Serological tests

It is an autoantibody whose autoantigen is the Fc portion of IgG. Rheumatoid factors may be of any immunoglobulin isotype but it is IgM rheumatoid factor that is commonly measured in rheumatoid arthritis. Classification criteria for rheumatoid arthritis include only one serological test, namely rheumatoid factor. However, it is not diagnostic test rather it may be confirmatory when a number of other clinical features are present. 

Non-endoscopic testing methods include the urea breath test, serologic testing, and the stool antigen assay. Compared to endoscopic procedures, these tests are more comfortable, less expensive, and do not require a special procedure. The urea breath test is usually the first-line test to detect active... 

Office-based serologic testing provides a quick assessment (within 15 minutes) of an exposure to HP, but patients can remain seropositive for up to 1 year after eradication, making the clinical utility of this test limited. Stool antigen assays can be useful for the initial diagnosis or to confirm HP eradication, and unlike the urea breath test, are less affected by concomitant medication use.9... 

Treatment to Administer if Serology Test of Source Person Is ... 

Cenital herpes simplex virus. Characterized by vesicular or ulcerative lesions. Diagnosis confirmed by virologic or serologic testing. Prodrome manifests as pain, burning, or itching at the site where lesions will develop. 

Syphilis. Early disease may be characterized by a single genital lesion. Diagnosed by positive serologic testing [e.g., VDRL or rapid plasma reagin (RPR) test]. 

The practicing clinician has a number of different tests available to aid in the evaluation of patients with suspected hepatitis C. These include measurement of alanine aminotransferase (ALT) levels, liver biopsy, serological tests (ELISA and recombinant immunoblot assay), and molecular methods for detection and quantitation of HCV RNA. 

Trypanosomiasis gulated blood on ice (not frozen). Unfixed thick films may be sent in addition. Send serum for serologic tests. Send 5 ml of anticoagulated blood as for filariasis (above). 

Antibody serologic testing shows rising tilers over a 3- to 6-day period, but this test is not practical and is nonspecific. 

The diagnosis of acute HAV infection is based on clinical criteria of acute onset of fatigue, abdominal pain, loss of appetite, intermittent nausea and vomiting, jaundice or elevated serum aminotransferase levels, and serologic testing for immunoglobulin (Ig) G anti-HAV. 

TABLE 25-4 Interpretation of Serologic Tests in Hepatitis B Virus ... 

Persons with a positive serologic test for syphilis but with no other evidence of disease have latent syphilis. 

Because T. pallidum is difficult to culture in vitro, diagnosis is based primarily on dark-held or direct fluorescent antibody microscopic examination of serous material from a suspected syphilitic lesion or on results from serologic testing. 

Serologic tests are the mainstay in the diagnosis of syphilis and are categorized as nontreponemal or treponemal. Commonly used nontrep-onemal tests include the Venereal Disease Research Laboratory shde test, the rapid plasma reagin card test, the unheated serum regain test, and the toluidine red unheated serum test. 

Hepatomegaly, jaundice, and altered liver function tests have been reported in accidental poisonings with DME An outbreak of toxic liver disease was associated with DME exposure at a fabric coating factory. Thirty-six of 58 workers had elevations of either aspartate aminotransferase or alanine aminotransferase. Serological tests excluded known infectious causes of hepatitis in all but two cases. After modification of work practices and removal of the most severely affected from exposure, improvement in liver enzyme abnormalities and symptoms occurred in most patients. Medical surveillance of the working population for 14 months revealed no further cases of toxic liver... 

Sexually transmitted diseases When treating gonococcal infections in which primary and secondary syphilis are suspected, perform proper diagnostic procedures, including darkfield examinations and monthly serological tests for at least 4 months. Resistance The number of strains of staphylococci resistant to penicillinase-resistant penicillins has been increasing widespread use of penicillinase-resistant penicillins may result in an increasing number of resistant staphylococcal strains. 

Syphilis In the treatment of sexually transmitted disease, if concomitant syphilis is suspected, perform a darkfield examination before treatment is started. Perform monthly serologic tests for 4 months or more. 

Hopper, A. D., Hadjivassiliou, M., Hurlstone, D. P., Lobo, A. J., McAlindon, M. E., Egner, W., Wild, G., and Sanders, D. S. (2008). What is the role of serologic testing in celiac disease A prospective, biopsy-confirmed study with economic analysis. Clin. Gastroenterol. Hepatol. 6,314-320. 

Answer Peptic ulcer disease is most frequently secondary to either Helicobacter pylori infection or use of NSAIDs. The patient does admit to NSAID use (naproxen), but should also be checked for concomitant H. pylori infection at time of endoscopy or by a serology test. If the patient was found to have H. pylori, an appropriate eradication regimen should be prescribed. The patient should also be counseled to avoid NSAIDs. The patient should be prescribed a proton pump inhibitor for 8 weeks to heal the ulcer. A repeat endoscopy should be done at that time to document ulcer healing and rule out gastric cancer. In addition, the patient should be counseled to stop smoking, which is a risk factor for more severe peptic ulcer disease. 

She denied previous treatment for syphilis. She could not recall signs or symptoms of primary or secondary syphilis in the past year. She had no previous syphilis serology tests for purposes of comparison. Which of the following would be the best treatment for the patient ... 

Postexposure 5 doses (IM only) at days 0, 3, 7, 14, and 28 and serologic testing every 6 months to 2 years in persons at high risk. 

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