Case Report
Misleading hepatitis B testing in the setting of intravenous immunoglobulin [v1; ref status: awaiting peer review, http://f1000r.es/25r]
Christelle M Ilboudo1, Erin M Guest2, Angela M Ferguson3, Uttam Garg3, Mary Anne Jackson1
Author affiliations
Grant information: The author(s) declared that no grants were involved in supporting this work.
Abstract
Intravenous immunoglobulin (IVIG) is commonly used for a wide range of diagnoses, by multiple pediatric subspecialists. We report two cases of hepatitis B screening results post IVIG infusion, where positive anti-Hepatitis B core antigen serology tests indicated possible occult hepatitis infection, leading to a delay in care. However, serial antibody testing showed results consistent with the passive transfer of antibodies.
Corresponding author: Christelle M Ilboudo
First Published: 18 Nov 2013, 2:249 (doi: 10.12688/f1000research.2-249.v1) Latest Published: 18 Nov 2013, 2:249 (doi: 10.12688/f1000research.2-249.v1)
Introduction
Intravenous immunoglobulin (IVIG) is a blood product prepared by pooling plasma from 3000–10,000 healthy blood donors. Adverse events are reported in 1–15% of treated patients, and most clinicians are aware of common events such as infusion reactions, and more serious reactions that follow IVIG infusion including renal dysfunction (a US Boxed warning), thrombotic events, anti-globulin hemolysis, and aseptic meningitis syndrome1.
Since IVIG is a passive antibody transfer, it can result in transiently positive anti-viral serology tests. We report two cases where screening hepatitis B testing resulted in an unusual pattern of immunoglobulin positivity after IVIG therapy prompting additional laboratory testing and delayed treatment in one of the children. Based on the known half-life of IVIG products of 21 days, we used serial testing of sera to confirm degradation of antibody over time. Clinicians should be aware that passive transfer of antibodies is expected and serologic screening should be performed pre-treatment if IVIG therapy is anticipated. 作者: StephenW 时间: 2013-11-25 17:52
静脉内免疫球蛋白（IVIG ）是常用的，适用范围广的诊断，通过多种儿科专科医师。我们报告两例乙肝筛查结果IVIG治疗后输液，其中积极抗乙型肝炎核心抗原血清学试验表明可能隐匿性肝炎感染，导致护理的延迟。然而，序列的抗体测试显示出与抗体的被动转移一致的结果。
通讯作者：和Christelle M Ilboudo
首先发布时间： 2013年11月18日， 2:249 （ DOI ： 10.12688/f1000research.2-249.v1 ）最新发布： 2013年11月18日， 2:249 （ DOI ： 10.12688/f1000research.2-249.v1 ）
介绍