Nervous system immunology test

Neurological immunological tests, including clinical serological tests and immunological tests, are highly diagnostic for neurological infectious diseases. [Differential diagnosis] In various cases of acute purulent inflammation, bacteremia, tissue necrosis, etc., CRP can be increased, which is earlier and more obvious than the acute phase reaction substance, which is helpful for early diagnosis. CRP also has a reference value for the identification of bacterial or viral inflammation. The former is mostly strongly negative, and the latter is mostly positive. The CRP test for cerebrospinal fluid helps identify bacterial and non-bacterial meningitis. Basic Information Specialist classification: neurological examination classification: immune examination Applicable gender: whether men and women apply fasting: not fasting Tips: Patients should avoid strenuous exercise such as walking, running, etc., and should sit for more than half an hour before collecting specimens. Normal value First, serum C-reactive protein (CRP) determination of normal human reaction negative or low titer. Second, the blood virus-specific antibody test negative or low titer in normal people. 3. Anti-Ach receptor antibodies in blood and cerebrospinal fluid were measured as normal human negative reactions. Fourth, cerebrospinal fluid purulent meningitis pathogenic antigen antibody determination of normal human negative reaction. 5. Cerebrospinal fluid tuberculosis immunoassay is normal for humans. 6. Blood and cerebrospinal fluid syphilis immunoassay is normal for normal people. Seven, cerebrospinal fluid gamma globulin and immunoglobulin determination: Gamma globulin accounts for 4-13% of cerebrospinal fluid protein quantitation IgA0 ~ 6mg / L. IgG 10 ~ 40mg / L. IgM0 ~ 13mg / L. Clinical significance Abnormal results: 1. Determination of serum C-reactive protein (CRP) In various cases of acute purulent inflammation, bacteremia, tissue necrosis, etc., CRP can be increased, which is earlier and more obvious than its acute reaction phase substance. Early diagnosis. CRP also has a reference value for the identification of bacterial or viral inflammation. The former is mostly strongly negative, and the latter is mostly positive. The CRP test for cerebrospinal fluid helps identify bacterial and non-bacterial meningitis. Second, blood virus specific antibody detection (1) Acute anterior poliomyelitis (acutepoliomyelitis) poliovirus antibody peaked in the early stage of sputum. If you can compare the two serum specific antibody titers in the early stage of infection and after 3 to 4 weeks, those who increase the latter by more than 4 times have diagnostic significance. (2) Epidemic encephalitis (epidemicencephalitis B) The routine complement test for JE, the positive reaction appears later, peaks after 4 weeks of onset, and the value is greater than 4:1. The test is only used as a diagnostic value. Retrospective diagnosis or epidemiological studies of methods of latent infection. Hemagglutination inhibition test. The detection of IgM antibodies in serum or cerebrospinal fluid by the monoclonal antibody of Japanese encephalitis virus is more sensitive and specific. (C) forest encephalitis (forestencephalitis) serum test take the acute phase of the patient and the recovery of the double serum, hemagglutination inhibition test, neutralization test, complement binding test and enzyme-linked immunosorbent assay, such as antibody titer increased 4 times Above, there is diagnostic value. (d) High titer of measles virus antibodies in serum and cerebrospinal fluid of subacutes sclerosing panencephalitis. (5) The titer of anti-Rubella antibody in blood and cerebrospinal fluid of progestsive rubella virus panic-cephalitis was significantly increased. Third, blood and cerebrospinal fluid anti-Ach receptor antibody determination myastheniagravis (myastheniagravis): more than 80% of cases of serum anti-Ach receptor antibody positive. Some cases were positive for anti-Ach receptor antibodies in cerebrospinal fluid. Fourth, cerebrospinal fluid purulent meningitis pathogenic antigen antibody determination purulent meningitis (purulentmeningitis) immunofluorescent antibody staining, convective immunoelectrophoresis determination of antigen, latex agglutination test, radioimmunoassay and enzyme-linked immunosorbent assay (ELISA) to help rapid diagnosis . V. Cerebrospinal fluid tuberculosis immunoassay Tuberculous meningitis (tubercular meningitis) cerebrospinal fluid sodium test is almost all positive, with reliable early diagnosis value. Sixth, blood and cerebrospinal fluid syphilis immunoassay nerveyphilis including syphilitic myelitis, spinal cord hernia, syphilitic meningitis, paralytic dementia, serum and cerebrospinal fluid syphilis serotonin flocculating test (VDRL) Treponema fluorescein antibody The adsorption test (FTA-ABS) and the immunolocalization test (TPItESt) were positive. The positive rate of various tests for advanced neurosyphilis was 65% for VDRL, 90% for TPItest, and 95% for FTA-ABS. Seven, cerebrospinal fluid gamma globulin and immunoglobulin determination (1) Multiple sclerosis (90%) has increased gamma globulin content. It can be seen that when the total protein content of CSF is normal, most of them are IgG, and occasionally IgM and IgA are elevated. 85% to 95% of patients with clinically confirmed multiple sclerosis, IgG oligoclonal bands can be detected in CSF, and sometimes IgA and IgM oligoclonal bands are not found in serum, and are not specific to this disease. (B) chronic infective demyelinating multiple nerve root neuralgia (chronicinfetiousdemyelinatedpolyradiculoneuropathy) neurosyphilis (nervesyphilis) cerebrospinal fluid gamma globulin increased. A small number of chronic infections of demyelinating multiple radiculopathy have cerebrospinal fluid gamma globulin higher than 160mg / L. (C) progressive rubella viral encephalitis (progressive rubella viral epidecephalitis) acute disseminated cerebrospinal fluid (acutedisseminated encephalomyelitis) patients with elevated IgG in the cerebrospinal fluid, and may have IgG oligoclonal bands. People in need of examination: patients with acute spinal anterior polio, myasthenia gravis, epidemic encephalitis, and purulent meningitis. Precautions Taboo before inspection: 1, aspirin, dipyridamole, heparin, warfarin and other drugs can inhibit platelet aggregation, so should not take such drugs for a period of time before blood collection. 2, patients should avoid strenuous exercise, running and other strenuous exercise, and should sit for more than half an hour before collecting specimens. Requirements for inspection: 1, cerebrospinal fluid cell count should be carried out in time, generally should be carried out within 1 hour. If placed for too long, the cells will break or precipitate and fibrin aggregate, resulting in inaccurate counting. Specimens should be mixed before counting, otherwise the results will be affected. 2, if the vertigo induced by hypoglycemia, you can immediately intravenous glucose or sputum patients can take oral sugar. Inspection process I. Determination of serum C-reactive protein (CRP) [Differential diagnosis in various acute suppurative inflammation, bacteremia, tissue necrosis, etc., CRP can increase, compared with its acute reaction phase substances appear early, and more obvious, it is helpful for early diagnosis. CRP also has a reference value for the identification of bacterial or viral inflammation. The former is mostly strongly negative, and the latter is mostly positive. The CRP test for cerebrospinal fluid helps identify bacterial and non-bacterial meningitis. Second, blood virus specific antibody detection [normal reference value] Normal people have a negative reaction or low titer. [Differential diagnosis] (1) Acute anterior poliomyelitis (acutepoliomyelitis) poliovirus antibody peaked in the early stage of sputum. If you can compare the two serum specific antibody titers in the early stage of infection and after 3 to 4 weeks, those who increase the latter by more than 4 times have diagnostic significance. (2) Epidemic encephalitis (epidemicencephalitis B) The routine complement test for JE, the positive reaction appears later, peaks after 4 weeks of onset, and the value is greater than 4:1. The test is only used as a diagnostic value. Retrospective diagnosis or epidemiological studies of methods of latent infection. Hemagglutination inhibition test. The detection of IgM antibodies in serum or cerebrospinal fluid by the monoclonal antibody of Japanese encephalitis virus is more sensitive and specific. (C) forest encephalitis (forestencephalitis) serum test take the acute phase of the patient and the recovery of the double serum, hemagglutination inhibition test, neutralization test, complement binding test and enzyme-linked immunosorbent assay, such as antibody titer increased 4 times Above, there is diagnostic value. (d) High titer of measles virus antibodies in serum and cerebrospinal fluid of subacutes sclerosing panencephalitis. (5) The titer of anti-Rubella antibody in blood and cerebrospinal fluid of progestsive rubella virus panic-cephalitis was significantly increased. 3. Determination of anti-Ach receptor antibodies in blood and cerebrospinal fluid [Normal reference value] Normal human negative reaction. [Differential diagnosis] Myastheniagravis: Serum anti-Ach receptor antibody is positive in more than 80% of cases. Some cases were positive for anti-Ach receptor antibodies in cerebrospinal fluid. Fourth, cerebrospinal fluid purulent meningitis pathogenic antigen antibody determination [normal reference value] Normal humans are negative. [Differential diagnosis] Purulent meningitis immunofluorescent antibody staining, convective immunoelectrophoresis for antigen determination, latex agglutination test, radioimmunoassay and enzyme-linked immunosorbent assay (ELISA) facilitate rapid diagnosis. Five, cerebrospinal fluid tuberculosis immune test [normal reference value] Normal humans are negative. [Differential diagnosis] The tuberculous meningitis (tubercular meningitis) cerebrospinal fluid serotonin test is almost all positive and has a reliable early diagnostic value. Sixth, blood and cerebrospinal fluid syphilis immunoassay [normal reference value] Normal humans are positive. [Differential diagnosis] Nerveyphilis includes syphilitic myelitis, spinal cord hernia, syphilitic meningitis, paralytic dementia, serum and cerebrospinal fluid syphilis serotonin flocculation test (VDRL) Treponema fluorescein antibody adsorption test (FTA-ABS), The immunolocalization test (TPItESt) was positive. The positive rate of various tests for advanced neurosyphilis was 65% for VDRL, 90% for TPItest, and 95% for FTA-ABS. Seven, cerebrospinal fluid gamma globulin and immunoglobulin determination [normal reference value] Gamma globulin accounts for 4-13% of cerebrospinal fluid protein quantitation IgA 0～6mg/L IgG 10~40mg/L IgM 0～13mg/L [Differential diagnosis] (1) Multiple sclerosis (90%) has increased gamma globulin content. It can be seen that when the total protein content of CSF is normal, most of them are IgG, and occasionally IgM and IgA are elevated. 85% to 95% of patients with clinically confirmed multiple sclerosis, IgG oligoclonal bands can be detected in CSF, and sometimes IgA and IgM oligoclonal bands are not found in serum, and are not specific to this disease. (B) chronic infective demyelinating multiple nerve root neuralgia (chronicinfetiousdemyelinatedpolyradiculoneuropathy) neurosyphilis (nervesyphilis) cerebrospinal fluid gamma globulin increased. A small number of chronic infections of demyelinating multiple radiculopathy have cerebrospinal fluid gamma globulin higher than 160mg / L. (C) progressive rubella viral encephalitis (progressive rubella viral epidecephalitis) acute disseminated cerebrospinal fluid (acutedisseminated encephalomyelitis) patients with elevated IgG in the cerebrospinal fluid, and may have IgG oligoclonal bands. Not suitable for the crowd Inappropriate people: not yet known. Adverse reactions and risks No related complications or hazards.