[Increase in polyclonal immunoglobulins: a possible useful aid in diagnosis of uveitis caused by sarcoidosis].
BACKGROUND
Polyclonal elevation of immunoglobulins is classically described in sarcoidosis and could possibly be useful in the work-up of suspected sarcoidosis uveitis. Because exposure to viruses of the herpes group is high in all populations, determination of herpes serologies is probably suited for this purpose.


METHODS
Therefore serum anti-herpes antibody patterns in sarcoidosis (SARC), HLA-B27 positive acute anterior uveitis (AAU), pars planitis (PP) and healthy age-matched controls were analysed. Frozen sera were analysed for exposure to CMV, HSV, VZV by ELISA IgG testing and to EBV-VCA by immunofluorescence. Complement fixing titers > or = 1/40 and an EBV-VCA titer > or = 1/1280 were considered elevated. For each patient exposed to 2 or more herpes viruses, a score made out of the number of elevated titers divided by the number of herpes viruses the patient was exposed to, was calculated and mean scores were compared using Student's t-test.


RESULTS
Mean score of patients with sarcoidosis was 0.47 +/- 0.27 (N = 18, mean age 60.2 +/- 21.4 years), significantly higher than AAU (N = 21; score 0.12 +/- 0.2; p < or = 0.000), than PP (N = 20; score 0.18 +/- 0.2; p < 0.003), and than age-matched healthy controls (N = 341, mean age 59 +/- 5.5 years; score = 0.15 +/- 0.14; p < 0.000).


CONCLUSIONS
Anti-herpes antibodies were found to be significantly elevated in sarcoidosis uveitis, suggesting that herpes serologies may be useful in the work-up of suspected ocular sarcoidosis, a disease for which sufficiently sensitive and specific tests are lacking.
Berthoud Kündig
J F
JF
Hôpital Jules Gonin, Service Universitaire d'Ophtalmologie, Lausanne.
Keller
A
A
Herbort
C P
CP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000032:analysis; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis*; D016849:Keratitis, Herpetic / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009113:Muramidase / Q000032:analysis; D012507:Sarcoidosis / Q000175:diagnosis* / Q000276:immunology; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis / Q000276:immunology; D018139:Simplexvirus / Q000276:immunology; D014605:Uveitis / Q000175:diagnosis* / Q000276:immunology
D000914:Antibodies, Viral; D007136:Immunoglobulins; D009113:Muramidase
Elévation polyclonale des immunoglobulines: une aide plutôt qu'un piège dans le diagnostic des uvéites causées par la sarcoïdose.