[Utility of clinical examinations and anti-Kveim monoclonal antibody in the diagnosis of sarcoidosis].
The most reliable method for a diagnosis of sarcoidosis is histological examinations. However, compatible histological findings were detected among 60% of cases and 40% of cases was diagnosed by clinical evidence only (Clinical sarcoidosis). We assessed the diagnostic reliability of the cases based on clinical features only with a comparison of positivity between definite and clinical sarcoidosis for different clinical examinations. Chest X-ray, ACE, PPD skin test etc., % positivity of BHL, ACE, PPD skin test and 67Ga scan were positive in more than 80% of definite cases but only 50% in clinical cases except for 67Ga scan. This finding means that it is necessary to develop new clinical laboratory methods to diagnose clinical sarcoidosis. From these points of view, we prepared a monoclonal antibody (IHY-1) to the sarcoid granulomagenic agent contained in Kveim suspension by immunizing mice with Kveim suspension. IHY-1 is an IgM monoclonal antibody that did not react with erythrocytes, lymphocytes, monocytes, alveolar macrophages or macrophage derived cell lines. It reacted with granuloma epithelioid cells of sarcoidosis-affected lymph nodes. Also in the granuloma of cases accompanied by tuberculosis, the monoclonal antibody positively reacted with epithelioid cells although the reaction was not strong.
Second Department of Internal Medicine, Hiroshima University School of Medicine.
S
S
Ishioka
M
M
Yamakido
D000818:Animals; D000911:Antibodies, Monoclonal / Q000096:biosynthesis; D006801:Humans; D007124:Immunoenzyme Techniques; D007731:Kveim Test; D051379:Mice; D008807:Mice, Inbred BALB C; D012507:Sarcoidosis / Q000175:diagnosis* / Q000276:immunology; D012882:Skin Tests
D000911:Antibodies, Monoclonal