PMID- 35215121
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220301
IS  - 2076-0817 (Print)
IS  - 2076-0817 (Electronic)
IS  - 2076-0817 (Linking)
VI  - 11
IP  - 2
DP  - 2022 Jan 27
TI  - Misleading Positive Serology for Cat Scratch Disease following Administration of 
      Intravenous Immunoglobulin.
LID - 10.3390/pathogens11020177 [doi]
LID - 177
AB  - Cat scratch disease (CSD), caused by Bartonella henselae, usually presents as 
      regional lymphadenopathy/lymphadenitis, known as typical CSD or as atypical CSD, 
      which includes, among others, neurological manifestations. Serology for anti-B. 
      henselae IgG antibodies is the most commonly used diagnostic tests for CSD. 
      Intravenous immunoglobulin (IVIG) is given for an increasing number of medical 
      conditions and may cause interference with serological testing. We report six 
      patients with neurological manifestations and two patients with Kawasaki disease 
      mimicking typical CSD, mistakenly diagnosed as CSD due to false-positive serology 
      following IVIG therapy. Bartonella IgG serology was positive one to six days 
      after IVIG administration and reverted to negative in seven of eight patients or 
      significantly decreased (1 patient) </=30 days later. In patients with CSD, IgG 
      titers remained essentially unchanged 15-78 days after the positive serum sample. 
      An additional eight patients treated with IVIG for various conditions were 
      evaluated prospectively. All were seronegative one day pre-IVIG infusion, five 
      patients demonstrated an increase in the IgG titers one to three days after IVIG 
      administration, one interpreted as positive and four as intermediate, whereas 
      three patients remained seronegative, suggesting that false seropositivity after 
      IVIG therapy may not occur in all patients. Treatment with IVIG can result in 
      false-positive serology for B. henselae. Increased awareness to the misleading 
      impact of IVIG is warranted to avoid misinterpretation. Repeat testing can 
      distinguish between true and false serology. Preserving serum samples prior to 
      IVIG administration is suggested.
FAU - Yakubovsky, Michal
AU  - Yakubovsky M
AUID- ORCID: 0000-0002-1587-7310
AD  - Infectious Disease Unit, Tel Aviv Sourasky Medical Center, Tel Aviv University, 
      Tel Aviv 6423906, Israel.
AD  - The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
FAU - Golan, Yoav
AU  - Golan Y
AD  - Tufts Medical Center, The Tufts University School of Medicine, Boston, MA 02446, 
      USA.
FAU - Guri, Alex
AU  - Guri A
AD  - Department of Pediatrics, Kaplan Medical Center, Rehovot 76100, Israel.
AD  - The School of Medicine, The Hebrew University and Hadassah Medical Center, 
      Jerusalem 7661041, Israel.
FAU - Levy, Itzhak
AU  - Levy I
AD  - The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
AD  - Pediatric Infectious Disease Unit, Schneider Children's Medical Center, Petah 
      Tiqva 4920235, Israel.
FAU - Glikman, Daniel
AU  - Glikman D
AUID- ORCID: 0000-0002-8006-5845
AD  - Infectious Disease Unit, Padeh Poriya Medical Center, Poriya 1528001, Israel.
AD  - The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 
      1311502, Israel.
FAU - Ephros, Moshe
AU  - Ephros M
AD  - Pediatric Infectious Disease Unit, Carmel Medical Center, Haifa 3436212, Israel.
AD  - The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 
      3200003, Israel.
FAU - Giladi, Michael
AU  - Giladi M
AD  - Infectious Disease Unit, Tel Aviv Sourasky Medical Center, Tel Aviv University, 
      Tel Aviv 6423906, Israel.
AD  - The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
AD  - The Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases, Tel 
      Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.
LA  - eng
PT  - Journal Article
DEP - 20220127
PL  - Switzerland
TA  - Pathogens
JT  - Pathogens (Basel, Switzerland)
JID - 101596317
PMC - PMC8876604
OTO - NOTNLM
OT  - Bartonella henselae
OT  - cat scratch disease
OT  - enzyme immunoassay
OT  - false positive results
OT  - intravenous immunoglobulin
OT  - serology
COIS- The authors declare no conflict of interest.
EDAT- 2022/02/27 06:00
MHDA- 2022/02/27 06:01
PMCR- 2022/01/27
CRDT- 2022/02/26 01:04
PHST- 2022/01/01 00:00 [received]
PHST- 2022/01/23 00:00 [revised]
PHST- 2022/01/25 00:00 [accepted]
PHST- 2022/02/26 01:04 [entrez]
PHST- 2022/02/27 06:00 [pubmed]
PHST- 2022/02/27 06:01 [medline]
PHST- 2022/01/27 00:00 [pmc-release]
AID - pathogens11020177 [pii]
AID - pathogens-11-00177 [pii]
AID - 10.3390/pathogens11020177 [doi]
PST - epublish
SO  - Pathogens. 2022 Jan 27;11(2):177. doi: 10.3390/pathogens11020177.