The diagnostic value of gliadin IgG, IgA and IgE antibody (AB) determinations using the fluorescent immunosorbent test was examined in 586 children with malabsorptive disorders and/or failure to thrive. All patients underwent jejunal biopsy and were on a gluten-containing diet. IgG AB were found in all patients (331/331) with untreated coeliac disease (CD) in our study, but IgA AB in only 295/331 (89%). Therefore a screening test based only on IgA AB determinations is not recommended. By contrast, 203 (80%) of 255 children with other malabsorptive disorders had no gliadin AB, 43 (16.5%) had only IgG AB and only 9 (3.5%) had IgG and IgA AB. IgE AB proved to be of no additional value as a diagnostic tool because they were found in a quarter of the children without CD. Statistical evaluation of combined IgG and IgA AB determination showed at least 96% sensitivity and a specificity of 97%. The subjective ("Bayesian") probability that an actual patient with a given AB test result has CD, is considered: a patient very probably has CD in the case of positive IgG and IgA AB, and no CD in the case of a negative AB result. In the case of negative IgA AB but positive IgG AB the physician's judgement ("prior probability") influences the ("posterior") probability of CD for an actual patient. In contrast to IgG AB, IgA AB decline rapidly after the introduction of a gluten-free diet and may be used for diet control after diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Nasopharyngeal aspirates and nasopharyngeal swabs from 177 children exhibiting mild to severe clinical symptoms of whooping cough were tested by the polymerase chain reaction (PCR) and culture for the presence of Bordetella pertussis. In the PCR analysis amplifications of samples prepared with and without DNA extraction were compared. In 26% of samples prepared without DNA extraction, the PCR was found to be inhibited, whereas no inhibition was detected after DNA extraction. Twelve percent (21/177) of the samples were positive in both culture and the PCR, and an additional 49% (87/177) of the samples were positive exclusively in the PCR. Thirty-eight percent (8/21) of culture-positive patients and 63% (55/87) of the patients in whom infection was detected only by PCR had mild or atypical clinical symptoms. Of these groups 26% (5/19) and 50% (39/78), respectively, had been fully vaccinated with three or more doses of diphtheria, tetanus and pertussis vaccine.

Humoral antibodies and specific cellular immune reactions (proliferative immune response in the lymphocyte transformation test) to varicella-zoster virus antigen were measured in children, young adults, and elderly people. In children and young adults, the humoral varicella-zoster-specific antibodies and the virusspecific cellular immune response generally coincided. In the over-60 age group, however, a discrepancy was often observed between these parameters. Ninety percent of the elderly subjects showed humoral antibodies, but only 64% still had a measurable varicella-zoster-specific immune response. There was no correlation between the magnitude of the virus antigen-specific immune response and the mitogen-induced lymphoproliferative response (phytohemagglutinin stimulation). One in three elderly people, therefore, showed no cellular immune response to the varicella-zoster virus antigen, and this person could probably be regarded as a potential herpes zoster patient. out essentially by the method of Pellegrino et al. (13). Briefly, heparinized whole blood was diluted 1:20 with RPMI 1640 culture medium containing glutamine and supplemented with 10% fetal calf serum, penicillin (100 U/ml), and streptomycin (100 yg/ml). Ten 0.1-ml sam-24

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