The sensitivity, specificity and efficiency values of some serological tests used in the diagnosis of paracoccidioidomycosis

Negro, G. Del; Garcia, Nilma Maciel; Rodrigues, Elaine G.; Cano, Maria Isabel Nogueira; Aguiar, M S M; Lírio, Vanda de Sá; Lacaz, Carlos da Silva

doi:10.1590/s0036-46651991000400006

Cited by 53 publications

(51 citation statements)

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“…However, despite its low cost and simplicity, several studies have demonstrated the occurrence of false-negative results with this method (8,10,11).…”

Section: Discussionmentioning

confidence: 99%

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Negative Immunodiffusion Test Results Obtained with Sera of Paracoccidioidomycosis Patients May Be Related to Low-Avidity Immunoglobulin G2 Antibodies Directed against Carbohydrate Epitopes

Neves

Mamoni

Rossi

et al. 2003

Clin Vaccine Immunol

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Immunodiffusion (ID) is the serologic test most frequently used for the diagnosis and posttherapy follow-up of patients with paracoccidioidomycosis (PCM). The ID test is highly specific (100%), but its sensitivity is relatively low (90%), leading to false-negative results. The aim of this study was to determine the profiles of antibodies in sera from patients with proven PCM and with negative results in the ID test (ID neg ) versus positive results in the ID test (ID pos ). We analyzed 46 sera from patients with active PCM for total immunoglobulin G (IgG) and IgG subclass responses to Paracoccidioides brasiliensis gp43 antigen (treated or not treated with sodium metaperiodate) by enzyme-linked immunosorbent assay and immunoblotting. Immunoblotting showed that both ID neg and ID pos sera recognized predominantly the gp43 fraction of the P. brasiliensis antigen used in the ID test. ID neg sera contain low-avidity antibodies, low levels of specific IgG (total) and IgG1, and high levels of IgG2 compared with ID pos sera. The antibodies present in ID neg sera were predominantly directed against carbohydrate epitopes, since treatment with sodium metaperiodate resulted in a significant decrease in antibody reactivity. These data suggest that the lack of reactivity of sera from PCM patients in the ID test may be related to the production of low-avidity IgG2 antibodies directed against carbohydrate epitopes.

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“…However, despite its low cost and simplicity, several studies have demonstrated the occurrence of false-negative results with this method (8,10,11).…”

Section: Discussionmentioning

confidence: 99%

“…The immunodiffusion (ID) test is one of the most widely used techniques due to the simplicity and low costs involved in its execution. The ID test is highly specific (about 100%), but false-negative results are not rare due to a sensitivity of 85 to 90% (8,10,11).…”

mentioning

confidence: 99%

Negative Immunodiffusion Test Results Obtained with Sera of Paracoccidioidomycosis Patients May Be Related to Low-Avidity Immunoglobulin G2 Antibodies Directed against Carbohydrate Epitopes

Neves

Mamoni

Rossi

et al. 2003

Clin Vaccine Immunol

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“…Like in ID test, the antigens used varied from laboratory to laboratory, and they are extracts from sonicated yeast cell suspensions, exocellular antigens from yeast or mycelial cultures, cell-free antigens obtained from yeast cells, and cross-reactions are due to the use of unfractionated antigens. Counter-immunoelectrophoresis is regarded as having a sensitivity equal to or slightly greater than that provided by ID [22]. Some authors related sensitivity between 77% and 97% and specificity at least 95%.…”

Section: Counter-immunoelectrophoresis (Cie)mentioning

confidence: 99%

Serology of paracoccidioidomycosis

Camargo

2008

Mycopathologia

113

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This review provides the background for understanding the role of a battery of diagnostic methods in paracoccidioidomycosis (PCM). This systemic mycosis is a disease endemic in many regions of Latin America, with sporadic cases also occurring throughout the world (mycosis of importation). Although excellent laboratory methods for diagnosis are available, there are deficiencies that must be met by continued research. Understanding the uses and limitations of a battery of laboratory methods is essential to diagnose PCM. Clinicians and laboratory directors must be familiar with the uses and limitations of a battery of serologic and mycological tests to accurately diagnose of PCM. Antibody and antigen detections are valuable adjuncts to histopathology and culture. More recently, the gp43 and gp70 antigen detection assay have improved the methodology of diagnosis of this mycosis, which improves reproducibility and facilitates monitoring antigen clearance during antifungal treatment. Furthermore, detection of antigen in cerebrospinal fluid and in bronchoalveolar lavage fluid increases the sensitivity for diagnosis of PCM in central nervous system and in pulmonary infections, respectively.

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“…Limitations of these tests include (i) cross-reactivity to other mycotic disorders, mainly histoplasmosis, and (ii) difficulties in standardization of the various tests and reagents (21,33,46,60). Hence, attempts to eliminate these problems include the examination of purified and well-characterized antigens derived from P. brasiliensis.…”

Section: Paracoccidioidomycosismentioning

confidence: 99%

Current Status of Nonculture Methods for Diagnosis of Invasive Fungal Infections

2002

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The incidence of invasive fungal infections has increased dramatically in recent decades, especially among immunocompromised patients. However, the diagnosis of these infections in a timely fashion is often very difficult. Conventional microbiologic and histopathologic approaches generally are neither sensitive nor specific, and they often do not detect invasive fungal infection until late in the course of disease. Since early diagnosis may guide appropriate treatment and prevent mortality, there has been considerable interest in developing nonculture approaches to diagnosing fungal infections. These approaches include detection of specific host immune responses to fungal antigens, detection of specific macromolecular antigens using immunologic reagents, amplification and detection of specific fungal nucleic acid sequences, and detection and quantitation of specific fungal metabolite products. This work reviews the current status and recent developments as well as problems in the design of nonculture diagnostic methods for invasive fungal infections

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The sensitivity, specificity and efficiency values of some serological tests used in the diagnosis of paracoccidioidomycosis

Cited by 53 publications

References 5 publications

Negative Immunodiffusion Test Results Obtained with Sera of Paracoccidioidomycosis Patients May Be Related to Low-Avidity Immunoglobulin G2 Antibodies Directed against Carbohydrate Epitopes

Negative Immunodiffusion Test Results Obtained with Sera of Paracoccidioidomycosis Patients May Be Related to Low-Avidity Immunoglobulin G2 Antibodies Directed against Carbohydrate Epitopes

Serology of paracoccidioidomycosis

Current Status of Nonculture Methods for Diagnosis of Invasive Fungal Infections

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