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Revista do Instituto de Medicina Tropical de São Paulo

On-line version ISSN 1678-9946

Rev. Inst. Med. trop. S. Paulo vol.29 no.5 São Paulo Sept./Oct. 1987

http://dx.doi.org/10.1590/S0036-46651987000500009 

ARTIGOS ORIGINAIS

 

Detecção de anticorpos IgM nas infecções primárias e secundárias pelo citomegalovírus em pacientes submetidos a transplante renal

 

Specific IgM antibodies in primary and secundary cytomegalovirus infections after renal transplantation

 

 

Cláudio Sergio PannutiI; Lucy Santos Vilas BoasI; Vicente Amato NetoI; Maria José de Oliveira AngeloII; Emil SabbagaIII

IInstituto de Medicina Tropical de São Paulo: Laboratórios de Investigação Médica HC FMUSP Av. Dr. Eneas de Carvalho Aguiar, 470. 05403 São Paulo, SP - Brasil
IIInstituto de Ciências Biomédicas da Universidade de São Paulo
IIIUnidade de Transplante Renal do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

 

 


RESUMO

Foram acompanhados 27 pacientes submetidos a transplante renal para avaliação do comportamento dos anticorpos IgM e IgG CMV-específicos.
Dos 27 casos estudados, 17 (63,0%) tinham anticorpos IgG, detectados pela reação de fixação de complemento (RFC), antes de serem submetidos ao transplante, e 10 (37,0%) eram soro negativos. A pesquisa de anticorpos IgM (técnica de imunofluorescência indireta) foi negativa em todas as amostras pré transplante. Num período de acompanhamento que variou de 28 a 425 dias (média de 115 dias) após o transplante, observou-se que 20 dos 27 (74,1%) apresentaram evidências sorológicas de infecçáo pelo CMV, ocorrendo a maioria dos casos (14/20, 70%) em pacientes que já tinham anticorpos para o CMV antes do transplante. A pesquisa de anticorpos IgM CMV-específicos foi positiva em 12 dos 14 pacientes com evidências sorológicas de reinfecção ou reativação da infecção pelo CMV, e em 100% (6/6) dos pacientes com infecção primária. Dentre os 10 pacientes acompanhados por mais de 4 meses, somente 1 (10%) negativou o IgM neste período.

Unitermos: Anticorpos IgM anti-citomegalovírus; Infecções primárias e secundarias; Transplante Renal.


SUMMARY

Twenty-seven patients who underwent renal allograft transplants were periodically screened for the presence of IgM and IgG cytomegalovirus (CMV) antibodies.
Before transplantation, 17 (63%) had IgG antibodies by complement fixation and 10 (37%) were seronegative. Immunofluorescent IgM CMV-antibodies were absent in all pre-transplant sera.
During a follow-up period of 28 to 425 days (median of 115 days), 20 (74%) developed serologic evidence of CMV infection. Of these, 6 (30%) were primary and 14 (70%) secondary (reactivation or reinfection). IF-IgM antibodies were seen in 12 out of 14 patients with secondary CMV infection and in all patients with primary infection.
IgM antibodies became negative in one out of 10 IgM-positive patients who were followed-up for 4 months or more.


 

 

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Recebido para publicação em 08/07/87.

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