Kernbaum S, Bastin R, Geniteau M, Civatte J, Morel P
Ann Med Interne (Paris). 1982;133(2):97-102.
To evaluate the diagnostic help afforded by immune determinations in feverish valvular patients, we prospectively determined: total hemolytic complement, cryoglobulin, rheumatoid factor, circulating immune complexes and direct skin immunofluorescence. Twenty patients entered the study, twelve with bacterial endocarditis, six without any bacteremia and two septicemic patients without endocarditis. We detected at least one immune abnormality in 10/12 endocarditis patients: - in 7/11 (64 p. cent) circulating immune complexes; - in 3/12 rheumatoid factor; - in 3/12 positive fluorescence in dermal vessels (IgM-C3); - and in one patient an IgG lupus-like band in the membrane basal zone. We also found circulating immune complexes in 3/4 patients without bacteremia and in 1/2 septicemic patients. We conclude that, in our small prospective study, immune abnormalities are frequent in bacterial endocarditis patients but their diagnostic values is rather limited : their absence do not rule out endocarditis and they can be present in many other febrile disorders.
为评估免疫测定对发热性瓣膜病患者的诊断帮助，我们前瞻性地测定了：总溶血补体、冷球蛋白、类风湿因子、循环免疫复合物及直接皮肤免疫荧光。20例患者进入本研究，其中12例患有细菌性心内膜炎，6例无任何菌血症，2例为无心脏内膜炎的败血症患者。我们在10/12例心内膜炎患者中检测到至少一种免疫异常： - 7/11例（64%）有循环免疫复合物； - 3/12例有类风湿因子； - 3/12例真皮血管荧光阳性（IgM - C3）； - 1例患者在膜基底带有IgG狼疮样带。我们还在3/4例无菌血症患者及1/2例败血症患者中发现了循环免疫复合物。我们得出结论，在我们这项小型前瞻性研究中，免疫异常在细菌性心内膜炎患者中很常见，但其诊断价值相当有限：它们的缺失不能排除心内膜炎，且它们可存在于许多其他发热性疾病中。
