghli

    2008-01-01

    Full Text Available Neonatal abdominal masses have broad spectrum of pathology, ranging from small lesions found incidentally to large masses occupying the entire of peritoneal cavity. These tumors are benign to malignant, and from unilocular cysts to complex solid lesions. Many of these lesions identified and will treat before delivery. Others are discovered during routine examination. These lesions may be life threatening, or cause persistent morbidity. Some of these have no sequel."nDiagnosis began with history. Characteristic of the mass which must be note include location, size, shape, texture, mobility and tenderness. Other findings should be in mind to find out nature of mass, for example hypoplasia of chest wall with oligohydramnios due to GU tract obstruction (potter sequwnce, a bulging hymen due to hydrometrocolpus, skin metastasis due to neuroblastoma. Radiography is the next step that shows organomegaly and calcification. Next step is US which is an excellent screening tool. CT and MRI are occasionally indicated."nThe purpose of this presentation is to review the diagnosis of abdominal masses in neonates.

  5. Neonatal intracranial hemorrhages (perinatal onset)

    International Nuclear Information System (INIS)

    1. We have reviewed 34 cases of neonatal intracranial hemorrhages (perinatal onset, 23 mature and 11 premature infants) experienced in 10-year period from 1971 to 1980, with special reference to gestational age, birth weight, type of delivery, presence or absence of asphyxia, symptoms and cause of death. 2. Regarding 9 autopsied cases and 7 cases diagnosed by CT-scan, 10 mature infants composed of 3 subarachnoid hemorrhages, 2 intraventricular hemorrhages, 2 subdural hematomas, 2 intracerebral and 1 subependymal hemorrhage; 6 premature infants consisted of 4 subependymal hemorrhages with ventricular rupture and 2 subarachnoid hemorrhages. Most of them presented with respiratory distress, vomiting and convulsive seizures which developed within 5 days after birth. 3. Poor outcome including death amounted 49% of mature and 63% of premature infants. Along with degree of intracranial hematoma, prematurity and pulmonary complication were felt to be important prognostic factors. 4. Introduction of CT-scan led to prompt diagnosis and treatment, thus lowering mortality rate of neonatal intracranial hemorrhages. (author)

  6. Patient dose in neonatal units

    International Nuclear Information System (INIS)

    Lung disease represents one of the most life-threatening conditions in prematurely born children. In the evaluation of the neonatal chest, the primary and most important diagnostic study is therefore the chest radiograph. Since prematurely born children are very sensitive to radiation, those radiographs may lead to a significant radiation detriment. Hence, knowledge of the patient dose is necessary to justify the exposures. A study to assess the patient doses was started at the neonatal intensive care unit (NICU) of the Univ. Hospital in Leuven. Between September 2004 and September 2005, prematurely born babies underwent on average 10 X-ray examinations in the NICU. In this sample, the maximum was 78 X-ray examinations. For chest radiographs, the median entrance skin dose was 34 μGy and the median dose area product was 7.1 mGy.cm2. By means of conversion coefficients, the measured values were converted to organ doses. Organ doses were calculated for three different weight classes: extremely low birth weight infants (2500 g). The doses to the lungs for a single chest radiograph for infants with extremely low birth weights, low birth weights and normal birth weights were 24, 25 and 32 μGy, respectively. (authors)

  7. Palivizumab use in preterm neonates.

    LENUS (Irish Health Repository)

    Kingston, S

    2012-01-31

    Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis in infants. Palivizumab is an immunoprophylactic agent for RSV prevention in preterm infants and those with neonatal chronic lung disease. This study examines its use across neonatal units in Ireland. A questionnaire was administered to one Consultant Neonatologist or Paediatrician in each of the 20 maternity centres in Ireland about their guidelines for Palivizumab administration. There is variation in administration of Palivizumab with little consistency found between protocols reported in terms of age and presence of chronic lung disease. Ten centres have in house protocols, 3 centres use the American Academy of Paediatrics (AAP) guidelines, 2 centres prefer the UK Joint Committee on Vaccination and Immunisation (JCVI) guidelines and 3 centres do not have a set protocol. Four participants felt its use has impacted on hospital admissions and 61% believe its use is cost effective. The budgetary implication for immunoprophylaxis with Palivizumab in Ireland is estimated at 1.5 to 2 million euros annually. Given current pharmacoeconomic constraints there is a need to implement a national protocol on RSV immunoprophylaxis.

  8. Palivizumab use in preterm neonates.

    LENUS (Irish Health Repository)

    Kingston, S

    2010-05-01

    Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis in infants. Palivizumab is an immunoprophylactic agent for RSV prevention in preterm infants and those with neonatal chronic lung disease. This study examines its use across neonatal units in Ireland. A questionnaire was administered to one Consultant Neonatologist or Paediatrician in each of the 20 maternity centres in Ireland about their guidelines for Palivizumab administration. There is variation in administration of Palivizumab with little consistency found between protocols reported in terms of age and presence of chronic lung disease. Ten centres have in house protocols, 3 centres use the American Academy of Paediatrics (AAP) guidelines, 2 centres prefer the UK Joint Committee on Vaccination and Immunisation (JCVI) guidelines and 3 centres do not have a set protocol. Four participants felt its use has impacted on hospital admissions and 61% believe its use is cost effective. The budgetary implication for immunoprophylaxis with Palivizumab in Ireland is estimated at 1.5 to 2 million euros annually. Given current pharmacoeconomic constraints there is a need to implement a national protocol on RSV immunoprophylaxis.

  9. Knowledge, attitudes and practices of neonatal staff concerning neonatal pain management

    Directory of Open Access Journals (Sweden)

    Sizakele L.T. Khoza

    2014-10-01

    Full Text Available Background: Neonatal pain management has received increasing attention over the past four decades. Research into the effects of neonatal pain emphasises the professional, ethical and moral obligations of staff to manage pain for positive patient outcomes. However, evaluation studies continuously report evidence of inadequate neonate pain management and a gap between theory and practice.Objective: This study reviewed current practice in neonatal pain management to describe the knowledge, attitudes and practices of nurses and doctors regarding pain management for neonates in two academic hospitals.Method: A non-experimental, prospective quantitative survey, the modified Infant Pain Questionnaire, was used to collect data from 150 nurses and doctors working in the neonatal wards of two academic hospitals in central Gauteng.Results: The response rate was 35.33% (n = 53, most respondents being professional nurses (88.68%; n = 47 working in neonatal intensive care units (80.77%; n = 42; 24 (45.28% had less than 5 years’ and 29 respondents 6 or more years’ working experience in neonatal care. A review of pain management in the study setting indicated a preference for pharmacological interventions to relieve moderate to severe pain. An association (p < 0.05 was found between pain ratings on 5 procedures and frequency of administration of pharmacological pain management. Two-thirds of respondents (64% reported that there were no pain management guidelines in the neonatal wards in which they worked.Conclusion: The interventions to manage moderate neonatal pain are in line with international guidelines. However, neonatal pain management may not occur systematically based on prior assessment of neonatal pain, choice of most appropriate intervention and evaluation. This study recommends implementation of a guideline to standardise practice and ensure consistent and adequate pain management in neonates

  10. Síndrome do lúpus neonatal Neonatal lupus syndrome

    Directory of Open Access Journals (Sweden)

    Jozélio Freire de Carvalho

    2005-06-01

    Full Text Available A síndrome do lúpus neonatal (SLN é uma doença auto-imune associada à presença de auto-anticorpos na circulação materno-fetal contra complexos ribonucléicos, SSA/Ro e SSB/La, e se caracteriza principalmente por bloqueio cardíaco congênito isolado (BCCI e/ou manifestações cutâneas e hematológicas. A despeito da sua raridade, a SLN é a principal causa de BCCI, sendo responsável pela importante mortalidade (20% a 30% e morbidade desses pacientes. A denominação de lúpus neonatal se baseia na semelhança das lesões cutâneas associadas à SLN nos neonatos com aquelas observadas em pacientes com lúpus eritematoso sistêmico (SLE. Por outro lado, o termo "isolado", para designar o BCC na SLN, é utilizado para especificar a ausência de malformações cardíacas congênitas e a ausência de infecções que causam alterações na condução átrio-ventricular (BAV. A SLN constitui-se num clássico modelo de auto-imunidade adquirida, no qual os anticorpos IgG maternos atravessam a barreira placentária e na circulação fetal podem exercer um papel importante na patogênese da síndrome. A presença quase universal dos anticorpos anti-Ro/SSA e anti-SSB/La no soro materno e fetal os inclui como marcadores para a SLN. Ao contrário da lesão cardíaca que compromete irreversivelmente a condução átrio-ventricular, os acometimentos cutâneos e/ou hematológicos são transitórios e podem regredir após o desaparecimento dos anticorpos maternos da circulação do lactente. Clinicamente, a SLN representa um desafio para profissionais reumatologistas, obstetras, neonatalogistas, dermatologistas e cardiologistas pediátricos que têm como meta identificar o risco gestacional de desenvolvimento da doença fetal, diagnosticar a síndrome precocemente e definir uma estratégia terapêutica adequada quando "in utero" ou pós-natal.Neonatal Lupus Syndrome (NLS is an autoimmune disease associated to the presence of autoantibodies against

  11. Current concept and diagnosis of IgG4-related disease in the hepato-bilio-pancreatic system

    OpenAIRE

    Okazaki, Kazuichi; Uchida, Kazushige; Ikeura, Tsukasa; Takaoka, Makoto

    2013-01-01

    Recently, IgG4-related disease (IgG4-RD) has been recognized as a novel clinical entity with multiorgan involvement and unknown origin, associated with abundant infiltration of IgG4-positive cells. The Japanese research committee, supported by the Ministry of Health, Labor and Welfare of Japan, unified many synonyms for these conditions to the term “IgG4-RD” in 2009. The international symposium on IgG4-RD endorsed the comprehensive nomenclature as IgG4-RD, and proposed the individual nomencla...

  12. Laser Photoradiation Therapy For Neonatal Jaundice

    Science.gov (United States)

    Hamza, Mostafa; Hamza, Mohammad

    1987-04-01

    This paper describes our leading experience in the clinical application of laser in the treatment of neonatal jaundice. Currently, the irradiation of jaundiced infants during neonatal life to fluorescent light is the most common treatment of neonatal hyperbilirubinemia. The authors have investigated the photodegradation of bilirubin by laser in vitro and in Gunn rats before embarking on its clinical application in the treatment of jaundice in the new born child. This work was done to study the theraputic effect of laser compared to the currently used phototherapy in the treatment of neonatal jaundice. We selected 16 full term neonates with jaundice to be the subject of this study. The neonates of the study were devided into two groups. The first group was treated with continuous phototherapy . The second group recieved photoradiation therapy with gas laser The laser used was a CW argon-ion laser tuned to oscillate at 488.0 nm wavelength. This wavelength selection was based on our previous studies on the effect of laser irradiation of Gunn rats at different wavelengths. Comparison of the results of both methods of treatment will be reported in detail. The advantages and limitations of laser photoradiation therapy for neonatal jaundice will be discussed.

  13. Perivascular fibrosis and IgG4-related disease: a case report

    Directory of Open Access Journals (Sweden)

    S. Monti

    2014-11-01

    Full Text Available Immunoglobulin G4-related disease (IgG4-RD is a newly recognized fibroinflammatory condition which can potentially involve any organ. Some characteristic histopathologic features with lymphoplasmacytic infiltrate, an increased number of IgG4+ cells, storiform fibrosis and obliterative phlebitis are the mainstay for diagnosis. Serum IgG4 levels often increase. We report the case of a patient with perivascular fibrotic lesions involving the aortic arch and the splenic hilum, with a surgical biopsy-proven diagnosis of IgG4-related disease. The patient is now undergoing a low-dose corticosteroid maintenance therapy without evidence of new localizations of the disease. This case highlights the need for increasing awareness and recognition of this new, emerging clinical condition.

  14. IgG4-related disease: a systemic condition with characteristic microscopic features

    DEFF Research Database (Denmark)

    Detlefsen, Sönke

    2013-01-01

    observation that many patients suffering from autoimmune pancreatitis (AIP), a specific type of chronic pancreatitis, had elevated serum levels of IgG4, it was reported that these patients also had increased numbers of IgG4-positive cells in the inflamed pancreatic tissue. In 2003, it was noted that a...... diseases on their own, others have been included under the umbrella of "multifocal fibrosclerosis". Biopsies or resection specimens from affected organs in IgG4-RD reveal several common microscopic features irrespective of the site of the lesion. Cellular and storiform fibrosis, lymphoplasmacytic...... microscopic features, diagnosis and differential diagnosis of the different organ manifestations of IgG4-RD, and the current concepts of its pathogenesis will also be addressed....

  15. Diagnostic value of CagA IgG in the process to eradicate Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Zhi Bang Yang; Pi Long Wang; Ming Ming Gu; Li Hao Chen; Quan Chen; Lin Zhan

    2000-01-01

    AIM To investigate the diagnostic value of CagA IgG in serum.METHODS Seventy three patients with peptic ulcer infected with HP were eradicated by antibioticstherapy. At pretreatment, wk9 and wk20 after treatment, the detection of Hp in gastric muscosa bybacteriologic method were performed, and CagA and whole-cell antigen of HP igG in serum by ELISAmethod were also performed at the same time.RESULTS The IgG titres of Hp CagA and whole-cell antigen changes in accordance with the efficacy ofHp eradicated. The former with an earlier appearance and a greater number of cases decreased to normallevel in comparison with the latter.CONCLUSION CagA IgG is a better index for observing the effectiveness of the eradication of Hp.

  16. Materno-Fetal Transfer of Preproinsulin Through the Neonatal Fc Receptor Prevents Autoimmune Diabetes.

    Science.gov (United States)

    Culina, Slobodan; Gupta, Nimesh; Boisgard, Raphael; Afonso, Georgia; Gagnerault, Marie-Claude; Dimitrov, Jordan; Østerbye, Thomas; Justesen, Sune; Luce, Sandrine; Attias, Mikhaël; Kyewski, Bruno; Buus, Søren; Wong, F Susan; Lacroix-Desmazes, Sebastien; Mallone, Roberto

    2015-10-01

    The first signs of autoimmune activation leading to β-cell destruction in type 1 diabetes (T1D) appear during the first months of life. Thus, the perinatal period offers a suitable time window for disease prevention. Moreover, thymic selection of autoreactive T cells is most active during this period, providing a therapeutic opportunity not exploited to date. We therefore devised a strategy by which the T1D-triggering antigen preproinsulin fused with the immunoglobulin (Ig)G Fc fragment (PPI-Fc) is delivered to fetuses through the neonatal Fc receptor (FcRn) pathway, which physiologically transfers maternal IgGs through the placenta. PPI-Fc administered to pregnant PPIB15-23 T-cell receptor-transgenic mice efficiently accumulated in fetuses through the placental FcRn and protected them from subsequent diabetes development. Protection relied on ferrying of PPI-Fc to the thymus by migratory dendritic cells and resulted in a rise in thymic-derived CD4(+) regulatory T cells expressing transforming growth factor-β and in increased effector CD8(+) T cells displaying impaired cytotoxicity. Moreover, polyclonal splenocytes from nonobese diabetic (NOD) mice transplacentally treated with PPI-Fc were less diabetogenic upon transfer into NOD.scid recipients. Transplacental antigen vaccination provides a novel strategy for early T1D prevention and, further, is applicable to other immune-mediated conditions. PMID:25918233

  17. MuSK induced experimental autoimmune myasthenia gravis does not require IgG1 antibody to MuSK.

    Science.gov (United States)

    Küçükerden, Melike; Huda, Ruksana; Tüzün, Erdem; Yılmaz, Abdullah; Skriapa, Lamprini; Trakas, Nikos; Strait, Richard T; Finkelman, Fred D; Kabadayı, Sevil; Zisimopoulou, Paraskevi; Tzartos, Socrates; Christadoss, Premkumar

    2016-06-15

    Sera of myasthenia gravis (MG) patients with muscle-specific receptor kinase-antibody (MuSK-Ab) predominantly display the non-complement fixing IgG4 isotype. Similarly, mouse IgG1, which is the analog of human IgG4, is the predominant isotype in mice with experimental autoimmune myasthenia gravis (EAMG) induced by MuSK immunization. The present study was performed to determine whether IgG1 anti-MuSK antibody is required for immunized mice to develop EAMG. Results demonstrated a significant correlation between clinical severity of EAMG and levels of MuSK-binding IgG1+, IgG2+ and IgG3+ peripheral blood B cells in MuSK-immunized wild-type (WT) mice. Moreover, MuSK-immunized IgG1 knockout (KO) and WT mice showed similar EAMG severity, serum MuSK-Ab levels, muscle acetylcholine receptor concentrations, neuromuscular junction immunoglobulin and complement deposit ratios. IgG1 and IgG3 were the predominant anti-MuSK isotypes in WT and IgG1 KO mice, respectively. These observations demonstrate that non-IgG1 isotypes can mediate MuSK-EAMG pathogenesis. PMID:27235354

  18. IgG4 deposits in pure and combined membranous lupus nephritis.

    Science.gov (United States)

    Herrera van Oostdam, David; Martínez Martínez, Marco U; Oros-Ovalle, Cuauhtémoc; Martínez-Gala, David; Jaimes Piñón, Gerardo T; Abud Mendoza, Carlos

    2016-06-01

    The aim of this study is to determine the frequency and prognosis of IgG4 deposits in renal biopsy of patients with membranous lupus nephritis (MLN). This is a retrospective cohort study in which we included patients with class V alone or combined (III/V or IV/V) of lupus nephritis according to the 2004 ISN/RPS. All the patients included must have availability of renal tissue for immunohistochemistry analyses. We excluded other classes of lupus nephritis. The renal tissue was examined by a nephro-pathologist. We included 65 patients with MLN; of these, 24 (37 %) were class V, and the other had proliferative concomitant with membranous patterns. Seven renal specimens had IgG4 deposits (10 %). Patients with IgG4 deposits had higher levels of eosinophils in serum. All of the patients with IgG4 had renal involvement as first manifestations of systemic lupus erythematosus. The rate of renal failure was 42 and 43 % in IgG4 positive and negative, respectively, 28 % of IgG4 required renal replacement therapy. From a histological view, 42 % of IgG4 had evidence of arteriolar vasculitis in renal biopsies. Lupus patients with IgG4 deposits were more likely to have renal involvement as a first manifestation of systemic lupus erythematosus, and they course with a worse prognosis since they required more dialysis. Also, they have more probability of vascular inflammation on the renal biopsy. PMID:27139512

  19. Acute Interstitial Nephritis and Membranous Nephropathy in the Context of IgG4-Related Disease

    OpenAIRE

    Stylianou, Kostas; Maragkaki, Eleftheria; Tzanakakis, Michael; Stratakis, Stavros; Gakiopoulou, Hariklia; Daphnis, Eugene

    2014-01-01

    We present the case of a patient with IgG4-related disease, which manifested in an asynchronous manner as vitiligo, cholecystitis, sialadenitis, lymphadenopathy, facial palsy and kidney dysfunction. The patient underwent a renal biopsy, and a presumptive diagnosis of lupus nephritis was made due to compatible clinical and immunological findings. The biopsy revealed IgG4-related kidney disease with severe interstitial nephritis and membranous nephropathy. Corticosteroids treatment restored all...

  20. Clinical utility of testing AQP4-IgG in CSF

    Science.gov (United States)

    Majed, Masoud; Fryer, James P.; McKeon, Andrew; Lennon, Vanda A.

    2016-01-01

    Objective: To define, using assays of optimized sensitivity and specificity, the most informative specimen type for aquaporin-4 immunoglobulin G (AQP4-IgG) detection. Methods: Results were reviewed from longitudinal service testing for AQP4-IgG among specimens submitted to the Mayo Clinic Neuroimmunology Laboratory from 101,065 individual patients. Paired samples of serum/CSF were tested from 616 patients, using M1-AQP4-transfected cell-based assays (both fixed AQP4-CBA Euroimmun kit [commercial CBA] and live in-house flow cytometry [FACS]). Sensitivities were compared for 58 time-matched paired specimens (drawn ≤30 days apart) from patients with neuromyelitis optica (NMO) or high-risk patients. Results: The frequency of CSF submission as sole initial specimen was 1 in 50 in 2007 and 1 in 5 in 2015. In no case among 616 paired specimens was CSF positive and serum negative. In 58 time-matched paired specimens, AQP4-IgG was detected by FACS or by commercial CBA more sensitively in serum than in CSF (respectively, p = 0.06 and p 1:100 predicted CSF positivity (p < 0.001). The probability of CSF positivity was greater around attack time (p = 0.03). No control specimen from 128 neurologic patients was positive by either assay. Conclusions: FACS and commercial CBA detection of AQP4-IgG is less sensitive in CSF than in serum. The data suggest that most AQP4-IgG is produced in peripheral lymphoid tissues and that a critical serum/CSF gradient is required for IgG to penetrate the CNS in pathogenic quantity. Serum is the optimal and most cost-effective specimen for AQP4-IgG testing. Classification of evidence: This study provides Class IV evidence that for patients with NMO or NMOSD, CSF is less sensitive than serum for detection of AQP4-IgG. PMID:27144221

  1. Increased in vivo effector function of human IgG4 isotype antibodies through afucosylation.

    Science.gov (United States)

    Gong, Qian; Hazen, Meredith; Marshall, Brett; Crowell, Susan R; Ou, Qinglin; Wong, Athena W; Phung, Wilson; Vernes, Jean-Michel; Meng, Y Gloria; Tejada, Max; Andersen, Dana; Kelley, Robert F

    2016-01-01

    For some antibodies intended for use as human therapeutics, reduced effector function is desired to avoid toxicities that might be associated with depletion of target cells. Since effector function(s), including antibody-dependent cell-mediated cytotoxicity (ADCC), require the Fc portion to be glycosylated, reduced ADCC activity antibodies can be obtained through aglycosylation of the human IgG1 isotype. An alternative is to switch to an IgG4 isotype in which the glycosylated antibody is known to have reduced effector function relative to glycosylated IgG1 antibody. ADCC activity of glycosylated IgG1 antibodies is sensitive to the fucosylation status of the Fc glycan, with both in vitro and in vivo ADCC activity increased upon fucose removal ("afucosylation"). The effect of afucosylation on activity of IgG4 antibodies is less well characterized, but it has been shown to increase the in vitro ADCC activity of an anti-CD20 antibody. Here, we show that both in vitro and in vivo activity of anti-CD20 IgG4 isotype antibodies is increased via afucosylation. Using blends of material made in Chinese hamster ovary (CHO) and Fut8KO-CHO cells, we show that ADCC activity of an IgG4 version of an anti-human CD20 antibody is directly proportional to the fucose content. In mice transgenic for human FcγRIIIa, afucosylation of an IgG4 anti-mouse CD20 antibody increases the B cell depletion activity to a level approaching that of the mIgG2a antibody. PMID:27216702

  2. Mortality audit of neonatal sepsis secondary to Acinetobacter

    OpenAIRE

    Anuradha S; Madhuri R Rathi; Mathur, Meenakshi M

    2013-01-01

    Background: Multidrug resistant Acinetobacter infection has emerged as an important pathogen in neonatal sepsis in the recent years causing morbidity as well as mortality. Materials and Methods: A retrospective analysis was performed over a one and a half year period of all neonates admitted with sepsis in our neonatal intensive care unit (NICU), who developed Acinetobacter infection and to identify mortality-associated risk factors in these neonates. Results: Incidence of neonatal septicaemi...

  3. Bedside Neonatal Intensive Care Unit Surgery- Myth or Reality!

    OpenAIRE

    Shandip Kumar Sinha; Sujoy Neogi

    2013-01-01

    Neonatal transport is associated with complications, more so in sick and unstable neonates who need immediate emergency surgery. To circumvent these problems, surgery in Neonatal intensive care unit (NICU) is proposed for these neonates. This article reviews the literature regarding feasibility of this novel concept and based on the generated evidence, suggest the NICU planners to always include infrastructure for this. Also neonatal surgical team can be developed that could be transported.

  4. Morphine metabolism in neonates and infants.

    OpenAIRE

    Choonara, I; Lawrence, A.; Michalkiewicz, A; Bowhay, A; Ratcliffe, J.

    1992-01-01

    The metabolism of morphine was studied in seven fullterm neonates and five infants receiving a continuous infusion of morphine. All the patients had detectable plasma concentrations of morphine 3-glucuronide (M3G) and 10 had detectable concentrations of morphine 6-glucuronide (M6G). The mean plasma clearance of morphine was 20.1 ml min-1 kg-1 in neonates and 23.4 ml min-1 kg-1 in the group as a whole. The M3G/morphine ratio (7.3) was higher than that previously reported for preterm neonates (...

  5. Laparoscopic management of neonatal ovarian cysts

    Directory of Open Access Journals (Sweden)

    Oak Sanjay

    2005-01-01

    Full Text Available The first prenatal detection of an ovarian cyst was by Valenti in 1975. Since then antenatal and neonatal ovarian cysts are encountered more frequently due to the improvement of imaging techniques as well as routine antenatal ultrasound scanning. We discuss here the laparoscopic management of three cases of neonatal ovarian cysts. This approach is well tolerated by neonates, and it may overcome the controversy between the ′wait and see′ policy and early surgical intervention, as laparoscopy has both diagnostic and therapeutic value with minimal morbidity, and ovarian salvage whenever possible.

  6. Determinants of neonatal mortality in Indonesia

    Directory of Open Access Journals (Sweden)

    Agho Kingsley

    2008-07-01

    Full Text Available Abstract Background Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002. Methods The data source for the analysis was the 2002–2003 Indonesia Demographic and Health Survey from which survival information of 15,952 singleton live-born infants born between 1997 and 2002 was examined. Multilevel logistic regression using a hierarchical approach was performed to analyze the factors associated with neonatal deaths, using community, socio-economic status and proximate determinants. Results At the community level, the odds of neonatal death was significantly higher for infants from East Java (OR = 5.01, p = 0.00, and for North, Central and Southeast Sulawesi and Gorontalo combined (OR = 3.17, p = 0.03 compared to the lowest neonatal mortality regions of Bali, South Sulawesi and Jambi provinces. A progressive reduction in the odds was found as the percentage of deliveries assisted by trained delivery attendants in the cluster increased. The odds of neonatal death were higher for infants born to both mother and father who were employed (OR = 1.84, p = 0.00 and for infants born to father who were unemployed (OR = 2.99, p = 0.02. The odds were also higher for higher rank infants with a short birth interval (OR = 2.82, p = 0.00, male infants (OR = 1.49, p = 0.01, smaller than average-sized infants (OR = 2.80, p = 0.00, and infant's whose mother had a history of delivery complications (OR = 1.81, p = 0.00. Infants receiving any postnatal care were significantly protected from neonatal death (OR = 0.63, p = 0.03. Conclusion Public health interventions directed at reducing neonatal death should

  7. An Overlapping Case of Lupus Nephritis and IgG4-Related Kidney Disease.

    Science.gov (United States)

    Zaarour, Mazen; Weerasinghe, Chanudi; Eter, Ahmad; El-Sayegh, Suzanne; El-Charabaty, Elie

    2015-07-01

    We report a case of a 71-year-old Filipino female who was admitted to the hospital for abdominal pain, vomiting and diarrhea of 8 days duration. The patient was found to have marked acute kidney injury (AKI), which required hemodialysis in the next 3 days. Extensive workup revealed hematuria, subnephrotic range proteinuria, elevated anti-nuclear antibody (ANA) and elevated total immunoglobulin G (IgG) levels, with normal IgG4 and anti-dsDNA levels. On kidney biopsy, mild membranous glomerulonephritis was found, along with autoimmune tubulointerstitial nephritis (TIN) with a "full-house" pattern of immune deposits. These findings were suggestive of lupus interstitial nephritis. However, IgG4+ plasma cells were detected in the interstitium by immunostaining, favoring a diagnosis of IgG4-related kidney disease (IgG4-RKD). Our case highlights the difficulty in differentiating lupus nephritis (LN) from IgG4-RKD in some patients, raising the suspicion that these two entities can co-exist. PMID:26015827

  8. Utility of FDG PET/CT in IgG4-related systemic disease

    International Nuclear Information System (INIS)

    IgG4-related systemic disease (IgG4-RSD) is an emerging clinical entity about which much remains to be elucidated, in terms of its aetiology, pathogenesis, diagnosis, treatment and outcome. Autoimmune pancreatitis (AIP) and Mikulicz disease (MD) are the two major, well-studied constituents of IgG4-RSD. AIP and MD have common characteristics of forming tumour-mimicking lesions that consist of lymphoplasmacytic infiltrates and fibrosclerosis with numerous immunoglobulin G4 (IgG4)-positive plasma cells, as well as various multi-organ manifestations of IgG4-RSD. 2-[18F]-fluoro-2-deoxy-D-glucose positron-emission tomography/ computed tomography (FDG PET/CT) enables the acquisition of whole-body images and provides functional information about disease activity; as such it has a valuable role in staging extent of disease, guiding biopsy, and monitoring response to treatment. However, FDG PET/CT is likely to be only one component of the management strategy, and clinical, laboratory, imaging and histological findings are crucial in the overall diagnosis of the condition. At present FDG PET/CT does not have a well-established role in the assessment of patients with IgG4-RSD and future prospective studies are required to define the cost-effectiveness and clinical impact in this patient group more accurately.

  9. Enhancement of anti-OVA IgG2c production in vivo by enalapril

    Directory of Open Access Journals (Sweden)

    L.C. Almeida

    2016-01-01

    Full Text Available Angiotensin-converting enzyme (ACE inhibitors have non-hemodynamic, pleiotropic effects on the immune response. The effects of ACE inhibitors on the production of cytokines and T-cell functions are well established. However, little is known on the effects of these medicines on humoral response to foreign antigens. In this study, we investigated the effect of enalapril treatment on ovalbumin (OVA-specific IgG1 and IgG2c production in mice determined by ELISA. Two groups of 8-week-old C57BL/6 females mice (3–4/group were subcutaneously immunized with OVA (10 μg/animal in presence of Alhydrogel (1 mg/mouse and boosted at day 21. The mice were treated with enalapril (5 mg/kg daily, po or were left without treatment for one month. The animals were bled from the orbital plexus on days 0, 7, 14, 21, and 28 after the first immunization and the sera were stored at –20°C until usage. OVA-specific serum IgG1 and IgG2c were determined by ELISA using serum from each individual animal. The results showed that enalapril significantly increased anti-OVA serum IgG2c in the secondary response without affecting IgG1 synthesis. These data expand our understanding on the properties of enalapril on the immune response, including antibody production.

  10. Enhancement of anti-OVA IgG2c production in vivo by enalapril.

    Science.gov (United States)

    Almeida, L C; Muraro, L S; Albuquerque, D A

    2016-07-11

    Angiotensin-converting enzyme (ACE) inhibitors have non-hemodynamic, pleiotropic effects on the immune response. The effects of ACE inhibitors on the production of cytokines and T-cell functions are well established. However, little is known on the effects of these medicines on humoral response to foreign antigens. In this study, we investigated the effect of enalapril treatment on ovalbumin (OVA)-specific IgG1 and IgG2c production in mice determined by ELISA. Two groups of 8-week-old C57BL/6 females mice (3-4/group) were subcutaneously immunized with OVA (10 μg/animal) in presence of Alhydrogel (1 mg/mouse) and boosted at day 21. The mice were treated with enalapril (5 mg/kg daily, po) or were left without treatment for one month. The animals were bled from the orbital plexus on days 0, 7, 14, 21, and 28 after the first immunization and the sera were stored at -20°C until usage. OVA-specific serum IgG1 and IgG2c were determined by ELISA using serum from each individual animal. The results showed that enalapril significantly increased anti-OVA serum IgG2c in the secondary response without affecting IgG1 synthesis. These data expand our understanding on the properties of enalapril on the immune response, including antibody production. PMID:27409332

  11. Serum IgG antibodies to C1q in hypocomplementemic urticarial vasculitis syndrome.

    Science.gov (United States)

    Wisnieski, J J; Naff, G B

    1989-09-01

    Urticaria, angioedema, and arthritis are cardinal features of hypocomplementemic urticarial vasculitis syndrome (HUVS). Considered to be an immune complex-mediated disorder, HUVS has been differentiated from systemic lupus erythematosus (SLE), based on its clinical manifestations and the C1q precipitin (C1q-p) reaction, which is manifested as gel precipitation of C1q by a small percentage of HUVS IgG molecules. This phenomenon has been attributed to an Fc region abnormality, and the responsible IgG molecules are said to possess C1q-p activity. We purified IgG from 4 HUVS patients and confirmed that HUVS IgG contains C1q binding activity. F(ab')2 fragments from these patients also bound to C1q, as measured by 2 different C1q binding methods at physiologic ionic strength; HUVS IgG Fc fragments did not bind to C1q. Preincubation of HUVS F(ab')2 fragments with antibody to human F(ab')2 prevented subsequent binding to C1q. We conclude that IgG antibodies to C1q are present in HUVS serum, and it is likely that these antibodies are C1q-p. Because the clinical manifestations of HUVS and the presence of anti-C1q antibodies have been described in patients with SLE, our findings support the concept that HUVS is an autoimmune syndrome related to SLE. PMID:2528353

  12. THE EFFECT OF SLEEP DEPRIVATION ON SERUM IGG RESPONSES TO AEROBIC ACTIVITY IN COLLEGE STUDENT ATHLETES

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    Saeed Jamshidi Far

    2014-11-01

    Full Text Available Background & Aims: Sleep is a restorative process for the immune system. There are many situations in which sleep is disturbed prior to an athletic event. However, the effect of sleep deprivation on immune indices in response to exercise remains unknown. The aim of this study was to investigate the effects of sleep deprivation on serum IgG responses to aerobic activity. Materials & Methods: In this quasi-experimental study, 10 male physical education students were voluntarily participated. Study was performed in two separate occasions; control and experimental within two weeks. In the control occasion, normal sleep and aerobic activity and in the experimental occasion, sleep deprivation and aerobic activity was applied. Aerobic activity was performed on bicycle ergometer for 30 minutes at intensity of 70 to 75 percent of maximum heart rate. Changes in serum IgG concentrations in pre-test, before and after aerobic activity in both occasions were analyzed by the two repeated measures ANOVA and dependent T-test using SPSS software. Results: The results showed that sleep deprivation not significantly effect on Serum IgG response to aerobic activity (p=0.130. Also, aerobic activity not significantly effect on Serum IgG concentration (p=0.357. But sleep deprivation caused a significantly increase in serum IgG concentration (p=0.035. Conclusion: No significant effect of sleep deprivation on serum IgG concentrations response to aerobic activity.

  13. The Pathology of IgG4-Related Disease in the Bile Duct and Pancreas.

    Science.gov (United States)

    Zen, Yoh

    2016-08-01

    Immunoglobulin G4-related disease (IgG4-RD) in the pancreatobiliary system manifests as sclerosing cholangitis (SC), hepatic inflammatory pseudotumors, and type 1 autoimmune pancreatitis (AIP). The pathology of IgG4-RD involves an inflammatory process and fibrogenic pathway, the combination of which damages the affected organs. Fibroinflammatory injury is characterized by three microscopic findings: a diffuse lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, obliterative phlebitis, and storiform fibrosis. Although the diagnosis of IgG4-related pancreatocholangitis is relatively straightforward in surgical specimens, the current clinical requirement is to diagnose patients using biopsy samples, which remains challenging. Histological differential diagnoses include primary SC, follicular cholangitis/pancreatitis, SC with granulocytic epithelial lesions, and type 2 AIP. Although the massive infiltration of IgG4-positive plasma cells is a histological hallmark of IgG4-RD, many other immune cells (e.g., Th2 lymphocytes, regulatory T cells, and M2 macrophages) appear to be strongly involved in orchestral immune reactions. PMID:27466794

  14. Elbow- and hinge-bending motions of IgG: Dielectric response and dynamic feature.

    Science.gov (United States)

    Hayashi, Yoshihito; Yagihara, Shin

    2016-09-01

    Immunoglobulin G (IgG) is a Y-shaped globular protein consisting of two Fab segments connecting to an Fc segment with a flexible hinge region, in which the Fab segments show secondary flexibility at an "elbow" region. In the present work, the hinge-bending and elbow-bending motions of aqueous solutions of IgG by microwave dielectric measurements below the freezing point of bulk water was observed. The presence of unfreezable water around the macromolecules reduced the effects of steric hindrance normally generated by ice and enabled the intramolecular motions of IgG. At the same time, the overall IgG molecule rotation was restricted by ice. Papain digestion and reduction of the disulfide linkage at the hinge region was used to generate Fab and Fc fragments. In solutions of these fragments, the dielectric relaxation process of the hinge-bending motion was absent, although the elbow-bending motion remained. Three relaxation processes were observed for papain-digested IgG. The high, middle, and low frequency processes were attributed to unfrozen water, local peptide motions cooperating with bound water, and the elbow-bending motion, respectively. In the case of the intact IgG, an additional relaxation process due to the hinge-bending motion was observed at frequencies lower than that of the elbow-bending motion. © 2016 Wiley Periodicals, Inc. Biopolymers 105: 626-632, 2016. PMID:27018805

  15. Neuromyelitis optica IgG stimulates an immunological response in rat astrocyte cultures

    Institute of Scientific and Technical Information of China (English)

    Howe CL; Kaptzan T; Magaa SM; Ayers-Ringler JR; LaFrance-Corey RG; Lucchinetti CF

    2014-01-01

    Neuromyelitis optica (NMO) is a primary astrocyte disease associated with central nervous system inflammation, demyelination, and tissue injury. Brain lesions are frequently observed in regions enriched in expression of the aquaporin-4 (AQP4) water channel, an antigenic target of the NMO IgG serologic marker. Based on observations of disease reversibility and careful characterization of NMO lesion development, we propose that the NMO IgG may induce a dynamic immunological response in astrocytes. Using primary rat astrocyte-enriched cultures and treatment with NMO patient-derived serum or purified IgG, we observed a robust pattern of gene expression changes consistent with the induction of a reactive and inflammatory phenotype in astrocytes. The reactive astrocyte factor lipocalin-2 and a broad spectrum of chemokines, cytokines, and stress response factors were induced by either NMO patient serum or purified IgG. Treatment with IgG from healthy controls had no effect. The effect is disease-specific, as serum from patients with relapsing-remitting multiple sclerosis, Sj gren's, or systemic lupus erythematosus did not induce a response in the cultures. We hypothesize that binding of the NMO IgG to AQP4 induces a cellular response that results in transcriptional and translational events within the astrocyte that are consistent with a reactive and inflammatory phenotype. Strategies aimed at reducing the inflammatory response of astrocytes may short circuit an amplification loop associated with NMO lesion development.

  16. Frequency of cytomegalo virus igm and igg in pre renal transplant donors and recipients

    International Nuclear Information System (INIS)

    One of the most opportunistic infection in kidney transplant recipients is Cytomegalovirus. This study was conducted to find the frequency of cytomegalo- virus IgM and IgG in kidney transplant donors and recipients. Methods: We carried out retrospective analysis of laboratory values of cytomegalovirus IgG and IgM antibodies of all donors and recipients presented from 2006 to 2013 to National Institute of Kidney diseases Sheikh Zayed Hospital Lahore Pakistan. Results: Total no. of patients were 410 (205 donors and 205 recipients). Among recipients 169 (82%) were male and 36 (18%) female while among donors 125 (60%) were male and 80(40%) female. Total 05 (2.4 %) recipients were CMV IgG negative and 03 (1.4%) CMV IgM positive. Out of two hundred five recipients 200 (98%) were IgG positive and 202 (99%) were IgM negative. All the donors were CMV IgM negative and CMV IgG positive. Conclusion: There is very high frequency of CMV IgM and IgG positivity in donors and recipient of renal transplant in our population so we should consider prophylactic therapy. (author)

  17. Dose-dependent platelet stimulation and inhibition induced by anti-PIA1 IgG

    International Nuclear Information System (INIS)

    The PIA1 antibody produces several clinically distinct and severe thrombocytopenias. Investigations have demonstrated divergent effects on platelet function; prior reports demonstrated inhibition, while a conflicting publication showed platelet activation. We have resolved this conflict using anti-PIA1 IgG produced by a patient with posttransfusion purpura. Relatively low concentrations stimulated platelet aggregation and release of adenosine triphosphate (ATP) whereas high concentrations inhibited platelet function, producing a thrombasthenia-like state. The number of molecules of platelet-associated IgG necessary to initiate aggregation and ATP release (2,086 +/- 556) or produce maximum aggregation (23,420 +/- 3,706) or complete inhibition (63,582 +/- 2654) were measured with a quantitative radiometric assay for bound anti-PIA1. Preincubation of platelets with high concentrations of PIA1 antibody inhibited platelet aggregation with 10 mumol/L adenosine diphosphate and blocked 125I-labeled fibrinogen platelet binding. Platelet activation with nonfibrinogen dependent agonist, 1 U/ml thrombin, was not inhibited by this high concentration of PIA1 IgG. In conclusion, anti-PIAI IgG produces (1) stimulation of platelet aggregation and ATP release that is initiated with 2000 molecules IgG per platelet and is associated with an increase of 125I-fibrinogen binding; (2) conversely, inhibition of platelet aggregation is observed with maximum antibody binding, 63,000 molecules IgG per platelet, and is mediated via a blockade of fibrinogen binding

  18. Utility of FDG PET/CT in IgG4-related systemic disease

    Energy Technology Data Exchange (ETDEWEB)

    Nakatani, K., E-mail: koyakn@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto (Japan); Nakamoto, Y.; Togashi, K. [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto (Japan)

    2012-04-15

    IgG4-related systemic disease (IgG4-RSD) is an emerging clinical entity about which much remains to be elucidated, in terms of its aetiology, pathogenesis, diagnosis, treatment and outcome. Autoimmune pancreatitis (AIP) and Mikulicz disease (MD) are the two major, well-studied constituents of IgG4-RSD. AIP and MD have common characteristics of forming tumour-mimicking lesions that consist of lymphoplasmacytic infiltrates and fibrosclerosis with numerous immunoglobulin G4 (IgG4)-positive plasma cells, as well as various multi-organ manifestations of IgG4-RSD. 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose positron-emission tomography/ computed tomography (FDG PET/CT) enables the acquisition of whole-body images and provides functional information about disease activity; as such it has a valuable role in staging extent of disease, guiding biopsy, and monitoring response to treatment. However, FDG PET/CT is likely to be only one component of the management strategy, and clinical, laboratory, imaging and histological findings are crucial in the overall diagnosis of the condition. At present FDG PET/CT does not have a well-established role in the assessment of patients with IgG4-RSD and future prospective studies are required to define the cost-effectiveness and clinical impact in this patient group more accurately.

  19. Active Immunity Induced by Passive IgG Post-Exposure Protection against Ricin

    Directory of Open Access Journals (Sweden)

    Charles Chen Hu

    2014-01-01

    Full Text Available Therapeutic antibodies can confer an instant protection against biothreat agents when administered. In this study, intact IgG and F(ab’2 from goat anti-ricin hyperimmune sera were compared for the protection against lethal ricin mediated intoxication. Similar ricin-binding affinities and neutralizing activities in vitro were observed between IgG and F(ab’2 when compared at the same molar concentration. In a murine ricin intoxication model, both IgG and F(ab’2 could rescue 100% of the mice by one dose (3 nmol administration of antibodies 1 hour after 5 × LD50 ricin challenge. Nine days later, when the rescued mice received a second ricin challenge (5 × LD50, only the IgG-treated mice survived; the F(ab’2-treated mice did not. The experimental design excluded the possibility of residual goat IgG responsible for the protection against the second ricin challenge. Results confirmed that the active immunity against ricin in mice was induced quickly following the passive delivery of a single dose of goat IgG post-exposure. Furthermore, it was demonstrated that the induced active immunity against ricin in mice lasted at least 5 months. Therefore, passive IgG therapy not only provides immediate protection to the victim after ricin exposure, but also elicits an active immunity against ricin that subsequently results in long term protection.

  20. Early diagnosis of congenital toxoplasmosis in newborn infants using IgG subclasses against two Toxoplasma gondii recombinant proteins

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    Carlos Henryque de Souza e Silva

    2012-05-01

    Full Text Available The aim of this work was to evaluate the utility of ELISA-based testing of total IgG (IgGt antibodies and its subclasses (IgG1, IgG2, IgG3 and IgG4 against soluble (STAg and recombinant (rSAG1 and rMIC3 antigens of Toxoplasma gondii for diagnosing congenital toxoplasmosis. Sera from 217 newborns initially testing positive for specific IgM in filter paper dried blood spots were tested for specific IgM and IgG by ELFA-VIDAS®. Congenital toxoplasmosis was confirmed in 175 and ruled out in 42 infants. The validity of the ELISA tests was determined using the persistence of IgG antibodies (ELFA-VIDAS® kit at the end of 12 months, which is considered the reference test for the diagnosis of congenital toxoplasmosis. The frequency of positivity with IgGt against STAg, rSAG1 and rMIC3 was found in 97.2%, 96.3% and 80.2%, respectively, of the newborns with confirmed congenital toxoplasmosis. IgG1 reacted with all three antigens, while IgG3 and IgG4 reacted preferentially with rMIC3. Higher mean values of reactivity (sample optical density/cut-off were found for all subclasses when using rMIC3. All of the antigens showed high sensitivity and low specificity in detecting anti-T. gondii IgGt and IgG1 and low sensitivity and high specificity in detecting IgG3 and IgG4. In conclusion, the combined detection of IgG antibody subclasses against recombinant toxoplasmic antigens may be useful for the early diagnosis of congenital toxoplasmosis.

  1. Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India

    OpenAIRE

    Fottrell, E.; Osrin, D.; Alcock, G; Azad, K.; Bapat, U; Beard, J.; Bondo, A.; Colbourn, T; Das, S; King, C.; Manandhar, D.; S Manandhar; Morrison, J; Mwansambo, C; Nair, N.

    2015-01-01

    Objective Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data. Design We prospectively recorded births, neonatal deaths and stillbirths in seven population surveillance sites. VAs w...

  2. Neonatal Adaptation in Infants Prenatally Exposed to Antidepressants- Clinical Monitoring Using Neonatal Abstinence Score

    OpenAIRE

    Forsberg, Lisa; Navér, Lars; Lars L Gustafsson; Wide, Katarina

    2014-01-01

    Background Intrauterine exposure to antidepressants may lead to neonatal symptoms from the central nervous system, respiratory system and gastrointestinal system. Finnegan score (Neonatal Abstinence Score, NAS) has routinely been used to assess infants exposed to antidepressants in utero. Aim The purpose was to study neonatal maladaptation syndrome in infants exposed to selective serotonin reuptake inhibitors (SSRI) or serotonin-norepinephrine reuptake inhibitors (SNRI) in utero. Method Retro...

  3. Antiradiation Antitoxin IgG : Immunological neutralization of Radiation Toxins at Acute Radiation Syndromes.

    Science.gov (United States)

    Popov, Dmitri; Maliev, Slava

    Introduction: High doses of radiation induce apoptotic necrosis of radio-sensitive cells. Mild doses of radiation induce apoptosis or controlled programmed death of radio-sensitive cells with-out development of inflammation and formation of Radiation Toxins. Cell apoptotic necrosis initiates Radiation Toxins (RT)formation. Radiation Toxins play an important role as a trig-ger mechanism for inflammation development and cell lysis. If an immunotherapy approach to treatment of the acute radiation syndromes (ARS) were to be developed, a consideration could be given to neutralization of radiation toxins (Specific Radiation Determinants-SRD) by specific antiradiation antibodies. Therapeutic neutralization effects of the blocking anti-radiation antibodies on the circulated RT had been studied. Radiation Toxins were isolated from the central lymph of irradiated animals with Cerebrovascular(Cv ARS),Cardiovascular (Cr ARS),Gastrointestinal(Gi ARS) and Haemopoietic (Hp ARS) forms of ARS. To accomplish this objective, irradiated animals were injected with a preparation of anti-radiation immunoglobulin G (IgG) obtained from hyperimmune donors. Radiation-induced toxins that we call Specific Radiation Determinants (SRD) possess toxic (neurotoxic, haemotoxic) characteristics as well as specific antigenic properties. Depending on direct physiochemical radiation damage, they can induce development of many of the pathological processes associated with ARS. We have tested several specific hyperimmune IgG preparations against these radiation toxins and ob-served that their toxic properties were neutralized by the specific antiradiation IgGs. Material and Methods: A scheme of experiments was following: 1.Isolation of radiation toxins (RT) from the central lymph of irradiated animals with different form of ARS. 2.Transformation of a toxic form of the RT to a toxoid form of the RT. 3.Immunization of radiation naive animals. Four groups of rabbits were inoculated with a toxoid form of SRD

  4. Molecular diagnosis of neonatal sepsis.

    Science.gov (United States)

    Jordan, Jeanne A

    2010-06-01

    Several molecular testing options are now or will soon be available for diagnosing bloodstream infections in the neonate. The advantages include the speed at which results would be available and the ability to use those results to tailor empirical therapy and reduce the amount of unnecessary or ineffective antibiotics an infant receives. However, there are still difficult challenges before this potential can be realized. A variety of technological advances are needed, including (1) improved recovery of microorganisms in whole blood extractions, (2) increased assay sensitivity, (3) simpler testing platforms that could be run 24/7, and (4) more assays to detect antibiotic resistance genes to reduce reliance on culture-based protocols for antimicrobial susceptibility testing. Although considerable hurdles remain, this challenge is now a priority for investigators in academia and industry. PMID:20569815

  5. Miliary pattern in neonatal pneumonia

    International Nuclear Information System (INIS)

    We have seen 10 newborn babies who developed respiratory distress and whose chest radiographs showed a miliary nodular pattern of disease. Of these infants only 3 had blood cultures that were positive for staphylococcus aureus. Of the remaining 7, 2 had conjunctivitis from which staphylococcus aureus was cultured, 4 had negative cultures and 1 did not have a blood culture done. All patients were diagnosed as having bacterial pneumonia and appeared to respond favourably to antibiotic therapy. The pulmonary abnormalities resolved. The children were clinically well in less than 3 weeks. The author suggests that the miliary pattern is one of the radiological patterns of neonatal pneumonia possibly produced by hematogenous bacterial dissemination. (orig.)

  6. Neonatal doses from X ray examinations by birth weight in a neonatal intensive care unit

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the frequency and type of X ray examinations performed on neonates classified according to their birth weight in a neonatal intensive care unit (NICU). In this study, the radiology records of 2408 neonates who were admitted to the NICU of Oita Prefectural Hospital between January 1994 and September 1999 were investigated. This study revealed that the neonates with earlier gestational ages and lower birth weights required longer NICU stays and more frequent X ray examinations made using a mobile X ray unit. The average number of X ray examinations performed on neonates of less than 750 g birth weight was 26 films per neonate. In regard to computed tomography and fluoroscopy, no significant relationship was found between the birth weight and number of X rays. This study revealed that the entrance-surface dose per neonate was dependent upon the birth weight, while the maximum dose was not dependent upon the birth weight. The average neonatal dose in the NICU was predominantly from computed tomography and fluoroscopy. The individual dose varied widely among neonates. (author)

  7. Neonatal doses from X ray examinations by birth weight in a neonatal intensive care unit

    Energy Technology Data Exchange (ETDEWEB)

    Ono, K.; Akahane, K.; Aota, T.; Hada, M.; Takano, Y.; Kai, M.; Kusama, T

    2003-07-01

    The aim of this study was to investigate the frequency and type of X ray examinations performed on neonates classified according to their birth weight in a neonatal intensive care unit (NICU). In this study, the radiology records of 2408 neonates who were admitted to the NICU of Oita Prefectural Hospital between January 1994 and September 1999 were investigated. This study revealed that the neonates with earlier gestational ages and lower birth weights required longer NICU stays and more frequent X ray examinations made using a mobile X ray unit. The average number of X ray examinations performed on neonates of less than 750 g birth weight was 26 films per neonate. In regard to computed tomography and fluoroscopy, no significant relationship was found between the birth weight and number of X rays. This study revealed that the entrance-surface dose per neonate was dependent upon the birth weight, while the maximum dose was not dependent upon the birth weight. The average neonatal dose in the NICU was predominantly from computed tomography and fluoroscopy. The individual dose varied widely among neonates. (author)

  8. IgG2 immunodeficiency: association to pediatric patients with bacterial meningoencephalitis Inmunodeficiencia de IgG2: asociación en pacientes pediátricos con meningoencefalitis bacterianas

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    XIOMARA ESCOBAR-PÉREZ

    2000-03-01

    Full Text Available An IgG subclass deficiency is often associated with bacterial infections. We studied four pediatric patients suffering from meningoencephalitis, two of them due to Streptococcus pneumoniae and two due to Haemophilus influenzae type b. Simultaneous diagnostic serum and cerebrospinal fluid samples were taken during income. The four subclasses of IgG and albumin were quantified in both biologic fluids by radial immunodiffusion. Very low levels of seric IgG2 with non detectable cerebrospinal fluid IgG2 were found in the patients. No intrathecal IgG subclass synthesis was found in two patients. One patient with S. pneumoniae had IgG3 intrathecal synthesis. Intrathecal IgG1, IgG3 and IgG4 synthesis was found in one patient suffering from H. influenzae according with reibergrams. Substitutive therapy with intravenous gammaglobulin was given to the patients as part of the treatment.Las deficiencias por subclases de IgG se asocian frecuentemente con infecciones de origen bacteriano. Se estudian cuatro pacientes en edad pediátrica con meningoencefalitis, dos de ellos a Streptococcus pneumoniae y dos a Haemophilus influenzae tipo b. Se toman muestras simultáneas diagnósticas de suero y líquido cefalorraquídeo en el momento del ingreso. Se cuantificaron las cuatro sublclases de IgG y albúmina en ambos líquidos biológicos por inmunodifusión radial. Se encontró que los pacientes presentaban cifras muy disminuidas de IgG2 sérico y ningun exhibia IgG2 en el líquido cefalorraquídeo. Dos pacientes no sintetizaron ninguna subclase de IgG intratecalmente. Un paciente con S. pneumoniae sintetizó IgG3 intratecal. Uno de los pacientes con meningoencefalitis a H. influenzae sintetizó IgG1, IgG3 e IgG4 intratecalmente de acuerdo com el reibergrama. Estos pacientes recibieron terapia substitutiva com gammaglobulina intravenosa como parte de la medicación.

  9. Expression of murine Fc receptors for IgG.

    Science.gov (United States)

    Schreiber, R E; Buku, A; Unkeless, J C

    1990-06-15

    There are two distinct genes that encode murine low affinity Fc gamma RII, murine Fc gamma RII alpha, and murine Fc gamma RII beta, which are transcribed in specific cell lineages. Fc gamma RII alpha transcripts are present in macrophages, NK cells, and mesangial cells; Fc gamma RII beta transcripts are expressed in Fc gamma R-bearing B cells, T cells, and macrophages. We have devised a sandwich ELISA to quantify the expression of Fc gamma RII alpha protein. The ELISA is specific for Fc gamma RII alpha, and does not detect the closely related Fc gamma RII beta protein. Upon stimulation with IFN-gamma the Fc gamma RII beta- macrophage cell line J774a expressed a twelvefold enhanced level of Fc gamma RII alpha protein. Peritoneal macrophages synthesized varying amounts of Fc gamma RII alpha. High levels of Fc gamma RII alpha were observed in resident and thioglycollate-elicited peritoneal macrophages, but no Fc gamma RII alpha was detected in Bacillus Calmette Guérin-elicited macrophages. J774a cells stimulated with rIL-6 bound approximately twice as much anti-Fc gamma RII mAb 2.4G2 IgG as did unstimulated controls. However, the Fc gamma RII alpha-specific ELISA showed no change in the amount of Fc gamma RII alpha expressed. A probe encompassing the extracellular coding sequence of Fc gamma RII beta hybridized to two distinct transcripts that were elevated in rIL-6-stimulated J774a cells. One of these transcripts had the same mobility in electrophoresis as Fc gamma RII alpha mRNA and hybridized to an Fc gamma RII alpha-specific probe, whereas the other transcript was larger and did not hybridize to probes specific for either Fc gamma RII alpha or Fc gamma RII beta. Moreover, we confirmed, with an Fc gamma RII beta-specific probe, that J774a cells do not make Fc gamma RII beta mRNA. Thus, the larger transcript appears to encode a novel Fc gamma RII. We suggest that the increased level of binding of the anti-Fc gamma RII mAb 2.4G2 to rIL-6-induced cells represents

  10. Regional distribution and variation of gamma-globulin absorption from the small intestine of the neonatal calf

    International Nuclear Information System (INIS)

    125I-labeled immunoglobulin (Ig)G1 in colostral whey was used to determine the region of maximum absorption of Ig from the small intestine of the neonatal calf and the variation in Ig absorption among calves at the intestinal level. In experiment 1, 5 segments (approx 5%, 35%, 60%, 80%, and 95% of the duodenocecal length) were formed in the small intestine of 9 colostrum-deprived calves shortly after birth. These segments were injected with colostral whey containing 125I-IgG1 4 hours after birth, and uptake, transfer, and absorption (defined as uptake plus transfer) were determined for each segment 2 hours later. Raw data were adjusted for the milligrams of IgG1 injected per gram of intestinal tissue to obtain the least squares mean (LSM) value. The LSM values for absorption of IgG1 from distal segments 3, 4, and 5 were significantly greater (P less than 0.05) than those values for proximal segments 1 and 2. The region of the maximum IgG1 absorption was the lower small intestine, 60% to 80% of the duodenocecal length. There was also an indication of independence between uptake and transfer in each of the segments. Significant differences (P less than 0.05) were present among calves in the LSM values for uptake and absorption, but not for transfer. In experiment 2, thoracic ducts of 8 newborn calves were cannulated 4 to 5 hours after birth. At 6 hours after birth, colostral whey with 125I-IgG1 was injected into an intestinal segment (approx 60% to 80% of the duodenocecal length)

  11. Ethical issues in neonatal intensive care

    Directory of Open Access Journals (Sweden)

    Marcello M. Orzalesi

    2011-01-01

    Full Text Available Recent progress in neonatal care have significantly improved the prognosis and chances of survival of critically ill or extremely preterm neonates and have modified the limits of viability. However, in some circumstances, when the child's death can only be briefly postponed at the price of severe suffering, or when survival is associated with severe disabilities and an intolerable life for the child and his/her parents, the application of the full armamentarium of modern neonatal intensive care may not be appropriate. In such circumstances the limitation of intensive treatments (withholding or withdrawing and shift towards palliative care, can represent a more humane and reasonable alternative. This article examines and discusses the ethical principles underlying such difficult decisions, the most frequent situations in which these decisions may be considered, the role of parents in the decisional process, and the opinions and behaviours of neonatologists of several European neonatal intensive units as reported by the EURONIC study.

  12. Neuropsychological Outcomes of Neonatal Herpes Encephalitis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-10-01

    Full Text Available Neuropsychological outcome and the relation to neuroimaging findings are studied in a cohort of 9 children between 2.5 and 13 years of age with neonatal herpes encephalitis, examined at Karolinska University Hospital, Sweden.

  13. Neonatal euthanasia: moral considerations and criminal liability.

    Science.gov (United States)

    Sklansky, M

    2001-02-01

    Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or even manslaughter. Passive neonatal euthanasia remains both a moral dilemma and a legal ambiguity. Even the definition of passive euthanasia remains unclear. This manuscript reviews the basic moral and legal considerations raised by the current practice of neonatal euthanasia, and examines the formal position statements of the American Medical Association and the American Academy of Pediatrics. The paper concludes by emphasising the need, at least in the United States, to clarify the legal status of this relatively common medical practice. PMID:11233379

  14. Heaf test results after neonatal BCG.

    OpenAIRE

    Crawshaw, P. A.; Thomson, A H

    1988-01-01

    Heaf testing was carried out on 98 preschool Asian children who had received a BCG vaccination. A strongly positive Heaf reaction (grade 3) occurred in only two children. Heaf testing can still be used in tuberculosis screening after neonatal BCG.

  15. Case report: Fibromatosis colli in a neonate

    Directory of Open Access Journals (Sweden)

    Smiti S

    2010-01-01

    Full Text Available Fibromatosis colli or pseudotumor of infancy of the sternocleidomastoid muscle is a rare cause of a benign neck mass in neonates and infants. If diagnosed correctly, it can be managed conservatively, and unnecessary investigations can be avoided.

  16. Benign neonatal pneumoperitoneum--an enigma.

    Directory of Open Access Journals (Sweden)

    Shah R

    1992-04-01

    Full Text Available A case of neonatal pneumoperitoneum in absence of a bowel perforation or intrathoracic pathology has been reported. The cause of such a rare manifestation remains to be established.

  17. NEONATAL TERATOMA PRESENTING AS HYGROMA-COLLI

    NARCIS (Netherlands)

    JAARSMA, AS; TAMMINGA, RYJ; DELANGEN, ZJ; NIKKELS, PGJ; KIMPEN, JLL

    1994-01-01

    We describe a neonate with a large tumour involving cranial, cervical and upper mediastinal regions, which presented clinically as hygroma colli. Radiological and pathological investigations showed characteristics of a mature teratoma and prominent cystic components within the tumour. These findings

  18. RISK FACTORS OF MORTALITY IN NEONATAL ILLNESS

    Directory of Open Access Journals (Sweden)

    Jeyanthi

    2016-03-01

    Full Text Available BACKGROUND Infant Mortality Rate (IMR is high in India. Identification of risk factors of mortality in neonatal illness is essential to reduce Neonatal Mortality Rate (NMR and ultimately the IMR. AIM To identify the risk factors of mortality in neonatal illness. SETTING AND DESIGN It was a nested case control study done at the sick neonatal unit of urban tertiary referral centre. METHODS AND MATERIALS After obtaining ethical committee approval, retrospective analysis of 150 out born neonatal case records of babies admitted during the period from October 2015 to December 2015 was done. Data such as demographic features, maternal details, referral details, perinatal events, clinical features, laboratory reports and outcome were recorded. STATISTICAL ANALYSIS These risk factors were subjected to univariate and multivariate logistic regression analysis and P value calculated for the same to find out significant risk factors of mortality in neonatal illness. RESULTS Neonatal mortality rate was 22%. Male-to-female ratio was 2:1, death occurred more commonly in female neonates (23.1%. Home deliveries carried more risk of mortality. Birth order 4 and above had 25% mortality. Neonates of mother who had primary education and below had higher mortality. Perinatal asphyxia and sepsis were the most common causes of neonatal mortality. By univariate analysis, preterms had 4.9 times increased risk of mortality than term babies. Apnoeic spells, chest retractions and shock had 8 times, 3 times and 3.6 times increased risk of mortality respectively. By multivariate analysis, birth weight below 2 kilograms (kg carried 11.8 times more risk of mortality with a p value 0.00 (95% C.I 3.2, 30.4 and poor maternal intake of iron and folic acid tablets was 3.9 times more risk p value 0.003 (95% C.I 1.6, 9.6, apnoeic spells were 5.8 times more risk of mortality with p value 0.02 (95% C.I 1.3, 26.2. CONCLUSION Birth weight below 2 kg, poor maternal intake of iron and folic

  19. APPRAISAL OF PRENATAL ANTI-TOXOPLASMA GONDII (IGG+IGM)- IHA/IGM-ELISA SCREENING IN SINGLE SAMPLES VIA IGG AVIDITY TEST.

    Science.gov (United States)

    El-Bali, Mohammed; Zaglool, Dina A M; Khodari, Yousif A W; Al-Harthi, Saeed A

    2016-04-01

    Congenital toxoplasmosis is associated with important morbidity and mortality. Since vertical transmission of Toxoplasma gondii can occur in acute cases, antenatal screening for recent infections is vital. Accurate determination of acute toxoplasmosis requires a combination of immunoassays, usually not routinely applied for screening purposes. This study evaluated the anti-T. gondii (IgG+IgM)/IgM prenatal screening procedure by IgG avidity assay. The routine prenatal screening for (IgG+IgM) anti-T. gondii by indirect hemagglutination (IHA) in serum samples was done of 2247 pregnant women who attended two hospitals between 2011 and 2013 revealed 487 (21.7%) positive samples. Examination of IHA-positive sera by IgM and IgG/IgG-avidity concurrent ELISA tests revealed 7 positive and 3 border-line IgM-ELISA titers during the initial check-up of 10 women, who were then followed up at 3-4 week-intervals. Among these, 4 (40%) showed simultaneous high avidity IgG antibodies, indicating distant infection by the parasite, and no anti-T. gondii specific IgG could be detected in follow-up sera of two cases (20%), indicating false IgM initial positive results. Only 4 (40%) women showed simultaneous IgM and low avidity IgG antibodies indicating active infections. Avoidance of an over-diagnosis of acute toxoplasmosis Anti-T. gondii (IgG+IgM)/IgM prenatal screening must be supplemented by a discriminative test like IgG avidity ELISA. PMID:27363056

  20. Reference ranges and cutoff levels of pneumococcal antibody global serum assays (IgG and IgG2) and specific antibodies in healthy children and adults.

    Science.gov (United States)

    Rose, M A; Buess, J; Ventur, Y; Zielen, S; Herrmann, E; Schulze, J; Schubert, R

    2013-08-01

    Pneumococcal antibodies represent the acquisition of natural immunity. Determination of pneumococcal antibodies is an important screening tool for immunodeficiencies. Our study generated reference ranges and cutoff levels for pneumococcal antibody global serum assays correlated to a specific pneumococcal antibody ELISA. Specific pneumococcal antibody levels were measured from 457 children undergoing elective surgery and 46 healthy adult volunteers (88 with previous pneumococcal immunization from both groups), 22 severe immunodeficient subjects with ataxia telangiectasia (A-T, negative controls), and age-matched 36 healthy allergic asthmatics. We determined a representative panel of serotype-specific pneumococcal antibodies (serotype 4, 5, 6B, 7F, 14, 18C, 19F, 23F) by ELISA and global pneumococcal IgG and IgG2 antibodies by EIA. In vaccine-naïve healthy subjects, initial pneumococcal IgG geometric mean concentrations of 13.1 μg/ml were low in the first year of life and increased over the time, reaching adult levels (70.5 μg/ml) at age 8-12 years. In parallel, IgG2 antibodies increased from 20.7 % (0.5-1 year old) to adult proportions (>30 %) in preschoolers. Correlation between the pneumococcal IgG screening assay and specific pneumococcal antibody levels was acceptable (Pearson's coefficient r = 0.4455; p = 0.001). Cutoff levels showed high sensitivity, whereas specificity was high to moderate calculated from correlations with the specific ELISA. We provide reference ranges and cutoff levels for the interpretation of specific antibody determinations in the clinical setting. The global pneumococcal IgG/IgG2 assay is a suitable screening tool and correlates with the ELISA serotype-specific pneumococcal antibodies. However, results below our cutoff values should be re-evaluated by serotype-specific ELISA testing. PMID:23529214

  1. Paracetamol overdose in a preterm neonate

    OpenAIRE

    Isbister, G; Bucens, I; Whyte, I

    2001-01-01

    The first oral overdose of paracetamol in a neonate is reported. A 55 day old neonate, born 29 weeks premature, was accidentally given 136 mg/kg paracetamol. Treatment was with activated charcoal, supportive care, and N-acetylcysteine. There was no biochemical evidence of hepatotoxicity, and no long term sequelae. After modelling of the data, the following pharmacokinetic variables were calculated: absorption half life (tabs), 0.51 hours; volume of distribution (V/Foral),...

  2. Neonatal withdrawal from maternal volatile substance abuse.

    OpenAIRE

    Tenenbein, M; Casiro, O. G.; Seshia, M. M.; Debooy, V. D.

    1996-01-01

    AIM: To determine whether neonates born to mothers who are volatile substance abusers are at risk for an abstinence syndrome. METHODS: A consecutive sample of infants born to volatile substance abusing mothers was studied over four years, in a university affiliated medical centre with a variable mix of primary, secondary, and tertiary care patients. Infants were clinically scored with the Finnegan Neonatal Abstinence Scoring System. Those who fulfilled a priori scoring criteria were treated w...

  3. Pyridoxal phosphate-dependent neonatal epileptic encephalopathy

    OpenAIRE

    Bagci, S.; Zschocke, J.; Hoffmann, G F; Bast, T.; Klepper, J; Müller, A.; Heep, A; Bartmann, P.; Franz, A R

    2009-01-01

    Pyridox(am)ine-5′-phosphate oxidase converts pyridoxine phosphate and pyridoxamine phosphate to pyridoxal phosphate, a cofactor in many metabolic reactions, including neurotransmitter synthesis. A family with a mutation in the pyridox(am)ine-5′-phosphate oxidase gene presenting with neonatal seizures unresponsive to pyridoxine and anticonvulsant treatment but responsive to pyridoxal phosphate is described. Pyridoxal phosphate should be considered in neonatal epileptic encephalopathy unrespons...

  4. Neonatal euthanasia: moral considerations and criminal liability

    OpenAIRE

    Sklansky, M

    2001-01-01

    Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or...

  5. Neonatal osteomyelitis examined by bone scintigraphy

    International Nuclear Information System (INIS)

    Thirty-three infants less than six weeks of age and suspected of having osteomyelitis were examined by bone scintigraphy. Each of the 25 sites of proved osteomyelitis in 15 individuals demonstrated abnormal radionuclide localization. Ten additional scintigraphically positive but radiographically normal sites were detected. Optimal quality scintigrams of the growth plate complex and osteomyelitis in neonates appeared similar to those in older children. All neonates suspected of having osteomyelitis should be studied with bone scintigraphy following initial radiographs

  6. The Neonatal Airway: Problems and Management

    OpenAIRE

    Bingham, W.T.

    1987-01-01

    Altered, distressed, and noisy breathing during the neonatal period may indicate problems of the upper airway. Typically, a neonate with upper airway obstruction will present with stridor, which may be inspiratory and/or expiratory, and which may represent either a minor or a life-threatening illness. Evaluation of stridor will require a systematic history and physical examination, laboratory and radiologic studies, and possible endoscopic examination of the airway. Rapid diagnosis and interv...

  7. Transcutaneous Bilirubin Measurement in Preterm Neonates

    Directory of Open Access Journals (Sweden)

    Paymaneh Alizadeh Taheri

    2012-11-01

    Full Text Available Hyperbilirubinemia is a common problem during neonatal period especially in preterm neonates. Transcutaneous bilirubin measurement (TcB by special devices had been documented as an effective tool for predicting neonatal jaundice in full term neonate, but for preterm infants the present evidences are controversial. We carried out a prospective study in Shariati Hospital NICU. 126 paired TcB/total serum bilirubin (TSB measurements were obtained. TcB (on forehead and sternum were measured using JH2-1A device for every admitted preterm infant who clinically showed jaundice and TSB measurements was obtained within 30 min of TcB. 58 (46% were male and 68 (54% were female. The mean gestational age was 31 week and mean birth weight was 1728 ± 60 g. 30 percent of neonates were ill. The mean value obtained by TBS was 8.8 mg/dl and for frontal TcB was 8.2mg/dl and for sternal TcB was 7.4mg/dl. There were good correlation between TBS and TcB and the maximum correlation were seen in 33-37 weeks of gestation and birth weight more than 2500 g with forehead TcB measurement. Healthy preterm infants had significant correlation of TSB and TcB (r=0.56, P<0.001 and ill preterm neonate had r =0.82, P<0.001. The correlation between TBS and TcB with and without phototherapy was r=0.66, P=0.000 and r=0.69, P=0.000 respectively. Although TcB measurement may underestimate TBS but there is significant correlation between TcB and TBS in preterm cases even in ill neonate or who receiving phototherapy. This method can be used for determination of bilirbin level in preterm neonate and reduces the number of blood sampling.

  8. Hospital infections in neonatal intensive care units

    OpenAIRE

    Đurišić Jasna; Marković-Denić Ljiljana N.; Ilić Slobodanka; Ramadani Ruždi

    2005-01-01

    Introduction Sick newborn babies in the neonatal intensive care units (NICU) are al increased risk for hospital-acquired infections (HI). The aim of our study was to determine the incidence and localization of neonatal hospital infections in NICU. Material and methods A prospective, six-month study was carried out in a NICU. All patients hospitalized in NICU longer then 48 hours were examined according to their basic descriptive-epidemiological characteristics and the incidence of all hospita...

  9. Nosocomial Infections in Neonatal Intensive Care Units

    OpenAIRE

    Ioanna Paulopoulou; Christina Nanou

    2013-01-01

    Neonates, especially prematures, requiring care in Intensive Care Unit are a highly vulnerable population group at increased risk for nosocomial infections. In recent decades become one of the leading causes of morbidity and mortality in the Neonatal Intensive Care Unit. Aim: Highlighting the severity of nosocomial infections for hospitalized infants and the imprinting of risk factors that affects their development. Material-Methods: Searched for studies published in international scientific ...

  10. Hipertiroidismo neonatal transitório

    OpenAIRE

    Jerónimo, M; Moinho, R; Nunes-Vicente, I; Oliveira, A; Dias, A; Mimoso, G; Dinis, I.; Mirante, A; Faria, D.

    2014-01-01

    Graves’ disease is the main cause of hyperthyroidism in women of childbearing age. It occurs by the presence of serum immunoglobulins which stimulate the thyrotropin receptor (TRAbs) and may cross the placenta. It has serious consequences when uncontrolled, leading to fetal and/or neonatal hyperthyroidism or hypothyroidism. The authors describe the case of a newborn from a mother with poorly controlled Graves’ disease during pregnancy. He had an uneventful early neonatal period bu...

  11. Transient neonatal Behçet's disease

    OpenAIRE

    Antonelou, Marilina; Braha, Nirit

    2013-01-01

    A term neonate with a transient form of Behçet's disease (BD) is described. The mother had a 3-year history of BD treated with corticosteroids, which remained in remission during pregnancy. On day 1 of life, the neonate was noted to have papulopustular lesions of the labia and perineum. She remained clinically well and bacterial and viral infection screens were negative. The lesions disappeared within 3 weeks without scarring. No recurrence has been reported.

  12. Fading kitten syndrome and neonatal isoerythrolysis.

    Science.gov (United States)

    Bücheler, J

    1999-07-01

    Fading kitten syndrome includes noninfectious and infectious causes for neonatal death (birth to weaning age). Noninfectious causes are mostly responsible for mortality in the first week of life and include congenital disorders, low birth weights, trauma, malnutrition, environmental causes, and neonatal isoerythroylsis. Infectious causes are more prevalent at 3-4 weeks of age. This article discusses the causes, clinical signs, and management of fading kitten syndrome. PMID:10390788

  13. Neonatal Seizures. Advances in Mechanisms and Management.

    OpenAIRE

    Glass, HC

    2013-01-01

    Seizures occur in approximately 1–5 per 1,000 live births, and are among the most common neurologic conditions managed by a neonatal neurocritical care service. There are several, age-specific factors that are particular to the developing brain, which influence excitability and seizure generation, response to medications, and impact of seizures on brain structure and function. Neonatal seizures are often associated with serious underlying brain injury such as hypoxia-ischemia, stroke or hemor...

  14. Fecal calprotectin concentration in neonatal necrotizing enterocolitis

    OpenAIRE

    Yoon, Jung Min; Park, Ju Yi; Ko, Kyung Ok; Lim, Jae Woo; Cheon, Eun Jeong; Kim, Hyo Jeong

    2014-01-01

    Purpose Among the many factors associated with acute intestinal mucosal infection, numerous studies have proposed the usefulness of fecal calprotectin. The aim of this study was to evaluate the usefulness of fecal calprotectin in the diagnosis of necrotizing enterocolitis (NEC). Methods We collected 154 stool samples from 16 very low birth weight and premature newborns at the Konyang University Hospital neonatal intensive care unit or neonatal nursery. The stool samples were collected using t...

  15. Nosocomial Infections in Neonatal Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Ioanna Paulopoulou

    2013-10-01

    Full Text Available Neonates, especially prematures, requiring care in Intensive Care Unit are a highly vulnerable population group at increased risk for nosocomial infections. In recent decades become one of the leading causes of morbidity and mortality in the Neonatal Intensive Care Unit. Aim: Highlighting the severity of nosocomial infections for hospitalized infants and the imprinting of risk factors that affects their development. Material-Methods: Searched for studies published in international scientific journals during the period 2004-2013. As a main tool of retraction of bibliography was used the internet. Specific web sites and library databases: PubMed, Cinahl and Google scholar with key-words: "prevent nosocomial infections", "infection control", "neonatal care", "nursing care prematurity", "neonates nosocomial infections", "neonatal intensive care unit" (NICU. Methodology was applied thematic content analysis, which provides a careful reading of the material and recording the recurring risk factors Neonatal Neonatal Unit. Results: All researchers agree that nosocomial infections of hospitalized infants are a result of interaction of intrinsic and extrinsic factors risk. The intrinsic factors predisposing to infection is the immaturity of the immune system, the barriers of the skin and mucous membranes. Furthermore, multiple external factors contribute to the development of infection, such as low birth weight, underlying disease, broad-spectrum antibiotics, prolonged hospitalization, invasive techniques, parenteral nutrition, numerical insufficiency of staff, and poor compliance with medical professionals on hand hygiene. In recent years, the use of protocols and guidelines for each intervention in newborns has dramatically reduce the incidence of nosocomial infections. Conclusions: Nosocomial infections constitute serious threat to the population of the Neonatal Intensive Care Unit. Surveillance of infections and the use of protocols will help control

  16. Symptomatic aneurysm of ductus arteriosus in neonates

    OpenAIRE

    Nageswara R Koneti; Vasudevan Kanchi; Hemasree Kandraju; Jaishankar, S

    2011-01-01

    Four neonates presented within 24 hours of birth with stridor, respiratory distress and a weak cry. Clinical examination of the cardiovascular system revealed no abnormality. The transthoracic echocardiogram showed large aneurysm of ductus arteriosus at the aortic isthmus, tapering to a small tortuous channel at the site of pulmonary artery insertion. Computerized tomography scan performed in two of the neonates demonstrated considerable compression of adjacent thoracic structures. One requir...

  17. Hypernatremic Dehydration in Term and Preterm Neonates

    OpenAIRE

    K. Kamrani; Z. Sanaei; N. Khosroshahi; S. Rajabi Eslami; J. Amiri

    2015-01-01

    Introduction & Objective: Hypernatremia is associated with serious complications in infants. Given the high morbidity and mortality of neonatal hypernatremia, and since some complica-tions can be prevented, this study was aimed to examine the prevalence of hypernatremia in hospitalized infants and related risk factors. Materials & Methods: This cross-sectional study was performed on 1923 neonates hospitalized in Bahrami Hospital affiliated to Tehran University from October 2011 to October 201...

  18. Could Neonatal Hypernatremia Dehydration Influence Hearing Status?

    OpenAIRE

    Hassan Boskabadi; Farnaz Anvarifar; Navid Nourizadeh

    2014-01-01

    Introduction: Neonatal hypernatremia dehydration (NHD) is a dangerous condition in neonates, which is accompanied by acute complications (renal failure, cerebral edema, and cerebral hemorrhage) and chronic complications (developmental delay). Children begin learning language from birth, and hearing impairment interferes with this process. We assessed the hearing status of infants with hypernatremia dehydration.   Materials and Methods: In a case-control study in 110 infants presenting at the...

  19. Unusual IgG4-related hypophysitis: one case report and analysis of clinicopathological characteristics

    Directory of Open Access Journals (Sweden)

    Zhen-qi LI

    2014-10-01

    Full Text Available Background Immunoglobulin G4 (IgG4-related disease is a recently characterized autoimmune disease entity marked by elevated serum IgG4 levels and tissue infiltration by IgG4-positive plasma cells in multiple involved organs. Hypophysitis is a rare inflammatory disorder and IgG4-related sclerosing disease involving the ituitary alone is especially rare. Imaging studies may reveal a mass lesion in the sellar area or a thickening of pituitary stalk, mimicking a pituitary tumor. Due to its rarity and non-specific appearance in radiological examination, it is a diagnostic challenge for clinicians and histopathologists to differentiate solitary IgG4-related hypophysitis from other pituitary lesions. The aim of this study is to summarize the clinicopathological features of unusual IgG4-related hypophysitis and discuss the differential diagnosis of histologically similar inflammatory lesions in pituitary. Methods The clinical manifestation of a patient with solitary IgG4-related hypophysitis was presented retrospectively. Resected mass was routinely paraffin-embedded and stained with Hematoxylin and Eosin. Dako EnVision immunohistochemical staining system was used to detect the tumor antigen expressions, including vimentin (Vim, S-100 protein (S-100, pan cytokeratin (PCK, epithelial membrane antigen (EMA, CD3, CD20, CD68, CD1a, κ-light chain, λ-light chain and progestrone receptor (PR.  Results A 47-year-old male patient presented with 1-year history of mild limb weakness and hyposexuality. Laboratory examination revealed hypopituitarism with low levels of serum testosterone, cortisol, luteinizing hormone (LH and follicle stimulating hormone (FSH, although his serum IgG4 level was high. MRI of the pituitary gland revealed a mass lesion in the sellar area with T1WI mild hyperintense and homogeneous enhancement after gadolinium administration. The patient underwent a transsphenoidal mass resection of the pituitary gland. Histological examination

  20. Use of IgG avidity ELISA to differentiate acute from persistent infection with Salmonella Dublin in cattle

    DEFF Research Database (Denmark)

    Hansen, K.R.; Nielsen, L.R.; Lind, Peter

    2006-01-01

    Aims: To investigate whether an immunoglobulin (Ig)G avidity ELISA can be used to differentiate between acute and persistent infection with Salmonella (S.) Dublin in cattle. To determine whether the IgG isotype, IgG(1) and IgG(2) responses in acute and persistent infections differ. Methods and...... calculated for IgG (IgG-AI), IgG(1) (IgG(1)-AI) and IgG(2) (IgG(2)-AI). The mean IgG-AI for suspected carrier animals with either persistently high (group 1) or persistently high to medium high (group 2) antibody levels was significantly (P = 0.003) higher (32.1% and 38.4%) than for acutely infected animals...... (21.7% and 22.3%). The probability of being a suspect carrier was associated with IgG-AI, antibody level in the sample and age. However, the effect of age could be the result of a biased sample selection. Specificities and sensitivities were calculated at a range of cut-off values for IgG-AI and IgG(1...

  1. Selenium status in neonates with connatal infection.

    Science.gov (United States)

    Wiehe, Lennart; Cremer, Malte; Wisniewska, Monika; Becker, Niels-Peter; Rijntjes, Eddy; Martitz, Janine; Hybsier, Sandra; Renko, Kostja; Bührer, Christoph; Schomburg, Lutz

    2016-08-01

    Infectious diseases impair Se metabolism, and low Se status is associated with mortality risk in adults with critical disease. The Se status of neonates is poorly characterised, and a potential impact of connatal infection is unknown. We hypothesised that an infection negatively affects the Se status of neonates. We conducted an observational case-control study at three intensive care units at the Charité-Universitätsmedizin Berlin, Germany. Plasma samples were collected from forty-four neonates. On the basis of clinical signs for bacterial infection and concentrations of IL-6 or C-reactive protein, neonates were classified into control (n 23) and infected (n 21) groups. Plasma Se and selenoprotein P (SePP) concentrations were determined by X-ray fluorescence and ELISA, respectively, at day of birth (day 1) and 48 h later (day 3). Se and SePP showed a positive correlation in both groups of neonates. Se concentrations indicative of Se deficit in adults (500 ng/l). During antibiotic therapy, SePP increased significantly from day 1 (1·03 (sd 0·10) mg/l) to day 3 (1·34 (sd 0·10) mg/l), indicative of improved hepatic Se metabolism. We conclude that both Se and SePP are suitable biomarkers for assessing Se status in neonates and for identifying subjects at risk of deficiency. PMID:27267586

  2. Conformational difference in human IgG2 disulfide isoforms revealed by hydrogen/deuterium exchange mass spectrometry.

    Science.gov (United States)

    Zhang, Aming; Fang, Jing; Chou, Robert Y-T; Bondarenko, Pavel V; Zhang, Zhongqi

    2015-03-17

    Both recombinant and natural human IgG2 antibodies have several different disulfide bond isoforms, which possess different global structures, thermal stabilities, and biological activities. A detailed mapping of the structural difference among IgG2 disulfide isoforms, however, has not been established. In this work, we employed hydrogen/deuterium exchange mass spectrometry to study the conformation of three major IgG2 disulfide isoforms known as IgG2-B, IgG2-A1, and IgG2-A2 in two recombinant human IgG2 monoclonal antibodies. By comparing the protection factors between amino acid residues in isoforms B and A1 (the classical form), we successfully identified several local regions in which the IgG2-B isoform showed more solvent protection than the IgG2-A1 isoform. On the basis of three-dimensional structural models of IgG2, these identified regions were located on the Fab domains, close to the hinge, centered on the side where the two Fab arms faced each other in spatial proximity. We speculated that in the more solvent-protected B isoform, the two Fab arms were brought into contact by the nonclassical disulfide bonds, resulting in a more compact global structure. Loss of Fab domain flexibility in IgG2-B could limit its ability to access cell-surface epitopes, leading to reduced antigen binding potency. The A2 isoform was previously found to have disulfide linkages similar to those of the classical A1 isoform, but with different biophysical behaviors. Our data indicated that, compared to IgG2-A1, IgG2-A2 had less solvent protection in some heavy-chain Fab regions close the hinge, suggesting that the A2 isoform had more flexible Fab domains. PMID:25730439

  3. A Study On Neonatal Mortality In Jamnagar District Of Gujarat

    Directory of Open Access Journals (Sweden)

    Yadav Sudha

    1998-01-01

    Full Text Available Research question: Which are the maternal, socio-demographic and neonatal attributes responsible for neonatal mortality in rural areas of Gujarat? Objectives: (i To know various maternal, socio-demographic and neonatal factors responsible for neonatal mortality in rural areas of Gujarat (ii To estimate neonatal mortality rate in the area. Setting: Rural areas of six Primary Health Centers of Jamnagar district of Gujarat State. Study design: Community based cohort study. Sample size: Population of 40512 Participants: Members of the family in which neonatal deaths occurred. Outcome variable: Neonatal mortality Analysis: Sample proportions. Results: Neonatal mortality rate on the basis of follow-up of births during one year was found to be 47.27 per thousand live births. The major maternal and socio-demographic factors responsible for neonatal mortality were; maternal age, illiteracy, lack of antenatal care, closely spaced pregnancies, delivery conducted at home, delivery conducted untrained personnel and delayed initiation of breast feeding. The major neonatal factors responsible for mortality in neonates were; low birth weight, prematurity, first order of birth, early phase of neonatal period, male gender of the child. The leading causes of neonatal mortality were found to be prematurity, birth asphyxia, neonatal infections and congenital anomalies.

  4. IgG4-related disease: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Lang D

    2016-02-01

    Full Text Available David Lang,1 Jochen Zwerina,2 Herwig Pieringer1,3 1Second Department of Internal Medicine, Kepler University Clinic, Linz, 2First Department of Internal Medicine, Ludwig Boltzmann-Institute of Osteology, Hanusch Hospital, Vienna, 3Paracelsus Private Medical University, Salzburg, Austria Abstract: Immunoglobulin G4-related disease (IgG4-RD represents an immune-mediated fibroinflammatory condition with a characteristic histopathological appearance that can affect various organs. Although numerous single-organ manifestations have been described more than a century ago, its systemic nature and unique features were only discovered in the last 2 decades, when IgG4-RD emerged as a new entity of disease. IgG4-RD is usually considered a rare disease, but its true epidemiology has not yet been fully clarified. Also, despite recent advances in the identification of the underlying immunological processes, its pathophysiology is only incompletely understood till now. The diagnostic workup of IgG4-RD is complex and usually requires a combination of clinical examination, imaging, histological, and serological analyses. However, no finding alone is specific for IgG4-RD. Therefore, its diagnosis requires careful interpretation of examination results in context with the patient’s clinical appearance as well as the exclusion of a broad variety of differential diagnoses. The past years brought rapid advances concerning this novel disease entity: diagnostic criteria, further insights into the underlying immunological processes, new biomarkers, and novel therapeutic approaches were proposed and widened the knowledge in the field of IgG4-RD. Still, a greater number of questions remain unanswered, and many recent developments require further discussion and proof from clinical trials. This review should give an overview on current knowledge and future perspectives in epidemiology, pathophysiology, diagnosis, and therapy of IgG4-RD. Keywords: PET/CT, autoimmune

  5. IgG4-Related Esophageal Disease Presenting as Esophagitis Dissecans Superficialis With Chronic Strictures.

    Science.gov (United States)

    Dumas-Campagna, Myriam; Bouchard, Simon; Soucy, Genevieve; Bouin, Mickael

    2014-08-01

    IgG4-related disease is a recently recognized autoimmune systemic disorder that has been described in various organs. The disease is characterized histologically by a dense lymphoplasmocytic infiltrate of IgG4-positive cells, storiform fibrosis and can be associated with tumefactive lesions. IgG4-related disease involving the upper gastrointestinal tract is rare and only two previous case reports have reported IgG4-related esophageal disease. We report the case of a 63-year-old female patient with a long-standing history of severe dysphagia and odynophagia with an initial diagnosis of reflux esophagitis. Symptoms persisted despite anti-acid therapy and control esophagogastroduodenoscopy (EGD) revealed endoscopic images consistent with esophagitis dissecans superficialis (sloughing esophagitis). An underlying autoimmune process was suspected and immunosuppressant agents were tried to control her disease. The patient eventually developed disabling dysphagia secondary to multiple chronic esophageal strictures. A diagnosis of IgG4-related disease was eventually made after reviewing esophageal biopsies and performing an immunohistochemical study with an anti-IgG4 antibody. Treatment attempts with corticosteroids and rituximab was not associated with a significant improvement of the symptoms of dysphagia and odynophagia, possibly because of the chronic nature of the disease associated with a high fibrotic component. Our case report describes this unique case of IgG4-related esophageal disease presenting as chronic esophagitis dissecans with strictures. We also briefly review the main histopathological features and treatment options in IgG4-related disease. PMID:24883156

  6. Effect of biotherapeutics on antitoxin IgG in experimentally induced Clostridium difficile infection

    Directory of Open Access Journals (Sweden)

    S Kaur

    2012-01-01

    Full Text Available Purpose: Recurrent diarrhoea after successful treatment of primary Clostridium difficile associated disease (CDAD occurs due to bowel flora alterations and failure to mount an effective antibody response. Apart from antibiotics, risk factors include immunosuppressive and acid-suppressive drug administration. Biotherapeutics such as probiotic and epidermal growth factor (EGF may offer potential effective therapy for CDAD. Materials and Methods: The effect of biotherapeutics in mounting an antibody response against C. difficile toxins was studied in BALB/c mice challenged with C. difficile after pre-treatment with ampicillin, lansoprazole or cyclosporin. Sera from sacrificed animals were estimated for antitoxin IgG by enzyme linked immunosorbent assay. Results: Antitoxin IgG was significantly higher (P0.05 in animals in which C. difficile was given after pre-treatment with cyclosporin compared to those without any pre-treatment, or pre-treatment with antibiotic or lansoprazole. In inter-subgroup comparisons also significant anomaly in production of antitoxin IgG was found. The antitoxin IgG levels were raised in animals administered C. difficile after pre-treatment with ampicillin, but lower in animals administered cyclosporin. High levels of antitoxin IgG were also found in the serum samples of animals receiving lansoprazole and C. difficile. Conclusions: Probiotics showed their beneficial effect by boosting the immune response as seen by production of antitoxin IgG. Oral administration of EGF did not affect the immune response to C. difficile toxins as significant increase was not observed in the serum antitoxin IgG levels in any of the groups investigated.

  7. Conformational plasticity of IgG during protein A affinity chromatography.

    Science.gov (United States)

    Gagnon, Pete; Nian, Rui

    2016-02-12

    Single step elution of a protein A column with 100mM acetate pH 3.5 produced a curvilinear gradient with pH dropping steeply at first then more gradually as it approached endpoint. IgG with a native hydrodynamic diameter of 11.5 nm began to elute at pH 6.0 with a size of 9.4 nm. IgG size continued to decrease across the peak, reaching a minimum of 2.2 nm at pH 3.9. Secondary structure of early eluting IgG was only mildly affected but later eluting fractions became increasingly non-native with the 2.2 nm population exhibiting the highest proportion of β-sheet and lowest random coil of all conformations. Size reduction and structural change of IgG through this portion of the elution peak were attributed dominantly to a pre-existing tendency of highly concentrated IgG to adopt reduced size conformations at low pH and conductivity, facilitated by the known conformational relaxation of IgG by its interaction with protein A. IgG size increased to 10.4 nm as elution pH approached 3.5 across the tailing fractions. Major loss of β-sheet and increase of α-helix and random coil were observed in parallel. Late elution of this population was attributed to it being eluted from interactions with 2 distinct protein A domains, one bound to each side of the Fc region, creating a higher dissociation constant than single-site Fc-protein A interactions, and requiring more severely disruptive conditions for elution. The high degree of conformational disruption was attributed to simultaneous interaction of both heavy chains with protein A. PMID:26805601

  8. IgG4-related disease: A relatively new concept for clinicians.

    Science.gov (United States)

    Vasaitis, Lilian

    2016-01-01

    IgG4-related disease (IgG4-RD) is a recently recognized chronic fibrotic inflammation, which can affect almost every organ, and may come to clinical attention first due to visible organ swelling or organ dysfunction, or is identified incidentally by imaging and specific biopsy. The disorder has an allergic background and is immune-mediated. Up-regulated responses of T helper 2 and T regulatory cells and their cytokines play a major role in disease progression. About 30-50% of patients are atopic or have mild eosinophilia. IgG4-RD predominantly affects middle-aged male patients. The cornerstones of diagnosis of the disease are compatible clinical features and typical histopathology. Swelling of salivary and lacrimal glands, lymphadenopathy, and type 1 autoimmune pancreatitis (AIP) are the most common manifestations of the disease. However, other tissues and organs, such as retroperitoneum, lung, kidney, aorta, upper airways, thyroid gland, meninges, heart, mesenterium and skin may be involved. Typical histopathology is lymphoplasmacytic infiltration abundant in IgG4-positive plasma cells, storiform-type fibrosis, and obliterative phlebitis. Elevated serum IgG4 concentration supports the diagnosis. Characteristic imaging features such as a "capsule-like rim" surrounding the pancreatic lesions is highly specific to type 1 AIP. 18F-fluorodeoxyglucose positron emission tomography/computed tomography enables mapping the sites of inflammation, permits evaluation of the extent of the disease, helps in guiding biopsy decision, and may be used in monitoring response to treatment. Glucocorticoids alone or in combination with B-cell depletion with rituximab induces prompt clinical response to IgG4-RD. This article reviews the current understanding, different clinical manifestations, and approaches to diagnosis and treatment of IgG4-RD. PMID:26481243

  9. Neonatal thyroid-stimulating hormone level is influenced by neonatal, maternal, and pregnancy factors.

    Science.gov (United States)

    Trumpff, Caroline; Vandevijvere, Stefanie; Moreno-Reyes, Rodrigo; Vanderpas, Jean; Tafforeau, Jean; Van Oyen, Herman; De Schepper, Jean

    2015-11-01

    The percentage of newborns with a neonatal whole blood thyroid-stimulating hormone (TSH) greater than 5 mIU/L has been used as an indicator of iodine deficiency at the population level. However, TSH levels in newborns may be influenced by many factors other than iodine status. The objective of this study was to identify neonatal, maternal, and pregnancy-related determinants of neonatal TSH levels in a retrospective cohort study. The study sample included 313 Belgian mothers and their 4- to 5-year-old children. The children had a neonatal TSH concentration between 0 and 15 mIU/L at neonatal screening, and blood samples were collected 3 to 5 days after birth. Children with suspected congenital hypothyroidism (neonatal TSH level >15 mIU/L), prematurely born (i.e., screening center via a self-administered questionnaire filled in by the mother together with the child's health booklet. Higher TSH levels were found in spring and winter compared to summer and autumn (P = .011). Higher TSH levels were associated with lifetime smoking behavior (up to child birth) in the mother (P = .005), lower weight gain during pregnancy (P = .014), and longer pregnancies (P = .003). This study showed that several neonatal, maternal, and pregnancy-related determinants are influencing neonatal TSH level. PMID:26428622

  10. Malaria resistance genes are associated with the levels of IgG subclasses directed against Plasmodium falciparum blood-stage antigens in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Afridi Sarwat

    2012-09-01

    Full Text Available Abstract Background HBB, IL4, IL12, TNF, LTA, NCR3 and FCGR2A polymorphisms have been associated with malaria resistance in humans, whereas cytophilic immunoglobulin G (IgG antibodies are thought to play a critical role in immune protection against asexual blood stages of the parasite. Furthermore, HBB, IL4, TNF, and FCGR2A have been associated with both malaria resistance and IgG levels. This suggests that some malaria resistance genes influence the levels of IgG subclass antibodies. Methods In this study, the effect of HBB, IL4, IL12, TNF, LTA, NCR3 and FCGR2A polymorphisms on the levels of IgG responses against Plasmodium falciparum blood-stage extract was investigated in 220 individuals living in Burkina Faso. The Pearson’s correlation coefficient among IgG subclasses was determined. A family-based approach was used to assess the association of polymorphisms with anti-P. falciparum IgG, IgG1, IgG2, IgG3 and IgG4 levels. Results After applying a multiple test correction, several polymorphisms were associated with IgG subclass or IgG levels. There was an association of i haemoglobin C with IgG levels; ii the FcγRIIa H/R131 with IgG2 and IgG3 levels; iii TNF-863 with IgG3 levels; iv TNF-857 with IgG levels; and, v TNF1304 with IgG3, IgG4, and IgG levels. Conclusion Taken together, the results support the hypothesis that some polymorphisms affect malaria resistance through their effect on the acquired immune response, and pave the way towards further comprehension of genetic control of an individual’s humoral response against malaria.

  11. Radiation doses and risks to neonates undergoing common radiographic examinations in the neonatal intensive care unit

    International Nuclear Information System (INIS)

    Neonates in the-Neonatal Intensive Care Unit (NICU) can receive large numbers of radiographs owing to the clinical conditions they may present. More neonatal radiation dosimetry data are required for three fundamental reasons: (1.) to aid in the establishment of reference dose levels for interinstitutional comparisons; (2.) to improve childhood cancer risk estimates following neonatal exposure; and (3.) to indicate appropriate directions for dose reduction. This paper describes an investigation of two different NICU radiological techniques with significantly different neonate doses. While patient-matched images taken with both techniques were assessed in a blind review, this component of the study is beyond the scope of this paper and is not discussed here. (author)

  12. Label-free Raman mapping of surface distribution of protein a and IgG biomolecules.

    Science.gov (United States)

    Combs, Zachary A; Chang, Sehoon; Clark, Tolecia; Singamaneni, Srikanth; Anderson, Kyle D; Tsukruk, Vladimir V

    2011-03-15

    We have demonstrated a nanoengineered substrate composed of micropatterned silver nanoparticles to be used for the label-free mapping of adsorbed biomolecules. We utilized surface-enhanced Raman scattering (SERS) phenomenon to monitor the known bioanalytes, protein A and human immunoglobulin G (IgG). The SERS substrate was composed of a poly(alylamine hydrochloride) (PAH)/poly(styrenesulfonate) (PSS) layer-by-layer (LbL) nanocoating micropatterned with silver nanoparticles confined to microscopic stripes. Selective adsorption of biomacromolecules is facilitated by the amine-terminated LbL nanocoating, which prevents the surface adsorption of positively charged protein A across the surface except on the patterned regions containing negatively charged silver nanoparticles. Furthermore, adsorption of IgG on predetermined regions is facilitated by the selective binding of the Fc region of IgG to protein A. This label-free SERS approach provides accurate, selective, and fast detection of protein A and IgG solutions with a nanomolar concentration, down to below 1 nM for IgG in solution. This method could also be utilized for the facile detection of proteins in field conditions as well as in clinical, forensic, industrial, and environmental laboratories. PMID:21294559

  13. IgG4-Related Lung Disease Associated with Usual Interstitial Pneumonia.

    Science.gov (United States)

    Schneider, Frank; Veraldi, Kristen L; Levesque, Marc C; Colby, Thomas V; S Yi, Eunhee

    2016-01-01

    We report a case of immunoglobulin(Ig)G4-related disease with the radiologic and histopathological manifestations resembling usual interstitial pneumonia (UIP). The patient was a 62-year-old man who presented with progressive dyspnea of insidious onset. High resolution computed tomography of the chest showed lower-lobe predominant peripheral reticulation and traction bronchiectasis but no honeycomb change. Microscopic examination of the surgical lung biopsy showed characteristic features of UIP including architectural distortion by fibrosis with peripheral and paraseptal accentuation, scattered fibroblast foci and microscopic honeycomb change. In addition there were prominent multifocal lymphoplasmacytic infiltrates with a marked increase of IgG4-positive plasma cells (79 per high power field in hot spots) and high IgG4/IgG ratio (up to 67%). The serum IgG4 level was elevated at 760 mg/dl (reference range 9-89), with normal levels for the other IgG subclasses and negative serologic markers for autoimmune diseases. The patient's symptoms improved significantly with oral corticosteroid treatment. PMID:27053971

  14. Multifocal fibrosclerosis and IgG4-related disease involving the cardiovascular system

    International Nuclear Information System (INIS)

    The cardiovascular system may be involved as a target organ of multifocal fibrosclerosis, which may manifest as idiopathic retroperitoneal fibrosis, inflammatory aortic aneurysm, inflammatory periarteritis, and inflammatory pericarditis. These pathological conditions can sometimes occur concomitantly. Idiopathic retroperitoneal fibrosis and inflammatory abdominal aortic aneurysm are both characterized by the presence of fibro-inflammatory tissue around the abdominal aorta expanding into the surrounding retroperitoneal structures, and together they may be termed 'chronic periaortitis'. Cardiovascular fibrosclerosis has become non-uncommonly encountered condition since imaging modalities have made its diagnosis more feasible. In addition, recent studies have demonstrated that a certain fraction, but not all, of cardiovascular fibrosclerosis may have a link with immunoglobulin-G4 (IgG4)-related sclerosing disease (IgG4-SD). IgG4-SD is histologically characterized by dense fibrosclerosis and infiltration of lymphocytes and IgG4-positive plasma cells, and these histopathologic findings seem to be essentially similar regardless of the organs involved. In this mini review, we summarize what is known so far about multifocal fibrosclerosis of the cardiovascular system and its association with IgG4-SD, and what remains to be clarified in future investigations. (author)

  15. Regulation of in vitro PWM-induced IgG secretion in humans

    International Nuclear Information System (INIS)

    PWM-induced differentiation of human PBMC into immunoglobulin (Ig) secreting cells is a widely used model of in vivo IgG secretion. We examined the relationship between the amount of IgG secreted in PBMC cultures obtained from individuals who consistently secrete either very high (HR) or very low amounts (LR) of IgG and various in vitro immune function assays. The PBMC obtained from LR contained a higher ratio of cells expressing the T-suppressor/inducer to T-helper/inducer phenotype. The autologous mixed lymphocyte response was lower and the amount of in vivo radiation sensitive suppression was higher in the LR than in the HR. LR E- cells secreted less IgG than the HR E- cells when both were mixed with heterologous HR E+ cells. Monocyte depletion reduced IgG secretion in both LR and HR. These results suggest that each of the subsets Ts, Th (Thi, Tsi), and B lymphocytes are involved in the regulation of PWM-induced Ig secretion and that the functions of each of these subsets differ in HR and LR individuals

  16. Increased Levels of IgG Antibodies against Human HSP60 in Patients with Spondyloarthritis

    DEFF Research Database (Denmark)

    Nielsen, Astrid Hjelholt; Carlsen, Thomas; Deleuran, Bent;

    2013-01-01

    Introduction: Spondyloarthritis (SpA) comprises a heterogeneous group of inflammatory diseases, with strong association to human leukocyte antigen (HLA)-B27. SpA is suggested triggered by bacterial infection, and bacterial heat shock protein (HSP) seems to be a strong T cell antigen. Since...... severity in relation to HLA-B27 was evaluated. Material & Methods: Serum samples from 82 patients and 50 controls were analysed by enzyme-linked immunosorbent assay (ELISA) for immunoglobulin (Ig)G1, IgG2, IgG3 and IgG4 antibodies against human HSP60 and HSP60 from Chlamydia trachomatis, Salmonella...... against human HSP60, but not antibodies against bacterial HSP60, were elevated in the SpA group compared with the control group. Association between IgG3 antibodies against human HSP60 and BASMI was shown in HLA-B27+ patients. Only weak correlation between antibodies against bacterial and human HSP60 was...

  17. Effects of adjuvants on IgG subclasses elicited by virus-like Particles

    Directory of Open Access Journals (Sweden)

    Visciano Maria Luisa

    2012-01-01

    Full Text Available Abstract Background Virus-Like Particles (VLPs represent an efficient strategy to present and deliver conformational antigens to the immune system, inducing both arms of the adaptive immune response. Moreover, their particulate structure surrounded by cell membrane provides an adjuvanted effect to VLP-based immunizations. In the present study, the elicitation of different patterns of IgG subclasses by VLPs, administered in CpG ODN1826 or poly(I:C adjuvants, has been evaluated in an animal model. Results Adjuvanted VLPs elicited a higher titer of total specific IgG compared to VLPs alone. Furthermore, while VLPs alone induced a balanced TH2 pattern, VLPs formulated with either adjuvant elicited a TH1-biased IgG subclasses (IgG2a and IgG3, with poly(I:C more potent than CpG ODN1826. Conclusions The results confirmed that adjuvants efficiently improve antigen immunogenicity and represent a suitable strategy to skew the adaptive immune response toward the differentiation of the desired T helper subset, also using VLPs as antigen.

  18. Socioeconomic factors and adolescent pregnancy outcomes: distinctions between neonatal and post-neonatal deaths?

    Directory of Open Access Journals (Sweden)

    Flick Louise H

    2005-07-01

    Full Text Available Abstract Background Young maternal age has long been associated with higher infant mortality rates, but the role of socioeconomic factors in this association has been controversial. We sought to investigate the relationships between infant mortality (distinguishing neonatal from post-neonatal deaths, socioeconomic status and maternal age in a large, retrospective cohort study. Methods We conducted a population-based cohort study using linked birth-death certificate data for Missouri residents during 1997–1999. Infant mortality rates for all singleton births to adolescent women (12–17 years, n = 10,131; 18–19 years, n = 18,954 were compared to those for older women (20–35 years, n = 28,899. Logistic regression was used to estimate adjusted odds ratios (OR and 95% confidence intervals (CI for all potential associations. Results The risk of infant (OR 1.95, CI 1.54–2.48, neonatal (1.69, 1.24–2.31 and post-neonatal mortality (2.47, 1.70–3.59 were significantly higher for younger adolescent (12–17 years than older (20–34 years mothers. After adjusting for race, marital status, age-appropriate education level, parity, smoking status, prenatal care utilization, and poverty status (indicated by participation in WIC, food stamps or Medicaid, the risk of post-neonatal mortality (1.73, 1.14–2.64 but not neonatal mortality (1.43, 0.98–2.08 remained significant for younger adolescent mothers. There were no differences in neonatal or post-neonatal mortality risks for older adolescent (18–19 years mothers. Conclusion Socioeconomic factors may largely explain the increased neonatal mortality risk among younger adolescent mothers but not the increase in post-neonatal mortality risk.

  19. Umbilical cord leptin predicts neonatal bone mass.

    Science.gov (United States)

    Javaid, M K; Godfrey, K M; Taylor, P; Robinson, S M; Crozier, S R; Dennison, E M; Robinson, J S; Breier, B R; Arden, N K; Cooper, C

    2005-05-01

    Evidence is accumulating that the risk of osteoporosis in later life may be determined in part by environmental influences on bone development during intrauterine and early postnatal life. A potential role for fetal leptin in mediating these effects is suggested by animal studies showing that leptin influences prenatal osteoblast growth and development, and that fetal leptin concentrations are altered by changes in maternal nutrition. In a group of term human infants we reported previously that maternal birthweight, smoking, fat mass, and exercise during late pregnancy independently predict neonatal bone mass. To investigate the potential role of leptin in mediating these effects, we now relate leptin concentrations in umbilical venous serum to neonatal bone mass and body composition in 117 infants. There were strong positive associations between umbilical venous leptin concentration and each of whole body bone mineral contents (BMC) (r = 0.42, P < or = 0.001) and estimated volumetric bone density (r = 0.21, P = 0.02); whole body lean mass (r = 0.21, P < or = 0.024); and whole body fat mass (r = 0.60, P < 0.001). The associations with neonatal BMC and fat mass, but not with lean mass, were independent of associations that we have reported previously between cord serum insulin-like growth factor 1 (IGF-1) concentrations and neonatal body composition. Among the maternal determinants of neonatal bone mass, cord leptin explained the relationship with maternal fat stores, but not those with the mother's own birthweight, smoking, or physical activity. We conclude that umbilical venous leptin predicts both the size of the neonatal skeleton and its estimated volumetric mineral density. In addition, among previously documented maternal determinants of neonatal bone mass in healthy pregnancies, maternal fat stores may mediate their effect on fetal bone accrual through variation in fetal leptin concentrations. PMID:15864467

  20. IgG4-Related Disease Combined with Autoimmune Hemolytic Anemia and Steroid-Responsive Transient Hypercalcemia

    OpenAIRE

    Sho Hasegawa; Sohtaro Mine; Shotaro Hagiwara

    2015-01-01

    A 67-year-old man with elevated serum immunoglobulin G4 (IgG4) levels, systemic lymphadenopathy infiltrated by IgG4-positive plasma cells, and Coombs-positive autoimmune hemolytic anemia (AIHA) showed marked hypercalcemia. Although the intact parathyroid hormone (PTH) level was elevated, 99mTc-MIBI scintigraphy and thyroid ultrasonography revealed no evidence of primary hyperparathyroidism. Liver biopsy showed marked infiltration of IgG4-positive plasma cells, which confirmed the diagnosis of...

  1. Memory in the neonate brain.

    Directory of Open Access Journals (Sweden)

    Silvia Benavides-Varela

    Full Text Available BACKGROUND: The capacity to memorize speech sounds is crucial for language acquisition. Newborn human infants can discriminate phonetic contrasts and extract rhythm, prosodic information, and simple regularities from speech. Yet, there is scarce evidence that infants can recognize common words from the surrounding language before four months of age. METHODOLOGY/PRINCIPAL FINDINGS: We studied one hundred and twelve 1-5 day-old infants, using functional near-infrared spectroscopy (fNIRS. We found that newborns tested with a novel bisyllabic word show greater hemodynamic brain response than newborns tested with a familiar bisyllabic word. We showed that newborns recognize the familiar word after two minutes of silence or after hearing music, but not after hearing a different word. CONCLUSIONS/SIGNIFICANCE: The data show that retroactive interference is an important cause of forgetting in the early stages of language acquisition. Moreover, because neonates forget words in the presence of some--but not all--sounds, the results indicate that the interference phenomenon that causes forgetting is selective.

  2. How to manage neonatal tuberculosis.

    Science.gov (United States)

    Di Comite, A; Esposito, S; Villani, A; Stronati, M

    2016-02-01

    This article reports the recommendations for managing neonatal tuberculosis (TB) drawn up by a group of Italian scientific societies. The Consensus Conference method was used, and relevant publications in English were identified through a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception until 31 December 2014. Group experts concluded that if suspicion is aroused, it is necessary to undertake promptly all of the investigations useful for identifying the disease not only in the newborn, but also in the mother and family contacts because a diagnosis of TB in the family nucleus can guide its diagnosis and treatment in the newborn. If the suspicion is confirmed, empirical treatment should be started. Breast-fed newborns being treated with isoniazid should be given pyridoxine supplementation at a dose of 1 mg kg(-1) day(-1). Mothers with active-phase TB can breast-feed once they have become smear negative after having received appropriate treatment. PMID:26270256

  3. Advances in Neonatal Pulmonary Hypertension.

    Science.gov (United States)

    Steinhorn, Robin H

    2016-01-01

    Persistent pulmonary hypertension of the newborn (PPHN) is a surprisingly common event in the neonatal intensive care unit, and affects both term and preterm infants. Recent studies have begun to elucidate the maternal, fetal and genetic risk factors that trigger PPHN. There have been numerous therapeutic advances over the last decade. It is now appreciated that oxygen supplementation, particularly for the goal of pulmonary vasodilation, needs to be approached as a therapy that has risks and benefits. Administration of surfactant or inhaled nitric oxide (iNO) therapy at a lower acuity of illness can decrease the risk of extracorporeal membrane oxygenation/death, progression of disease and duration of hospital stay. Milrinone may have specific benefits as an 'inodilator', as prolonged exposure to iNO plus oxygen may activate phosphodiesterase (PDE) 3A. Additionally, sildenafil and hydrocortisone may benefit infants exposed to hyperoxia and oxidative stress. Continued investigation is likely to reveal new therapies such as citrulline and cinaciguat that will enhance NO synthase and soluble guanylate cyclase function. Continued laboratory and clinical investigation will be needed to optimize treatment and improve outcomes. PMID:27251312

  4. National neonatal weight policy survey.

    LENUS (Irish Health Repository)

    Walsh, B

    2012-02-01

    This survey was conducted to review the current practice regarding frequency of weight measurement in neonatal units in the Republic of Ireland, and whether these practices are in keeping with best practice as described in the literature. There was an 88.5% (23 of 26) response rate to this survey. 6 (26%) units had a written policy, and 16 (70%) had an unwritten agreed practice. In the Vermont Oxford Network\\'s potentially better practices daily weight measurements on newborn infants are recommended until the infant is stable and growing and then alternate day measurements The most common practices in this survey were to weigh infants on alternate days, this occurred in 9 (39%) units, and twice weekly in 6 (26%). Less than 31% of units had a separate policy for those less than 30 weeks, on assisted ventilation, or transitioning to enteral feeds. Most weigh infants on alternate days, and plot weights weekly, which is in keeping with best practice. Few units have separate policies for specific subgroups as is recommended in the limited literature. Consensus guidelines should be developed and promoted nationally.

  5. National neonatal weight policy survey.

    LENUS (Irish Health Repository)

    Walsh, B

    2009-06-01

    This survey was conducted to review the current practice regarding frequency of weight measurement in neonatal units in the Republic of Ireland, and whether these practices are in keeping with best practice as described in the literature. There was an 88.5% (23 of 26) response rate to this survey. 6 (26%) units had a written policy, and 16 (70%) had an unwritten agreed practice. In the Vermont Oxford Network\\'s potentially better practices daily weight measurements on newborn infants are recommended until the infant is stable and growing and then alternate day measurements The most common practices in this survey were to weigh infants on alternate days, this occurred in 9 (39%) units, and twice weekly in 6 (26%). Less than 31% of units had a separate policy for those less than 30 weeks, on assisted ventilation, or transitioning to enteral feeds. Most weigh infants on alternate days, and plot weights weekly, which is in keeping with best practice. Few units have separate policies for specific subgroups as is recommended in the limited literature. Consensus guidelines should be developed and promoted nationally.

  6. Serum Concentrations of IgG4 in the Spanish Adult Population: Relationship with Age, Gender, and Atopy

    OpenAIRE

    Carballo, Iago; Alvela, Lucía; Pérez, Luis-Fernando; Gude, Francisco; Vidal, Carmen; Alonso, Manuela; Sopeña, Bernardo; Gonzalez-Quintela, Arturo

    2016-01-01

    Background and Aim Serum IgG4 concentrations are commonly measured in clinical practice. The aim of this study was to investigate serum IgG4 concentrations in adults and their potential relationship with demographic, lifestyle, metabolic, and allergy-related factors. Methods Serum IgG4 concentrations were measured with a commercial assay in 413 individuals (median age 55 years, 45% males) who were randomly selected from a general adult population. Results Median IgG4 concentration was 26.8 mg...

  7. The distribution of IgG subclass deposition on renal tissues from patients with anti-glomerular basement membrane disease

    OpenAIRE

    QU, ZHEN; Cui, Zhao; Liu, Gang; Zhao, Ming-Hui

    2013-01-01

    Background Renal injury of anti-glomerular basement membrane (GBM) disease is defined by the linear deposition of IgG along GBM and rapidly progressive glomerulonephritis. To date, the distribution of anti-GBM IgG subclasses on renal tissue is still unclear. In the current study, we investigated the deposition of the four IgG subclasses using immunohistochemistry in the renal biopsy specimens from 46 patients with anti-GBM disease. Results All four IgG subclasses can be detected within the GB...

  8. Etablierung und Evaluierung zweier IgG Subklassen-ELISA für die Borreliose-Diagnostik beim Menschen

    OpenAIRE

    Zebandt, Silke

    2001-01-01

    Es wurde in dieser Studie ein neues diagnostisches Verfahren in Form zweier borrelienspezifischer IgG1-und IgG3-Subklassen-ELISA (Antigen: Borrelienstamm Pko) und deren Auswertung etabliert, um durch mögliche Unterschiede in dem IgG1- und IgG3-Subklassenverhältnis in Bezug zur klinischen Symptomatik einen neuen diagnostischen Parameter zu finden. Dabei wurden untere Nachweisgrenzen für die beiden ELISA festgelegt, mit Hilfe derer eine Differenzierung der seronegativen und seropositiv...

  9. The many faces of Merlin: IgG4-associated pulmonary-renal disease.

    Science.gov (United States)

    Sprangers, Ben; Lioen, Pieter; Meijers, Björn; Lerut, Evelyne; Meersschaert, Joke; Blockmans, Daniel; Claes, Kathleen

    2011-09-01

    Pulmonary-renal syndrome is a common and serious disorder with a broad differential diagnosis. We describe a case of a middle-aged man presenting with interstitial pulmonary disease and severe renal impairment caused by a hypocomplementemic immune-complex-mediated interstitial nephritis. Serum levels of IgG4 were elevated, and renal biopsy specimens revealed the presence of interstitial IgG4(+) plasma cells. There was a rapid improvement of both pulmonary and renal abnormalities after the initiation of corticosteroids. To our knowledge, this report is the first to show interstitial pulmonary disease in association with interstitial kidney disease as the predominant and presenting symptoms of IgG4-related disease. PMID:21896524

  10. Homogeneous Detection of Human IgG by Gold Nanoparticle Probes

    Institute of Scientific and Technical Information of China (English)

    CAO Qihua; YUAN Hong; CAI Ruxiu

    2009-01-01

    A simple,and homogeneous detection system for human IgG based on the optical properties of aggregated gold nanoparticles probes were investigated.When gold nanoparticles with about 13 nm in diameter were modified by goat anti-human IgG,the addition of human IgG could change the absorption of colloidal gold solution,and the absorption intensity at 740 nm depended on the amount of human IgG.The aggregation of gold nanoparticles was also validated using transmission electron microscopy(TEM).A series of experiments were carried out to study the effects of pH value, the reaction temperature,and non-specific adsorption on the assay.A dynamic range of 10-500μg/~3 mL human IgG was observed.The new bioassay could be used for the rapid and ho-mogeneous detection of antibodies in bioanalytical chemistry.

  11. Autoimmune pancreatitis metachronously associated with retroperitoneal fibrosis with IgG4-positive plasma cell infiltration

    Institute of Scientific and Technical Information of China (English)

    Terumi Kamisawa; Pong Yui Chen; Yuyang Tu; Hitoshi Nakajima; Naoto Egawa

    2006-01-01

    Retroperitoneal fibrosis is an uncommon disorder characterized by the formation of a dense plaque of fibrous tissue in the retroperitoneum, and its etiology remains unknown. Autoimmune pancreatitis is a rare type of chronic pancreatitis characterized by fibrosis with abundant infiltration of IgG4-positive plasma cells and lymphocytes and obliterative phlebitis in the pancreas. We present a case of autoimmune pancreatitis that developed 10 mo after the occurrence of retroperitoneal fibrosis. Histological findings of the resected retroperitoneal mass were marked periureteral fibrosis with abundant infiltration of IgG4-positive plasma cells and lymphocytes and obliterative phlebitis.These findings suggest a common pathophysiological mechanism for retroperitoneal fibrosis and autoimmune pancreatitis in this case. Some cases of retroperitoneal fibrosis might be a retroperitoneal lesion of IgG4-related sclerosing disease.

  12. Voltage-driven translocation behaviors of IgG molecule through nanopore arrays

    Science.gov (United States)

    Liu, Lei; Wang, Bing; Sha, Jingjie; Yang, Yue; Hou, Yaozong; Ni, Zhonghua; Chen, Yunfei

    2013-05-01

    Nanopore-based biosensing has attracted more and more interests in the past years, which is also regarded as an emerging field with major impact on bio-analysis and fundamental understanding of nanoscale interactions down to single-molecule level. In this work, the voltage-driven translocation properties of goat antibody to human immunoglobulin G (IgG) are investigated using nanopore arrays in polycarbonate membranes. Obviously, the background ionic currents are modulated by IgG molecules for their physical place-holding effect. However, the detected ionic currents do `not' continuously decrease as conceived; the currents first decrease, then increase, and finally stabilize with increasing IgG concentration. To understand this phenomenon, a simplified model is suggested, and the calculated results contribute to the understanding of the abnormal phenomenon in the actual ionic current changing tendency.

  13. Comparison of Salivary Anti Helicobacter pylori IgG with Serum IgG and Bacteriological Tests in Detecting Helicobacter pylori Infections

    OpenAIRE

    H Ghasemian safaei; Fazeli, A.; H Tamizifar; Rashidi, N.(Department of Physics, Faculty of Basic Sciences, University of Mazandaran, P.O. Box 47416-1467, Babolsar, Iran)

    2005-01-01

    Background: This study was conducted to compare the efficacy of enzyme-linked immunosorbent assay (ELISA) for detecting anti-Helicobacter pylori (H. pylori) specific IgG antibodies in specimens of oral fluid and serum with bacteriological tests. Methods: Antral biopsy specimens, as well as serum and oral fluid samples were collected from 97 patients who underwent upper gastrointestinal endoscopy. The presence or absence of current H. pylori infection was determined by culture, ...

  14. Hypernatremic Dehydration in Term and Preterm Neonates

    Directory of Open Access Journals (Sweden)

    K. Kamrani

    2015-10-01

    Full Text Available Introduction & Objective: Hypernatremia is associated with serious complications in infants. Given the high morbidity and mortality of neonatal hypernatremia, and since some complica-tions can be prevented, this study was aimed to examine the prevalence of hypernatremia in hospitalized infants and related risk factors. Materials & Methods: This cross-sectional study was performed on 1923 neonates hospitalized in Bahrami Hospital affiliated to Tehran University from October 2011 to October 2012. Demographic data , ward ,gender ,mode of feeding ,gravidity, admission season and method of delivery related to the infants were recorded. For infants with a serum sodium above 150 meq/lit, additional information were collected, including serum urea level, gestational age, date of birth, birth weight, admission weight, head circumference and clinical symptoms. Fi-nally, the data were analyzed using the SPSS software. Results: 74 out of 1923 neonates had serum sodium above 150 meq per liter, which their mean Na was significantly associated with their age groups (P=0.04 and weight loss (P=0.008. Furthermore, the mean of urea in these neonates was significantly related to weight loss (P a few days after birth or to the non-exact weight at the birth time (risk factors. The study results confirmed that weighing the neonates at 72 to 96 hours after birth can prevent hypernatremia in infants. (Sci J Hamadan Univ Med Sci 2015; 22 (3: 203-209

  15. High Serum IgG4 Concentrations in Patients with Hashimoto's Thyroiditis.

    Science.gov (United States)

    Popławska-Kita, Anna; Kościuszko-Zdrodowska, Maria; Siewko, Katarzyna; Telejko, Beata; Hryniewicka, Justyna; Milewski, Robert; Abdelrazek, Saeid Soleman; Szelachowska, Małgorzata; Górska, Maria

    2015-01-01

    Purpose. Since recent reports suggest that Hashimoto thyroiditis (HT) may be associated with IgG4-related disease, we aimed to find out whether the measurement of serum IgG4 allows for the identification of distinct types of HT, with different clinical, sonographic, and serologic characteristics. Methods. The group studied consisted of 53 patients with HT and 28 healthy individuals who underwent thyroid ultrasonography and body composition analysis. Serum concentrations of IgG4, TSH, anti-peroxidase antibodies (TPOAb), anti-TSH receptor antibodies, TNF-α, TGF-β1, Fas Ligand, TRAIL, and chemokines (CXCL9, CXCL11, and CXCL10) were measured by ELISA or radioimmunoassay. Results. The group with IgG4 level >135 IU/ml accounted for 32.5% of the patients. The signs of fibrosis were present in 27.0% of the high-IgG4 patients and in 9.1% of the normal-IgG4 group. The patients with elevated IgG4 required higher doses of L-thyroxine and had significantly lower level of TPOAb (P=0.02) than the non-IgG4-HT individuals and higher TNF-α level in comparison with the controls (P=0.01). Conclusions. Our results suggest that the measurement of serum IgG4 allows for an identification of patients with more rapid progression of HT, requiring higher doses of L-thyroxine. Low TPOAb level and the absence of coexisting autoimmune diseases may suggest distinct pathomechanism of this type of thyroiditis. PMID:25784936

  16. Production of double antibody for radioimmunoassay (sheep anti-rabbit IgG antiserum)

    International Nuclear Information System (INIS)

    A second antibody (sheep anti-rabbit IgG antiserum) to be used in RIAs in which the first antibody is raised in rabbits was produced. For this production, initially the IgG was isolated from rabbit serum and purified by sodium sulphate precipitation followed by ion exchange chromatography on DEAE-cellulose. Four sheep were immunized with 500 u g of purified rabbit IgG, emulsified in Freund Complete Adjuvant and administered by multisite subcutaneous injections. These injections were repeated at 20-days intervals and blood samples (40 ml) were taken from the jugular vein 10 days after the boosts for the evaluation of the antisera title. After each four boosts a great bleeding was done by the same route. Approximately 500 ml of serum were obtained in each bleeding per animal. The antisera were evaluated by the human thyrotropin RIA developed at IPEN laboratories employing reagents provided by NIDDKD, USA. These evaluations referred to the determination of the antisera title and of the ideal concentration of carrier IgG, to the study of the kinetic of precipitation and to the confirmation of the inexistent cross-reactivity with human IgG, in comparison with a reference antiserum of know precipitation characteristics supplied by the Radioassay System Laboratories. Approximately 3,6 l of antiserum (sheep anti-rabbit IgG serum) were produced from the four sheep, which presented title and precipitation characteristics very similar to those exhibited by the imported commercial product, even presenting higher titles. The results obtained in this work indicated that it was created enough experience for the production of this biological reagent for RIA, that could be done integrally in the country in greater scale, and at a very reduced cost. (author). 81 refs, 36 figs, 33 tabs

  17. Profiling IgG N-glycans as potential biomarker of chronological and biological ages

    Science.gov (United States)

    Yu, Xinwei; Wang, Youxin; Kristic, Jasminka; Dong, Jing; Chu, Xi; Ge, Siqi; Wang, Hao; Fang, Honghong; Gao, Qing; Liu, Di; Zhao, Zhongyao; Peng, Hongli; Pucic Bakovic, Maja; Wu, Lijuan; Song, Manshu; Rudan, Igor; Campbell, Harry; Lauc, Gordan; Wang, Wei

    2016-01-01

    Abstract As an important post-translation modifying process, glycosylation significantly affects the structure and function of immunoglobulin G (IgG) molecules and is essential in many steps of the inflammatory cascade. Studies have demonstrated the potential of using glycosylation features of IgG as a component of predictive biomarkers for chronological age in several European populations, whereas no study has been reported in Chinese. Herein, we report various patterns of changes in IgG glycosylation associated with age by analyzing IgG glycosylation in 701 community-based Han Chinese (244 males, 457 females; 23–68 years old). Eleven IgG glycans, including FA2B, A2G1, FA2[6]G1, FA2[3]G1, FA2[6]BG1, FA2[3]BG1, A2G2, A2BG2, FA2G2, FA2G2S1, and FA2G2S2, change considerably with age and specific combinations of these glycan features can explain 23.3% to 45.4% of the variance in chronological age in this population. This indicates that these combinations of glycan features provide more predictive information than other single markers of biological age such as telomere length. In addition, the clinical traits such as fasting plasma glucose and aspartate aminotransferase associated with biological age are strongly correlated with the combined glycan features. We conclude that IgG glycosylation appears to correlate with both chronological and biological ages, and thus its possible role in the aging process merits further study. PMID:27428197

  18. Extraction of monoclonal antibodies (IgG1) using anionic and anionic/nonionic reverse micelles.

    Science.gov (United States)

    George, Daliya A; Stuckey, David C

    2010-01-01

    Purification schemes for antibody production based on affinity chromatography are trying to keep pace with increases in cell culture expression levels and many current research initiatives are focused on finding alternatives to chromatography for the purification of Monoclonal antibodies (MAbs). In this article, we have investigated an alternative separation technique based on liquid-liquid extraction called the reverse micellar extraction. We extracted MAb (IgG1) using reverse micelles of an anionic surfactant, sodium bis 2-ethyl-hexyl sulfosuccinate (AOT) and a combination of anionic (AOT) and nonionic surfactants (Brij-30, Tween-85, Span-85) using isooctane as the solvent system. The extraction efficiency of IgG1 was studied by varying parameters, such as pH of the aqueous phase, cation concentration, and type and surfactant concentration. Using the AOT/Isooctane reverse micellar system, we could achieve good overall extraction of IgG1 (between 80 and 90%), but only 30% of the bioactivity of IgG1 could be recovered at the end of the extraction by using its binding to affinity chromatography columns as a surrogate measure of activity. As anionic surfactants were suspected as being one of the reasons for the reduced activity, we decided to combine a nonionic surfactant with an anionic surfactant and then study its effect on the extraction efficiency and bioactivity. The best results were obtained using an AOT/Brij-30/Isooctane reverse micellar system, which gave an overall extraction above 90 and 59% overall activity recovery. An AOT/Tween-85/Isooctane reverse micellar system gave an overall extraction of between 75 and 80% and overall activity recovery of around 40-45%. The results showed that the activity recovery of IgG1 can be significantly enhanced using different surfactant combination systems, and if the recovery of IgG1 can be further enhanced, the technique shows considerable promise for the downstream purification of MAbs. PMID:20665658

  19. Overlapping IgG4 Responses to Self- and Environmental Antigens in Endemic Pemphigus Foliaceus.

    Science.gov (United States)

    Qian, Ye; Jeong, Joseph S; Ye, Jian; Dang, Bim; Abdeladhim, Maha; Aoki, Valeria; Hans-Filhio, Gunter; Rivitti, Evandro A; Valenzuela, Jesus G; Diaz, Luis A

    2016-03-01

    The etiology of human autoimmune diseases in general remains largely unknown, although the genetic and environmental interplay may be relevant. This applies to the autoimmune diseases of the skin such as the pemphigus phenotypes and others. In this group, there is an endemic form of pemphigus foliaceus (also known as fogo selvagem [FS]) in which the pathogenic IgG4 autoantibody response to the self-antigen desmoglein 1 (Dsg1) cross-reacts with the LJM11 sand fly salivary gland Ag. In this investigation, we dissected the IgG4 autoantibody repertoires used by FS patients in response to endogenous self-Dsg1 and exogenous LJM11 sand fly Ag. Based on analyses of the genetic clonal signatures of these Abs, our results indicate that there is a significant overlap between these two responses, as all identified IgG4 mAbs cross-react to both Dsg1 and LJM11 Ags. Germline H- and L-chain V gene Abs generated according to mutated cross-reactive mAbs preserved their reactivity to both Ags. Our findings suggest that both Dsg1 autoantigen and LJM11 environmental Ag could be the initial antigenic stimulants for the IgG4 autoimmune responses in FS. These results support our hypothesis that LJM11 Ag plays a substantial role in triggering the IgG4 autoantibody development in FS and provide new insights on how noninfectious environmental Ag(s) may drive the generation of autoantibodies in IgG4-related autoimmune diseases. PMID:26826247

  20. Short-acting sulfonamides near term and neonatal jaundice

    DEFF Research Database (Denmark)

    Klarskov, Pia; Andersen, Jon Trærup; Jimenez-Solem, Espen; Torp-Pedersen, Christian; Poulsen, Henrik E

    2013-01-01

    To investigate the association between maternal use of sulfamethizole near term and the risk of neonatal jaundice.......To investigate the association between maternal use of sulfamethizole near term and the risk of neonatal jaundice....

  1. IgG1 and IgG4 antibody responses to the Anopheles gambiae salivary protein gSG6 in the sympatric ethnic groups Mossi and Fulani in a malaria hyperhendemic area of Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Cinzia Rizzo

    Full Text Available Human antibody response to the Anopheles gambiae salivary protein gSG6 has recently emerged as a potentially useful tool for malaria epidemiological studies and for the evaluation of vector control interventions. However, the current understanding of the host immune response to mosquito salivary proteins and of the possible crosstalk with early response to Plasmodium parasites is still very limited. We report here the analysis of IgG1 and IgG4 subclasses among anti-gSG6 IgG responders belonging to Mossi and Fulani from Burkina Faso, two ethnic groups which are known for their differential humoral response to parasite antigens and for their different susceptibility to malaria. The IgG1 antibody response against the gSG6 protein was comparable in the two groups. On the contrary, IgG4 titers were significantly higher in the Fulani where, in addition, anti-gSG6 IgG4 antibodies appeared in younger children and the ratio IgG4/IgG1 stayed relatively stable throughout adulthood. Both gSG6-specific IgG1 and IgG4 antibodies showed a tendency to decrease with age whereas, as expected, the IgG response to the Plasmodium circumsporozoite protein (CSP exhibited an opposite trend in the same individuals. These observations are in line with the idea that the An. gambiae gSG6 salivary protein induces immune tolerance, especially after intense and prolonged exposure as is the case for the area under study, suggesting that gSG6 may trigger in exposed individuals a Th2-oriented immune response.

  2. An Overlapping Case of Lupus Nephritis and IgG4-Related Kidney Disease

    OpenAIRE

    Zaarour, Mazen; Weerasinghe, Chanudi; Eter, Ahmad; El-Sayegh, Suzanne; El-Charabaty, Elie

    2015-01-01

    We report a case of a 71-year-old Filipino female who was admitted to the hospital for abdominal pain, vomiting and diarrhea of 8 days duration. The patient was found to have marked acute kidney injury (AKI), which required hemodialysis in the next 3 days. Extensive workup revealed hematuria, subnephrotic range proteinuria, elevated anti-nuclear antibody (ANA) and elevated total immunoglobulin G (IgG) levels, with normal IgG4 and anti-dsDNA levels. On kidney biopsy, mild membranous glomerulon...

  3. Elevated Serum IgG4 Defines Specific Clinical Phenotype of Rheumatoid Arthritis

    OpenAIRE

    2014-01-01

    Objectives. To explore the correlation of serum IgG4 (sIgG4) with clinical manifestations or therapeutic response in rheumatoid arthritis (RA). Methods. Consecutive 136 RA patients were recruited and followed up at regular interval. SIgG4 was detected by immunonephelometry. Serial synovial tissue sections from 46 RA patients were stained immunohistochemically for IgG4. Results. Forty-six percent of 136 RA patients had elevated sIgG4. Patients with elevated sIgG4 had higher sIgG4/sIgG ratio, C...

  4. Significantly lower anti-Leishmania IgG responses in Sudanese versus Indian visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Tapan Bhattacharyya

    2014-02-01

    Full Text Available BACKGROUND: Visceral leishmaniasis (VL, a widely distributed systemic disease caused by infection with the Leishmania donovani complex (L. donovani and L. infantum, is almost always fatal if symptomatic and untreated. A rapid point-of-care diagnostic test for anti-Leishmania antibodies, the rK39-immunochromatographic test (rK39-ICT, has high sensitivity and specificity in South Asia but is less sensitive in East Africa. One of the underlying reasons may be continent-specific molecular diversity in the rK39 antigen within the L. donovani complex. However, a second reason may be differences in specific IgG anti-Leishmania levels in patients from different geographical regions, either due to variable antigenicity or immunological response. METHODOLOGY/PRINCIPAL FINDINGS: We determined IgG titres of Indian and Sudanese VL patients against whole cell lysates of Indian and Sudanese L. donovani strains. Indian VL patients had significantly higher IgG titres against both L. donovani strains compared to Sudanese VL patients (p<0.0001. Mean reciprocal log10 50% end-point titres (1/log10t50 were i 3.80 and 3.88 for Indian plasma and ii 2.13 and 2.09 for Sudanese plasma against Indian and Sudanese antigen respectively (p<0.0001. Overall, the Indian VL patients therefore showed a 46.8-61.7 -fold higher mean ELISA titre than the Sudanese VL patients. The higher IgG titres occurred in children (<16 years old and adults of either sex from India (mean 1/log10t50: 3.60-4.15 versus Sudan (mean 1/log10t50: 1.88-2.54. The greatest difference in IgG responses was between male Indian and Sudanese VL patients of ≥ 16 years old (mean 1/log10t50: 4.15 versus 1.99 = 144-fold (p<0.0001. CONCLUSIONS/SIGNIFICANCE: Anti-Leishmania IgG responses among VL patients in Sudan were significantly lower than in India; this may be due to chronic malnutrition with Zn(2+ deficiency, or variable antigenicity and capacity to generate IgG responses to Leishmania antigens. Such

  5. ADAMTS13-binding IgG are present in patients with thrombotic thrombocytopenic purpura

    OpenAIRE

    Tsai, Han-Mou; Raoufi, Mojgan; Zhou, Wenhua; Guinto, Enriqueta; Grafos, Nickolas; Ranzurmal, Safi; Greenfield, Robert S.; Rand, Jacob H.

    2006-01-01

    Functional assays are commonly used to measure the antibodies of ADAMTS13 found in patients of thrombotic thrombocytopenic purpura (TTP). In this study we used an enzyme-linked immunoassay to analyze the ADAMTS13-binding IgG levels in six groups of individuals: normal, random hospitalized patients, acute TTP,TTP after receiving plasma therapy, TTP in remission, and other types of thrombotic microangiopathy (TMA). The results showed thatADAMTS13-binding IgG levels were elevated in 100% of the ...

  6. IgG antibodies to dengue in dry blood samples in filter paper.

    OpenAIRE

    Carmen Acosta; Regla Herrera; Pedro Almenarez; Susana Vázquez

    2003-01-01

    En este trabajo se presentan los resultados de la normalización del procedimiento de detección de anticuerpos IgG contra el virus dengue en muestras de sangre colectadas sobre papel de filtro. Las muestras se obtuvieron de 216 individuos que acudieron al banco de sangre de Marianao de los cuales 25 presentaron resultados con títulos superiores a 1:40 por la técnica de Inhibición de la Hemaglutinación. En todas las muestras se determinó la presencia de anticuerpos IgG contra el virus dengue me...

  7. Turnover rate of anti-D IgG injected during pregnancy.

    OpenAIRE

    Eklund, J; M. Hermann; Kjellman, H; Pohja, P

    1982-01-01

    Anti-D IgG was injected into 15 Rh-negative women in the 28th week of gestation and into three non-pregnant women. The uptake of anti-D after the intramuscular injections was calculated by measuring the concentration of antibody in the plasma with an autoanalyser. The biological half life and the catabolic rate of anti-D IgG were calculated according to a compartmental model. The recovery in vivo of anti-D was an average 24% in the non-pregnant women and 21% in the pregnant women. The half li...

  8. Fluorescent Molecular Rotors as Dyes to Characterize Polysorbate-Containing IgG Formulations

    OpenAIRE

    Hawe, Andrea; Filipe, Vasco; Jiskoot, Wim

    2009-01-01

    Purpose The aim was to evaluate fluorescent molecular rotors (DCVJ and CCVJ), which are mainly sensitive to viscosity, for the characterization of polysorbate-containing IgG formulations and compare them to the polarity-sensitive dyes ANS, Bis-ANS and Nile Red. Methods IgG formulations with polysorbate 20 or 80 were stressed below the aggregation temperature and analyzed by steady-state and time-resolved fluorescence and by HP-SEC with UV and fluorescent dye detection (Bis-ANS and CCVJ). Furt...

  9. IgG antibodies to Aspergillus fumigatus in cystic fibrosis: a laboratory correlate of disease activity.

    OpenAIRE

    Forsyth, K D; Hohmann, A W; Martin, A J.; Bradley, J

    1988-01-01

    Serum was collected from 50 patients with cystic fibrosis, and IgG antibodies to Aspergillus fumigatus were measured by enzyme linked immunosorbent assay (ELISA). In addition, total IgE and Aspergillus specific IgE antibodies were measured in 41 of the 50. A close association was found between pulmonary function and clinical state, and IgG antibodies to Aspergillus. There was no association between pulmonary function or clinical state and IgE antibodies. It is postulated that in patients with...

  10. Micro-ELISA for the quantitation of human urinary IgG

    DEFF Research Database (Denmark)

    Fomsgaard, A; Feldt-Rasmussen, B; Deckert, M; Dinesen, B

    1987-01-01

    assay range was 5-200 micrograms/l. The relative standard deviations within and between assays were 5 and 9%, respectively. Recovery of IgG added to urine was 100-102% (n = 12), and dilution of urine was linear. The assay range allowed for the quantitation of IgG in human urine samples, covering the......When investigating glomerular changes in the early stages of diabetic renal disease, it is important to be able to estimate low concentrations of urinary immunoglobulins, as well as the albumin/immunoglobulin ratio. For this reason there is a need for highly sensitive and specific routine assays...

  11. IgG is transported across the mouse yolk sac independently of FcγRIIb

    OpenAIRE

    Mohanty, Sudhasri; Kim, Jonghan; Latha P Ganesan; Phillips, Gary S.; Hua, Keding; Jarjoura, David; Hayton, William L.; Robinson, John M.; Anderson, Clark L.

    2009-01-01

    It is generally accepted that FcRn is the major IgG transporter in human syncytiotrophoblast and the mouse yolk sac endoderm, however the finding of a different Fc receptor FcγRIIb (RIIb) in the human placental endothelium has suggested the existence of an additional IgG transporter. To test this hypothesis in the mouse, we utilized wild-type (RIIb+/+) mice and mice with a null mutation in the gene encoding RIIb (RIIb−/− mice). We found that while RIIb is expressed in the placental yolk sac v...

  12. Risk Factors for Neonatal Mortality Among Very Low Birth Weight Neonates

    Directory of Open Access Journals (Sweden)

    Fatemeh Nayeri

    2013-05-01

    Full Text Available The objective of this study is to determine risk factors causing increase in very low birth way (VLBW neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004 were studied. Two groups of neonates (living and dead were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age (P=0.02, low birth weight, lower than 1000 g (P=0.001, Apgar score <6 at 5th minutes (P=0.001, resuscitation at birth (P=0.001, respiratory distress syndrome (P=0.001 need for mechanical ventilation (P=0.001, neurological complications (P=0.001 and intraventricular hemorrhage (P=0.001. Regression analysis indicated that each 250 g weight increase up to 1250 g had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage.

  13. Tetanus toxoid immunization to reduce mortality from neonatal tetanus

    OpenAIRE

    Blencowe, Hannah; Lawn, Joy; Vandelaer, Jos; Roper, Martha; Cousens, Simon

    2010-01-01

    Background Neonatal tetanus remains an important and preventable cause of neonatal mortality globally. Large reductions in neonatal tetanus deaths have been reported following major increases in the coverage of tetanus toxoid immunization, yet the level of evidence for the mortality effect of tetanus toxoid immunization is surprisingly weak with only two trials considered in a Cochrane review. Objective To review the evidence for and estimate the effect on neonatal tetanus mortality of immuni...

  14. Neonatal maltreatment and brain development

    Directory of Open Access Journals (Sweden)

    Kadriye Yurdakök

    2014-06-01

    Full Text Available The early childhood years are a period of rapid change in the brain. During early childhood, the brain forms and refines a complex network of connections through synaptogenesis, pruning, and myelination. The development of the brain is regulated by genes, which interact profoundly with early experience. There are sensitive periods for development of certain capabilities. These refer to critical windows of time in the developmental process when certain parts of the brain may be most susceptible to particular experiences during its development. Most functions of the human brain result from a complex interplay between genetic potential and appropriately timed experiences. Early postnatal experiences play a major role in shaping the functional capacity of the neural systems responsible for mediating our cognitive, emotional, social and physiological functions. When the necessary experiences are not provided at the optimal times, these neural systems do not develop in optimal ways. Adverse environments and experiences during the neonatal period can dramatically affect the development of the hypothalamic-pituitary-adrenal axis (HPA axis that underlies adaptive behavioral responses. Early life stress programs HPA axis development and exerts profound effects on neural plasticity, with resultant long-term influences on neurobehavior. Animal studies show that not only are these neurobiological changes long lasting, but that they too can be passed on to future generations via non-genetic transmission. Olfactory, auditory, visual and tactile stimulation may serve as an important cue for brain development exerting specific effects on neuroendocrine systems regulating social and emotional behavior which may have consequences for subsequent generations of offspring. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios

  15. Fusion of the mouse IgG1 Fc domain to the VHH fragment (ARP1) enhances protection in a mouse model of rotavirus.

    Science.gov (United States)

    Günaydın, Gökçe; Yu, Shengze; Gräslund, Torbjörn; Hammarström, Lennart; Marcotte, Harold

    2016-01-01

    A variable fragment of a heavy chain antibody (VHH) directed against rotavirus, also referred to as anti-rotavirus protein 1 (ARP1), was shown to confer protection against rotavirus induced diarrhea in infant mouse model of rotavirus induced diarrhea. In this study, we have fused the mouse IgG1 Fc to ARP1 to improve the protective capacity of ARP1 by inducing an Fc-mediated effector function. We have shown that the Fc-ARP1 fusion protein confers significantly increased protection against rotavirus in a neonatal mouse model of rotavirus-induced diarrhea by reducing the prevalence, duration and severity of diarrhea and the viral load in the small intestines, suggesting that the Fc part of immunoglobulins may be engaged in Fc-mediated neutralization of rotavirus. Engineered conventional-like antibodies, by fusion of the Fc part of immunoglobulins to antigen-specific heavy-chain only VHH fragments, might be applied to novel antibody-based therapeutic approaches to enhance elimination of pathogens by activation of distinct effector signaling pathways. PMID:27439689

  16. Potentially harmful excipients in neonatal medicines

    DEFF Research Database (Denmark)

    Nellis, Georgi; Metsvaht, Tuuli; Varendi, Heili;

    2015-01-01

    OBJECTIVES: We aimed to describe administration of eight potentially harmful excipients of interest (EOI)-parabens, polysorbate 80, propylene glycol, benzoates, saccharin sodium, sorbitol, ethanol and benzalkonium chloride-to hospitalised neonates in Europe and to identify risk factors for exposure...... were recorded. EOI were found in 638 (31%) prescriptions and were administered to 456 (63%) neonates through a relatively small number of products (n=142; 27%). Parabens, found in 71 (13%) products administered to 313 (43%) neonates, were used most frequently. EOI administration varied by geographical...... region, GA and route of administration. Geographical region remained a significant determinant of the use of parabens, polysorbate 80, propylene glycol and saccharin sodium after adjustment for the potential covariates including anatomical therapeutic chemical class of the active ingredient. CONCLUSIONS...

  17. Season of birth shapes neonatal immune function

    DEFF Research Database (Denmark)

    Thysen, Anna Hammerich; Rasmussen, Morten Arendt; Kreiner-Møller, Eskil;

    2016-01-01

    Birth season has been reported to be a risk factor for several immune-mediated diseases. We hypothesized that this association is mediated by differential changes in neonatal immune phenotype and function with birth season. We sought to investigate the influence of season of birth on cord blood...... immune cell subsets and inflammatory mediators in neonatal airways. Cord blood was phenotyped for 26 different immune cell subsets, and at 1 month of age, 20 cytokines and chemokines were quantified in airway mucosal lining fluid. Multivariate partial least squares discriminant analyses were applied to...... determine whether certain immune profiles dominate by birth season, and correlations between individual cord blood immune cells and early airway immune mediators were defined. We found a birth season-related fluctuation in neonatal immune cell subsets and in early-life airway mucosal immune function. The...

  18. Neonatal management of pregnancy complicated by diabetes.

    Science.gov (United States)

    Mohsin, Fauzia; Khan, Shareen; Baki, Md Abdul; Zabeen, Bedowra; Azad, Kiswhar

    2016-09-01

    Women with diabetes in pregnancy, either pre-gestational Diabetes Mellitus (Type 1 & Type 2) or Gestational Diabetes, are at increased risk for adverse pregnancy outcomes, including preterm labour and increased foetal mortality rate. Adequate glycaemic control before and during pregnancy is crucial for improving foetal and perinatal outcomes in these babies. Perinatal and neonatal morbidities and mortality rates have declined since the development of specialized maternal, foetal, and neonatal care for women with diabetes and their offspring. However, infants of diabetic mothers are at risk for developing complications as macrosomia, hypoglycaemia, perinatal asphyxia, cardiac and respiratory problems, birth injuries and congenital malformations. In this review article we describe the neonatal management of the offspring of diabetic mothers. PMID:27582162

  19. Drug binding properties of neonatal albumin

    DEFF Research Database (Denmark)

    Brodersen, R; Honoré, B

    1989-01-01

    Neonatal and adult albumin was isolated by gel chromatography on Sephacryl S-300, from adult and umbilical cord serum, respectively. Binding of monoacetyl-diamino-diphenyl sulfone, warfarin, sulfamethizole, and diazepam was studied by means of equilibrium dialysis and the binding data were analyzed...... by the method of several acceptable fitted curves. It was found that the binding affinity to neonatal albumin is less than to adult albumin for monoacetyl-diamino-diphenyl sulfone and warfarin. Sulfamethizole binding to the neonatal protein is similarly reduced when more than one molecule of the drug...... is bound per albumin molecule, and binding of the first sulfamethizole molecule is possibly reduced as well. Diazepam binds with equal affinity to the fetal and adult proteins. Among the two main albumin drug-binding functions, for warfarin and diazepam, the former is thus compromised in the newborn...

  20. 21 CFR 880.5270 - Neonatal eye pad.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neonatal eye pad. 880.5270 Section 880.5270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... § 880.5270 Neonatal eye pad. (a) Identification. A neonatal eye pad is an opaque device used to...

  1. Motion based Segmentation of Chest and Abdomen Region of Neonates

    NARCIS (Netherlands)

    Venkitaraman, A.; Makkapati, V.V.

    2015-01-01

    Respiration rate (RR) is one of the important vital signs used for clinical monitoring of neonates in intensive care units. Due to thefragile skin of the neonates, it is preferable to have monitoring systems with minimal contact with the neonate. Recently, several methods have been proposed for con

  2. Detection of FMD virus type specific IgG1, IgG2 and IgA antibodies in milk and serum of buffaloes vaccinated with oil adjuvanted polyvalent FMD vaccine

    Directory of Open Access Journals (Sweden)

    R. Sharma

    2010-02-01

    Full Text Available The present investigation was carried out on 15 randomly selected milch buffaloes divided into three groups on the basis of lactation at an organized farm, to study the foot and mouth disease virus type specific antibodies in milk and serum following FMD vaccination. Milk and serum samples collected before vaccination i.e. 0 day and on 7, 14, 28, 42 and 56 days post vaccination, were analyzed for the detection of FMD virus specific IgG1, IgG2 and IgA antibody response by indirect double antibody sandwich ELISA. Significant FMD virus type specific antibody titres (IgG1, IgG2 and IgA were detected in milk and serum of buffaloes on different days post vaccination, though the levels of antibodies were lower in milk as compared to serum. FMD virus type specific IgG1 was found to be the predominant subclass as compared to IgG2 and IgA both in milk and serum of vaccinated buffaloes. Milk and serum IgG1, IgG2 and IgA antibody titres were positively correlated with values of regression coefficient (R as 0.506, 0.434 and 0.396, respectively.

  3. Bancroftian filariasis: the patterns of filarial-specific immunoglobulin G1 (IgG1), IgG4, and circulating antigens in an endemic community of northeastern Tanzania

    DEFF Research Database (Denmark)

    Simonsen, P E; Lemnge, M M; Msangeni, H A;

    1996-01-01

    The profile of filarial-specific immunoglobulin G1 (IgG1), IgG4, and Wuchereria bancrofti-specific circulating antigen (Og4C3) was analyzed in individuals one year of age and older in a community with high endemicity for Bancroftian filariasis. The overall microfilarial (mf) prevalence...

  4. Neonatal thyrotoxicosis caused by maternal autoimmune hyperthyroidism.

    Science.gov (United States)

    Correia, Miguel Fragata; Maria, Ana Teresa; Prado, Sara; Limbert, Catarina

    2015-01-01

    Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1-5% of infants born to women with Graves' disease (GD). In most of the cases it is due to maternal antibodies transferred from the mother into the fetal compartment, stimulating the fetal thyroid by binding thyrotropin (thyroid-stimulating hormone, TSH) receptor. We present a case of neonatal thyrotoxicosis due to maternal GD detected at 25 days of age and discuss the potential pitfalls in the diagnosis. PMID:25750228

  5. Chlamydial Pneumonitis: A Creepy Neonatal Disease

    Directory of Open Access Journals (Sweden)

    Kam Lun Hon

    2013-01-01

    Full Text Available We present a case of neonatal chlamydial pneumonitis to illustrate that a high index of suspicion is necessary to make the diagnosis so that treatment can be promptly instituted. The child was afebrile and the only symptom was a cough. The respiratory equations are calculated to understand the respiratory physiology. There was no overt abnormality with ventilation, oxygenation, compliance, resistance, or ventilation-perfusion mismatch despite radiographic abnormality. The literature is searched to review if treatment with a systemic macrolide antibiotic is needed in an otherwise asymptomatic neonate with chlamydial pneumonitis.

  6. Acute suppurative neonatal parotitis: Case report.

    LENUS (Irish Health Repository)

    Khan, Sardar U

    2012-02-01

    Neonatal suppurative parotitis is very rare. One review of the English-language literature spanning 35 years found only 32 cases. Most cases are managed conservatively with antibiotic therapy; early antibiotic treatment reduces the need for surgery. The predominant organism is Staphylococcus aureus. We report a new case of neonatal suppurative parotitis in a 3-week-old boy. The patient was diagnosed on the basis of parotid swelling, a purulent exudate from a Stensen duct, and the growth of pathogenic bacteria in culture. He responded well to 9 days of intravenous antibiotic therapy. We also discuss the microbiologic and clinical patterns of this disease.

  7. RELEASE OF TONGUE-TIE IN NEONATES

    Directory of Open Access Journals (Sweden)

    V. Raveenthiran

    2012-01-01

    Full Text Available Arguably, release of tongue tie is the oldest surgical procedure and it is perhaps older than circumcision. According to the Old Testament, the Lord released the tied tongue of Moses and made him speak well. Tongue-tie is pedantically known as ankyloglossia inferior minor. Simplicity of its treatment has earned this malady several etiological attributions such as difficulty of speech and breast feeding. All over the world, lactation consultants refer neonates for release of tongue tie as they believe it to be the cause of maternal nipple pain.Perhaps this is the only indication of tongue tie release in neonates.

  8. Is neonatal group B streptococcal infection preventable?

    LENUS (Irish Health Repository)

    Azam, M

    2011-05-01

    Early onset group B streptococcal (EOGBS) infection causes significant neonatal morbidity and mortality. We determined the incidence of EOGBS at Galway University Hospital (GUH) and examined any "missed opportunities" for preventing neonatal infection between 2004 and 2009. Our obstetric approach is risk-based. The incidence was 0.45\\/1,000 live-births; one death and one with neurological sequelae. A single mother received IAP; however we could not determine any potential for reducing cases of EOGBS by improving current IAP usage.

  9. NOMID - a neonatal syndrome of multisystem inflammation

    International Nuclear Information System (INIS)

    Neonatal onset multisystem inflammatory disease is a rare disorder first described by Lorber in 1973. An additional 29 cases have been recorded. Two patients are described here, one with a 17 year follow-up. The typical features are a rash, fever, adenopathy, hepatosplenomegaly, and a severe, deforming arthropathy predominantly affecting large joints. The most striking feature is the onset in the neonatal period. Other associated features include inflammation, chronic meningitis, anemia, and persistent leukocytosis. Most, if not all, patients develop bizarre epiphyseal radiographic findings that are virtually pathognomonic. This disease is distinct from Still disease. (orig.)

  10. Neonatal Marfan Syndrome: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Yazdan Ghandi

    2013-02-01

    Full Text Available Background: Neonatal Marfan syndrome is a rare and severe phenotype of this disease. A poor prognosis is anticipated due to the high probability of congestive heart failure, and mitral and tricuspid regurgitations with suboptimal response to medical therapy and difficulties in surgical management at an early age.Case Presentation: We presented two consecutive patients with this disease who are the first reported cases from Iran to the best of our knowledge. Unfortunately both of them died shortly after the diagnosis.Conclusion: Neonatal Marfan syndrome was reported from Iran and has a poor prognosis like the patient reported from elsewhere

  11. EVALUATION OF CARDIAC MURMURS IN NEONATES

    Directory of Open Access Journals (Sweden)

    Chakravathy

    2015-10-01

    Full Text Available BACKGROUND: Cardio vascular malformations are the most common congenital malformations. Early recognition of congenital heart disease is important in the neonatal period, as many of them may be fatal if undiagnosed. AIM : To study the epidemiology of neonatal cardiac murmurs. To identify clinical characteristics which differentiates pathological murmur from functional murmurs to assess the reliability of clinical evaluation in diagnosing congenital heart diseas e? METHODS : The study population included all neonates admitted in a Hospital in Visakhapatnam to the NICU, postnatal ward, attending pediatric OPD and were detected to have cardiac murmurs. It was a cross sectional study over a period of 16 months. A clinical diagnosis was made based on history and clinical examination. Then Chest X ray and ECG were done in symptomatic infants. Echo cardiography was done in all neonates for confirmation of diagnosis, the neonates were again examined daily till they were in hospital and during the follow up visit at 6 weeks. RESULTS : A total of 61 neonates were included and was conducted over a period of 16 months . T he incidence of cardiac murmurs among intramural neonates was 13.5 for 1000 live births. Most frequent symptom was fast breathing in 10[16.4%] cases. VSD was the most common diagnosis clinically in 19[31.47%] babies. The most frequent diagnosis was acyanotic complex congenital heart disease, Only intra mural neonates were considered for the incidence of murmurs and the incidence of cardiac murmurs among them babies was 13.5 for 1000 live in 23[37.7%] cases followed by 10[16.4%] cases each of VSD and ASD respectively. Overall in our study 73.77% [45 cases] of the murmurs were diagnosed correctly and confirmed by Echocardiography. INTERPRETATIONS & CONCLUSIONS: 1. It is possible to make clinical diagnosis in many cases of congenital heart diseases. 2. The functional murmurs could be differentiated from those arising from structural heart

  12. Gastrointestinal pathology in neonates: new imaging strategies

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, Stephanie; Donoghue, Veronica [Children' s University Hospital, Department of Radiology, Dublin 1 (Ireland)

    2010-06-15

    The mainstay of imaging of gastrointestinal (GI) pathology in infants has always been and still is the plain radiograph of the abdomen and conventional contrast studies. In this review emphasis is placed on the situations where there are new imaging strategies and alternative modalities of imaging, including US, CT, MRI and radionuclide studies. This review will deal with GI pathology in the newborn and in the older neonate. It will also refer to any new approaches to imaging GI pathology in the premature infant. Finally the review will address how antenatal diagnosis of gastrointestinal tract abnormalities has changed the imaging strategy and management of the neonate. (orig.)

  13. Inhibition of murine fibrocyte differentiation by cross-linked IgG is dependent on FcγRI.

    Science.gov (United States)

    Pilling, Darrell; Crawford, Jeffrey R; Verbeek, J Sjef; Gomer, Richard H

    2014-08-01

    Monocyte-derived, fibroblast-like cells, called fibrocytes, participate in wound-healing and the formation of fibrotic lesions. Aggregated or cross-linked IgG are key effectors in infections, autoimmune diseases, anaphylaxis, and immunotherapy. Cells, including monocytes and fibrocytes, bind IgG using FcγRs, and aggregated or cross-linked IgG inhibits fibrocyte differentiation. Mice have four different FcγRs, and which of these, if any, mediate the cross-linked IgG effect on fibrocyte differentiation is unknown. We find that in mice, deletion of FcγRI or the common signaling protein FcRγ significantly reduces the ability of cross-linked IgG or IgG2a to inhibit fibrocyte differentiation. Cells from FcγRIIb/III/IV KO mice are still sensitive to cross-linked IgG, whereas cells from FcγRI/IIb/III/IV KO mice are insensitive to cross-linked IgG. These observations suggest that IgG-mediated inhibition of fibrocyte differentiation is mediated by FcγRs, with FcγRI mediating most of the signaling. PMID:24752483

  14. The Contribution of Allergen-Specific IgG to the Development of Th2-Mediated Airway Inflammation

    Directory of Open Access Journals (Sweden)

    Jesse W. Williams

    2012-01-01

    Full Text Available In both human asthmatics and animal models of allergy, allergen-specific IgG can contribute to Th2-mediated allergic inflammation. Mouse models have elucidated an important role for IgG and Fc-gamma receptor (FcγR signaling on antigen presenting cells (APC for the induction of airway inflammation. These studies suggest a positive feedback loop between IgG produced by the adaptive B cell response and FcγR signaling on innate immune cells. Studies of IgG and FcγRs in humans with asthma or allergic lung disease have been more controversial. Some reports have identified associations between allergen-specific IgG and severity of allergic responses, while other studies have found associations of IgG subclass IgG4 with allergic tolerance. In this paper, we review the literature to help define the nature of IgG and FcγR signaling on innate immune cells and how it contributes to the development of allergic immune responses.

  15. Simultaneous use of serum IgG and IgM for risk scoring of suspected early Lyme borreliosis

    DEFF Research Database (Denmark)

    Dessau, Ram B; Ejlertsen, Tove; Hilden, Jørgen

    2010-01-01

    The laboratory diagnosis of early disseminated Lyme borreliosis (LB) rests on IgM and IgG antibodies in serum. The purpose of this study was to refine the statistical interpretation of IgM and IgG by combining the diagnostic evidence provided by the two immunoglobulins and exploiting the whole...

  16. Effects of plutonium on the immune system: IgG in beagle dogs exposed to plutonium and in nonexposed controls

    International Nuclear Information System (INIS)

    Serum IgG levels in plutonium-oxide-exposed and unexposed beagle dogs was assayed with the Mancini system. With this system, there was no significant difference between IgG levels of exposed dogs and controls, nor among exposed dogs with different degrees of lymphopenia. (U.S.)

  17. Indigenous Greenlanders have a higher sero-prevalence of IgG antibodies to Helicobacter pylori than Danes

    DEFF Research Database (Denmark)

    Milman, Nils; Byg, Keld-Erik; Andersen, Leif P; Mulvad, Gert; Pedersen, Henning Sloth; Bjerregaard, Peter

    2003-01-01

    To assess the sero-prevalence of IgG antibodies to Helicobacter pylori (H. pylori) in Greenlanders and compare with the sero-prevalence in Caucasian Danes.......To assess the sero-prevalence of IgG antibodies to Helicobacter pylori (H. pylori) in Greenlanders and compare with the sero-prevalence in Caucasian Danes....

  18. Cross-sectional Serosurvey of Crimean-Congo Hemorrhagic Fever Virus IgG in Livestock, India, 2013–2014

    Science.gov (United States)

    Yadav, Pragya D.; Shete, Anita M.; Sathe, Padmakar S.; Sarkale, Prasad C.; Pattnaik, Bramhadev; Sharma, Gaurav; Upadhyay, Kamlesh J.; Gosavi, Surekha; Patil, Deepak Y.; Chaubal, Gouri Y.; Majumdar, Triparna D.; Katoch, Vishwa M.

    2015-01-01

    We conducted a cross-sectional serosurvey of Crimean-Congo hemorrhagic fever (CCHF) among livestock in 22 states and 1 union territory of India. A total of 5,636 samples from bovines, sheep, and goats were screened for CCHF virus IgG. IgG was detected in 354 samples, indicating that this virus is widespread in this country. PMID:26402332

  19. Investigation of Hepatitis E Virus IgG Seroprevalence in Women of Reproductive Age

    Directory of Open Access Journals (Sweden)

    Erdal Özbek

    2016-03-01

    Full Text Available Objective: Hepatitis E virus (HEV infection can cause fa­tal hepatitis particularly in pregnant women. In this study, it was aimed to investigate the rate of anti HEV IgG se­roprevalence in women of childbearing age and whether there are differences in seroprevalence among people liv­ing in urban and rural areas or not. Methods: A total of 158 women volunteers aged 15-49 years living in rural or urban areas were included in this study. Anti-HEV IgG antibodies were performed with en­zyme immunoassay method. The obtained data were presented as numbers and percentages and statistically analyzed. Results: Anti-HAV IgG was detected positive in 41 of the 158 volunteers (25.9%. Anti-HEV IgG was found positive in 25 of the 92 volunteers living in urban areas (27.2% and in 16 of the 66 volunteers in rural areas (24.2%. Conclusion: In our city, HEV seroprevalence is above the average in Turkey. We think that epidemiological fac­tors should be investigated and that screening HEV serol­ogy can be useful in pregnancy monitoring. J Clin Exp Invest 2016; 7 (1: 69-72

  20. Contactin 1 IgG4 associates to chronic inflammatory demyelinating polyneuropathy with sensory ataxia

    OpenAIRE

    Miura, Yumako; Devaux, Jérôme J.; Fukami, Yuki; Manso, Constance; Belghazi, Maya; Wong, Anna Hiu Yi; Yuki, Nobuhiro

    2015-01-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is clinically heterogeneous and shows varying responses to immunotherapy. In a cohort of 533 Japanese patients with CIDP, Miura et al. identify 13 patients with IgG4 antibodies against the axonal adhesion molecule, contactin-1. Antibodies are associated with subacute onset, sensory ataxia and good response to corticosteroids.