SU1561038A1 - Method of diagnosis of rheumatic myocarditis - Google Patents

Abstract

The invention relates to medicine, namely to immunology, and can be used in rheumatology. The purpose of the invention is to improve the accuracy of diagnosis in the lottery or latent forms of rheumatic myocarditis in the early stages of the disease. The method is carried out by detecting E - rosette-forming cells with standard streptococcal antigen in the blood and with an increase in E-ROCK of 10% or more is diagnosed in the latent or latent form of rheumatic myocarditis.

Description

The invention relates to medicine, namely to immunology, and can be used in rheumatology.

The aim of the invention is to improve the accuracy of diagnosis in lottery or latent forms of rheumatic myocarditis.

The method is carried out as follows.

0.2 ml of patient's blood is taken from a finger into a tube with 0.2 ml of medium 199-. On a density gradient of 1077 g / cm, lymphocytes were isolated according to a conventional method. Then, 0.1 ml of lymphocyte suspension with a concentration of 2-10 cells / mm3 is incubated for 30 minutes at 37 ° C with 0.1 ml of the domestic standard streptococcal allergen (20-40 μg / ml of protein). The control is a sample with the same number of lymphocytes incubated with 0.1 ml of saline. Then, the cell samples are washed, incubated for 30 minutes at 37 ° C with 0.1 ml of a 0.5% sheep erythrocyte suspension, and centrifuged for 5 minutes at 800g, the relative amount of E-ROCK is calculated in the native preparation. With an increase in E-ROCK with a streptococcal allergen by 10% or more, rheumatic myocardial damage is diagnosed. ,

PRI me R 1. Sick S., was admitted to hospital with complaints of agility, malaise, intermittent puncture pain in the region of the heart, and shortness of breath during physical pressure. An objective and instrumental examination of the heart revealed signs of myocardial damage: displacement of the borders of the heart, weakness of tones, the presence of a systolic gaum along the left, sternal border of the sternum. On the ECG sinus tachyarrhythmia, the blockade of the right bundle of His is incomplete, a decrease in metabolic SP O

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ten

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Akih processes in the myocardium. Laboratory indicators: the picture of red white blood corresponds to the picture of healthy children, an ESR of 12 mm / h, there are no pathological changes in the biochemical acute phase indicators. Based on clinical and laboratory data, rheumatism and rheumatic heart disease could not be diagnosed. When determining the titer of antistreptolysin - O, ASL-o, no increase in titer (1: 125) was observed. In the study of blood by the method of growth (an increase in the number of rosette-forming cells with a specific streptococcal allergen, compared with the control by n Ј 17%. The diagnosis is made: rheumatism Ik active phase, activity I st., Myocarditis, during the course, And .o. Appointed appropriately contradictory therapy and received a rapid positive dynamics. The child was transferred to a sanatorium treatment with minimal changes in heart 25 C &.

Example 2. Ill A., was admitted to the hospital with complaints of subfebrile temperature for a long time, aching pain in the region of the heart. Free about a month. For a long time, based on the clinical, epidemiological, immunological and general methods of cardiac changes, the rheumatic and non-rheumatic carditis could not be differentiated, the antistreptopyzine titer - 0 was 250 U. When examining blood in a rosette-shaped reaction, with a specific allergen to

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they obtained an increase in the number of rosette-forming cells by 13% compared with the control. Diagnosis: Rheumatism I, active phase, activity I st, myocarditis, during the course of the current, Act. Since the correct diagnosis was made late and antirheumatic therapy was prescribed out of time, when examined in case of catamnesis after 6 months. from the onset of the disease, the child had a heart defect.

Below is a histogram of the distribution of patients depending on the titer of antistreptolysin-0 and the number of specific E-ROCKs (a significant increase).

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gg to

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The positive effect compared with the test for ASL-0 is higher by 79%.

Claims (1)

Invention Formula A method for diagnosing rheumatic myocarditis by examining blood, characterized in that, in order to improve diagnostic accuracy, lotto cells or latent forms of rheumatic myocarditis separate lymphocytes from the blood to be examined, add standard streptococcal allergen, incubate and insert sheep erythrocytes with subsequent counting cells and when elevated from a level of 10% or more compared to a control that does not contain an allergen, is diagnosed in a latent or latent form of rheumatic myocarditis.