Serological and immunohistochemical diagnosis of amniotic fluid embolism.
The purpose of this study was to evaluate whether serological assays and immunohistochemical staining, employing antibody TKH-2, are sensitive methods for the serological and histologic diagnosis of amniotic fluid embolism (AFE). TKH-2 is a sensitive antibody directed to sialyl Tn (STN), NeuAcalpha2-6GalNAc. Nineteen samples of maternal sera with clinical AFE and 120 control sera and 15 specimen of formalin-fixed, paraffin-embedded lung tissue sections were examined in this study. Tissue sections were stained using the streptavidin-biotin-immunoperoxidase method. The concentration of STN in serum was measured by an immunoradiometric competitive inhibition assay using the monoclonal antibody TKH-2 in a one-step procedure. Remarkable positive TKH-2 stainings were easily seen within the pulmonary vasculature in 14 of the 15 (93%) patients with AFE. The serum STN levels (mean+/-SD) in patients with AFE (110.8+/-48.1 U/ml) showed significantly higher concentrations compared with those of patients with non-AFE (17.3+/-2.6 U/ml) (p <0.01). Seventeen of 19 sera (89%) were diagnosed as AFE by serum TRH-2 level. We conclude that both TKH-2 immunostaining and serum STN assay are sensitive methods to diagnose patients with AFE.
Oi
H
H
Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Japan.
Kobayashi
H
H
Hirashima
Y
Y
Yamazaki
T
T
Kobayashi
T
T
Terao
T
T
D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis* / Q000276:immunology; D004619:Embolism, Amniotic Fluid / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D011247:Pregnancy; D012680:Sensitivity and Specificity; D012698:Serologic Tests
D015295:Antigens, Tumor-Associated, Carbohydrate; C055491:sialosyl-Tn antigen