Brucellossis

THE JOURNAL OF INFECTIOUS DISEASES • VOL. 159, NO.2. FEBRUARY 1989 © 1989 by The University of Chicago. All rights reserved. 0022-1899/89/5902-0005$01.00

Changes in IgM and IgG Antibody Concentrations in Brucellosis Over Time: Importance for Diagnosis and Follow-Up

Elena Gazapo, Juan Gonzalez Lahoz, Jose L. Subiza, Margarita Baquero, Juana Gil, and Emilio G. de la Concha

From the Department of Immunology, Hospital Universitario San Carlos, and the Departments of Internal Medicine and Microbiology, Hospital del Rey, Madrid, Spain

Changes in concentrations of IgM and IgO antibodies to Brucella were monitored for at least 13 mo by an enzyme-linked immunosorbent assay (ELISA) in 52 patients with culture-positive brucellosis. Two main patterns were observed. After an initial peak, 29 patients (56%) had a steady drop in their IgO levels, whereas 23 (44070) had more than one peak over time. All patients with a chronic form of brucellosis or a relapse were in the second group. In most cases, Brucella antibodies, although falling to low levels, remained measurable. Cutoff levels for IgM and IgO were calculated after considering serum antibody concentrations in people who had recovered from an infection. A separate normal range was established for occupationally exposed workers. On admission, sera from all patients contained Brucella antibody levelsgreater than established cutoff levels. Our results show that ELISA is an excellentmethod for diagnosis and follow-up of bruce1losis.

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Brucellosis remains a common infectious disease in many parts of the world, notably in Mediterranean countries and the Middle East. Because symptoms are usually nonspecific and cultures of blood are often unsuccessful, especially in chronic brucellosis [1], most patients are diagnosed by demonstrating serum antibodies [2, 3]. Conventionally, antibodies have been studied using agglutination, CF, and antibody...