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Interpretive Handbook

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Test 5194 :
Rubeola (Measles) Antibodies, IgG and IgM (Separate Determinations), Spinal Fluid

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Measles is a serious and highly contagious disease which can be a leading cause of death where nutrition and sanitation are limited. Onset begins with cough, fever, and lymphadenopathy approximately 2 weeks after exposure. Diagnosis is usually made when the rash appears. Koplik’s spots may be seen earlier on the buccal mucosa. Complications of measles may develop in children who appear to have normal immune functions.

 

Persistent infection of the central nervous system with measles virus is recognized to cause the disease subacute sclerosing panencephalitis (SSPE). SSPE is a rare, late complication of measles with an incidence of approximately 1 per 100,000 cases. SSPE is a progressive, usually fatal disease that occurs most often in children between the ages of 5 and 14. The onset is insidious and progressive. The incubation period from acute measles to onset of neurological symptoms varies from several months to many years. One of the most useful diagnostic tests involves the measurement of measles-specific antibodies in the cerebrospinal fluid (CSF) of patients with SSPE. Levels of antibody are significantly elevated in the CSF of SSPE patients compared to those without the disease.

Useful For Suggests clinical disorders or settings where the test may be helpful

Diagnosis of central nervous system infection with rubeola (measles) virus and/or subacute sclerosing panencephalitis

Interpretation Provides information to assist in interpretation of the test results

Detection of organism-specific antibodies in the cerebrospinal fluid (CSF) may suggest central nervous system infection. However, these results are unable to distinguish between intrathecal antibodies and serum antibodies introduced into the CSF at the time of lumbar puncture or from a breakdown in the blood-brain barrier. The results should be interpreted with other laboratory and clinical data prior to a diagnosis of central nervous system infection.

 

Patients with subacute sclerosing panencephalitis have serum antibody titers which are 10 to 100 times higher than those seen in late convalescent-phase sera. More importantly, there is pronounced local production of oligoclonal measles virus antibodies in the central nervous system.

 

Normals:

-IgG: <1:5

-IgM: <1:10

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Detection of organism-specific antibodies in the cerebrospinal fluid (CSF) may suggest central nervous system infection. However, these results are unable to distinguish between intrathecal antibodies and serum antibodies introduced into the CSF at the time of lumbar puncture or from a breakdown in the blood-brain barrier. The results should be interpreted with other laboratory and clinical data prior to a diagnosis of central nervous system infection.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

IgG: <1:5

IgM: <1:10

Clinical References Provides recommendations for further in-depth reading of a clinical nature

Gascon GG: Subacute sclerosing panencephalitis. Semin Pediatr Neurol 1996;3:260-269


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