病例报告:误导性乙肝检测, 静脉注射免疫球蛋白.

StephenW

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.

StephenW

病例报告
误导性乙肝检测的静脉注射免疫球蛋白的设定[卷;参考状态：等待同行评审， http://f1000r.es/25r ]
CHRISTELLE M Ilboudo1 ，艾琳M Guest2 ，安吉拉M Ferguson3 ，乌塔姆Garg3 ，玛丽安妮Jackson1
作者背景
格兰特信息：作者（ S）宣布任何补助参与支持这项工作。

摘要

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

静脉注射免疫球蛋白（IVIG ）是由来自3000-10,000健康献血者血浆汇集血液制品。不良事件报告于治疗患者的1-15 ％，最临床医生所知常见的事件，如输液反应，并按照IVIG输注，包括肾功能不全（美国盒装警告） ，血栓性事件，抗球蛋白更严重的反应溶血和无菌性脑膜炎syndrome1 。

由于免疫球蛋白是一种被动转移抗体，它可以导致短暂积极的抗病毒血清学试验。我们报告两例，其中筛查乙肝测试结果显示，免疫球蛋白阳性IVIG治疗促使更多的实验室测试后，一个不寻常的图案和延误治疗的孩子中的一个。基于21天的IVIG产品已知的半衰期，我们使用血清的连续测试，以确认抗体随时间退化。临床医生应该知道，抗体的被动转移，预计和血清学检查应进行预处理，如果IVIG治疗预期。