발열반응 항체 검사 종목의 결과 분석

Abstract

Background: Fever of unknown origin (FUO0 is one of the most important clinical symptoms and it presents with various diseases that needs differential diagnosis. In Korea, besides traditional contagious infections like typhoid fever, there are various diseases - hemolytic fever with renal syndrome, tsutsugamushi disease, leptospirosis - with acute fever that differential diagnosis is essential. There were various trials to develop diagnostic kits and finally domestic company in Korea made its own diagnostic kits. We evaluated the results of the diagnostic kits in differential diagnosis of febrile patients. Methods: We analysed the results of widal test, hanatan virus antibody test, tsutsugamushi antibody test and leptospiral antibody t4est at Severance hospital from November 1, 1994 through October 31, 1995. Weused micro-V plate method for widal test, domestic-made high density particle (HDP) agglutination test method for hantaan virus antibody, tsutsugamushi antibody and leptospiral antibody tests. We evaluated medical records of 106 patients who have undergone febrile agglutination tests, retrospectively. Results: Among 1,172 tidal tests, 116 cases (9.90%) showed significant high titer (O>1 : 160, H>1 : 32). In patients group, 56 cases performed with widal test and febrile agglutination tests and among them only 9 cases (16.07%) showed positive results. During the same period, 134 cases of hantaan virus antibody test, 142 cases of leptospiral antibody test and 141 cases of tsutsugamushi antibody test were done in our laboratory and 22 cases (16.42%), 3 cases (2.13%), 15, cases (10.64%) showed positive results, respectively. Nineteen patients revealed to have fever with positive febrile agglutination tests. Mean age of overall patient group was 4.25±16.47, for male and female 44.1±14.29, 40.6±18.86 respectively. Positive rate of the three febrile agglutination tests - hantaan virus antibody, leptospiral antibody, and tsutsugamushi antibody test - were 22 cases (22.22%), 3 cases (3.00%) and 15 cases (14.71%) respectively. We analysed the patient group by final diagnoses, and the results showed 22 patients diagnosed as Korean hemorrhagic fever and 20n of them revealed to have positive results in hantaan virus antibody test. Patients complaining of high fever have more positive rates in acute phase reactants, but no statistical correlations was observed. Between febrile agglutination tests and acute phase reactants, patients with negative results of febrile agglutination tests showed high positive results of non-specific acute phase reactants. ±±±± Conclusions: In febrile patients, besides the use of routine laboratory screening tests and widal test, newly developed febrile antibody tests such as hantaan virus, leptospiral and tsutsugamushi antibody test could be useful in differential diagnosis with ease. Especially these febrile agglutination tests are useful in diagnosing the patients who are suspicious of hemorrhagic fever.