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Improvement of serological diagnosis of human cytomegalovirus infection in renal transplant recipients by testing for specific immunoglobulin E by ELISA

Erweiterung der serologischen Labordiagnose der Zytomegalie bei Nierentransplantationspatienten durch den Nachweis von spezifischem IgE

Summary

The kinetics of human cytomegalovirus (HCMV)-specific immunoglobulin E (IgE), M (IgM), A (IgA) and G (IgG) were studied in 421 sera obtained from 19 renal allograft recipients by enzyme-linked immunosorbent assay (ELISA). Cytomegalic inclusion disease (CID) occurred in 11 (57.9%) patients. HCMV infection was diagnosed in all (100%) of these patients by testing for specific IgE. In contrast, increased levels of IgM and IgA class antibody against HCMV were detected in only 45.5% and 18.2% patients suffering from primary or recurrent HCMV infection, respectively. Concerning the time interval between the onset of clinical symptoms and the first positive test, no significant differences in the kinetics of HCMV-specific immunoglobulins E, M, A and G were observed. Elevated specific IgE levels persisted for longer time intervals than the other immunoglobulin classes. As shown by the present study, specific IgE proved to be a more reliable serologic marker than IgM and IgA for the serologic detection of HCMV infection in renal allograft recipients.

Zusammenfassung

Der Nachweis von HCMV-spezifischem IgG, IgA, IgE und IgM wurde in 421 Verlaufsseren von 19 Nierentransplantationspatienten anhand eines Enzymimmunassays (ELISA) untersucht. Eine floride Zytomegalie wurde in 11 (57,9%) Patienten beobachtet. Bei 11 (100%) dieser Patienten gelang die Diagnose einer HCMV-Infektion durch den Nachweis von spezifischem IgE. Spezifische IgA- und IgM-Antikörper wurden nur bei 45,5% bzw. 18,2% der Patienten mit primärer oder sekundärer HCMV-Infektion nachgewiesen. Zwischen dem Auftreten der klinischen Symptome der HCMV-Infektion und dem ersten positiven IgE-, IgG-, IgM- und IgA-Antikörpernachweis wurden keine signifikanten Zeitunterschiede festgestellt. Spezifisches IgE blieb über längere Zeiträume nachweisbar als die anderen Immunglobulinklassen. Die Ergebnisse unserer Studie deuten darauf hin, daß HCMV-spezifisches IgE besser zur serologischen Diagnose der Zytomegalie bei Nierentransplantierten geeignet ist als IgM und IgA.

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Weber, B., Stemmler, A., Braun, W. et al. Improvement of serological diagnosis of human cytomegalovirus infection in renal transplant recipients by testing for specific immunoglobulin E by ELISA. Infection 21, 158–163 (1993). https://doi.org/10.1007/BF01710536

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Keywords

  • Renal Transplant Recipient
  • Human Cytomegalovirus
  • HCMV Infection
  • Renal Allograft Recipient
  • Specific Immunoglobulin