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Potential use of IgG2-ELISA in the diagnosis of chronic elephantiasis and IgG4-ELISA in the follow-up of microfilaraemic patients infected with Brugia malayi

Rahmah N, Anuar AK, Karim R, Mehdi R, Sinniah B, Omar AW

Biochem Biophys Res Commun, 1994 Nov 30;205(1):202-7.
PMID: 7999024

Sera from fifty subjects with different presentations of Brugian filariasis and from common soil-transmitted helminth infections were tested for specific anti-filarial IgG and its subclasses. Anti-filarial IgG, IgG1 and IgG3 showed cross-reactivities with soil-transmitted helminthic infections and no significant differences in optical densities among the various groups of filarial patients. In comparison with other groups of subjects, IgG4-ELISA of sera from microfilaraemic patients and some previously microfilaraemic patients showed a significant increase in optical density readings, while IgG2-ELISA showed elevated optical density readings in sera of patients with chronic elephantiasis. Therefore IgG2-ELISA is potentially useful in the diagnosis of brugian chronic elephantiasis while IgG4-ELISA may be beneficial for follow-up diagnosis of treated microfilaraemic patients.

Matched MeSH terms: Immunoglobulin G/classification; Immunoglobulin G/immunology*
Evaluation of a capture screening enzyme-linked immunosorbent assay for combined determination of immunoglobulin M and G antibodies produced during Dengue infection

Kit Lam S, Lan Ew C, Mitchell JL, Cuzzubbo AJ, Devine PL

Clin Diagn Lab Immunol, 2000 Sep;7(5):850-2.
PMID: 10973469

A commercially available enzyme-linked immunosorbent assay (ELISA) (PanBio Dengue Screening ELISA) that utilized both immunoglobulin M (IgM) and IgG capture in the same microtiter well for the diagnosis of dengue infection was evaluated. Sensitivity in primary and secondary dengue was 95%, while specificity was 94%.

Matched MeSH terms: Immunoglobulin G/blood*; Immunoglobulin G/immunology
Fulltext Exposure to bacterial products lipopolysaccharide and flagellin and hepatocellular carcinoma: a nested case-control study

Fedirko V, Tran HQ, Gewirtz AT, Stepien M, Trichopoulou A, Aleksandrova K, et al.

BMC Med, 2017 04 04;15(1):72.
PMID: 28372583 DOI: 10.1186/s12916-017-0830-8

BACKGROUND: Leakage of bacterial products across the gut barrier may play a role in liver diseases which often precede the development of liver cancer. However, human studies, particularly from prospective settings, are lacking.
METHODS: We used a case-control study design nested within a large prospective cohort to assess the association between circulating levels of anti-lipopolysaccharide (LPS) and anti-flagellin immunoglobulin A (IgA) and G (IgG) (reflecting long-term exposures to LPS and flagellin, respectively) and risk of hepatocellular carcinoma. A total of 139 men and women diagnosed with hepatocellular carcinoma between 1992 and 2010 were matched to 139 control subjects. Multivariable rate ratios (RRs), including adjustment for potential confounders, hepatitis B/C positivity, and degree of liver dysfunction, were calculated with conditional logistic regression.
RESULTS: Antibody response to LPS and flagellin was associated with a statistically significant increase in the risk of hepatocellular carcinoma (highest vs. lowest quartile: RR = 11.76, 95% confidence interval = 1.70-81.40; P trend = 0.021). This finding did not vary substantially by time from enrollment to diagnosis, and did not change after adjustment for chronic infection with hepatitis B and C viruses.
CONCLUSIONS: These novel findings, based on exposures up to several years prior to diagnosis, support a role for gut-derived bacterial products in hepatocellular carcinoma development. Further study into the role of gut barrier failure and exposure to bacterial products in liver diseases is warranted.

Matched MeSH terms: Immunoglobulin G/blood*; Immunoglobulin G/immunology
Multicentre evaluations of two new rapid IgG4 tests (WB rapid and panLF rapid) for detection of lymphatic filariasis

Noordin R, Itoh M, Kimura E, Abdul Rahman R, Ravindran B, Mahmud R, et al.

Filaria journal, 2007;6:9.
PMID: 17961262

In the global effort to eliminate lymphatic filariasis (LF), rapid field-applicable tests are useful tools that will allow on-site testing to be performed in remote places and the results to be obtained rapidly. Exclusive reliance on the few existing tests may jeopardize the progress of the LF elimination program, thus the introduction of other rapid tests would be useful to address this issue. Two new rapid immunochromatographic IgG4 cassette tests have been produced, namely WB rapid and panLF rapid, for detection of bancroftian filariasis and all three species of lymphatic filaria respectively. WB rapid was developed using BmSXP recombinant antigen, while PanLF rapid was developed using BmR1 and BmSXP recombinant antigens. A total of 165 WB rapid and 276 panLF rapid tests respectively were evaluated at USM and the rest were couriered to another university in Malaysia (98 WB rapid, 129 panLF rapid) and to universities in Indonesia (56 WB rapid, 62 panLF rapid), Japan (152 of each test) and India (18 of each test) where each of the tests underwent independent evaluations in a blinded manner. The average sensitivities of WB rapid and panLF rapid were found to be 97.6% (94%-100%) and 96.5% (94%-100%) respectively; while their average specificities were both 99.6% (99%-100%). Thus this study demonstrated that both the IgG4 rapid tests were highly sensitive and specific, and would be useful additional tests to facilitate the global drive to eliminate this disease.

Matched MeSH terms: Immunoglobulin G
Fulltext Molecular characterization of Nipah virus from Pteropus hypomelanus in Southern Thailand

Wacharapluesadee S, Samseeneam P, Phermpool M, Kaewpom T, Rodpan A, Maneeorn P, et al.

Virol J, 2016;13(1):53.
PMID: 27016237 DOI: 10.1186/s12985-016-0510-x

Nipah virus (NiV) first emerged in Malaysia in 1998, with two bat species (Pteropus hypomelanus and P. vampyrus) as the putative natural reservoirs. In 2002, NiV IgG antibodies were detected in these species from Thailand, but viral RNA could not be detected for strain characterization. Two strains of NiV (Malaysia and Bangladesh) have been found in P. lylei in central Thailand, although Bangladesh strain, the causative strain for the outbreak in Bangladesh since 2001, was dominant. To understand the diversity of NiV in Thailand, this study identified NiV strain, using molecular characterizations, from P. hypomelanus in southern Thailand.

Matched MeSH terms: Immunoglobulin G
Fulltext Association of Immunoglobulin G abnormalities in diseases: a mini review

Foong, Audrey Kow Siew, Nuha Fahimah Binti Wan Zahidi, Chau, Ling Tham

Life Sciences, Medicine and Biomedicine, 2018;2(1):24-39.
MyJurnal

Immunoglobulins are antibodies that play important roles in preserving our immune system. They have the ability to initiate humoral responses and remove antigen from the body. Out of the five major isotypes of immunoglobulins, IgG are most abundantly found in human serum. Abnormalities – deficiency or elevation in the level of IgG are found to be associated to the occurrence of several autoimmune diseases. These may include rheumatoid arthritis, Crohn’s disease, Mikulicz’s disease, Kuttner’s tumour and Hashimoto’s thyroiditis. Apart from autoimmune diseases, IgG has been found to play a role in initiating anaphylaxis, a severe and life threatening form of allergy and lately it has been discovered in cases of dengue virus infection too. It is important to acknowledge the roles of IgG on diseases especially subclass IgG4 which the elevation has been tied to numerous diseases such as Kuttner’s tumour and Hashimoto’s thyroiditis hence termed IgG4-related diseases. In addition, the roles of IgG in anaphylaxis are of importance, too, as IgG has been used in allergy immunotherapy. Hence, this review is a mini compilation of effects of IgG abnormalities based on their subclasses. Hopefully it will provide insightful understanding on the development of diagnostic and therapeutic courses for the aforementioned IgG abnormalities in the future.

Matched MeSH terms: Immunoglobulin G
Fulltext Behavioural factors influencing the dengue infection : the study among students in the higher learning institution.

Zaiton Nasir, Illina Ishak, Osman Ali

Malaysian Journal of Public Health Medicine, 2001;1(1):39-43.
MyJurnal

Dengue and dengue hemorrhagic jiever are still a serious public health problem among people in developing countries. The study was conducted to assess the knowledge, attitude and practice among students in University Technology of MARA in Shah Alam Selangor, Malaysia, and to determine its association withprevious infection. A total of 218 students were selected randomly fom several residential colleges within the university main campus. They were interviewed for their perception of risk to dengue and their blood were taken for serological examination (Dengue IgG). It was found that 49.1% of students have had previous infection, however onlv 0.9% had history of symptomatic dengue infection. Males students originating fom urban areas were more at risk of being infected. The perception of risk to dengue was good among students but this factor is
unable to explain the magnitude of infection among them. Further study should look at the interaction between behaviour and environment among students who are sero negative.

Matched MeSH terms: Immunoglobulin G
Fulltext Dengue Virus NS1 Protein as a Diagnostic Marker: Commercially Available ELISA and Comparison to qRT-PCR and Serological Diagnostic Assays Currently Used by the State of Florida

Ambrose JH, Sekaran SD, Azizan A

J Trop Med, 2017;2017:8072491.
PMID: 28740517 DOI: 10.1155/2017/8072491

BACKGROUND: The proper management of patients infected with dengue virus requires early detection. Here, real-time molecular assays have proven useful but have limitations, whereas ELISAs that detect antibodies are still favored but results are obtained too late to be of clinical value. The production of DENV NS1 peaks early during infection and its detection can combine the advantages of both diagnostic approaches.
METHODS: This study compared assays currently used for detecting DENV infection at the Florida Department of Health including anti-DENV IgM and IgG ELISAs as well as qRT-PCR, against a commercially available DENV NS1 ELISA. These comparisons were made among a group of 21 human sera.
RESULTS: Nine of 14 (64.3%) DENV qRT-PCR+ samples were also DENV NS1+. Interestingly, the 5 NS1- samples that were qRT-PCR+ were additionally IgM- and IgG+ suggesting a nonprimary infection. Compared to qRT-PCR, the NS1 assay had a sensitivity of 64.3%, specificity 100%, PPV of 100%, and NPV of 58.3%.
CONCLUSIONS: The NS1 ELISA performed as expected in known DENV qRT-PCR+ samples; however negative NS1 results for qRT-PCR+ and IgG+ sera seemingly reduced the usefulness of the NS1 ELISA for nonprimary cases. We therefore conclude that diagnosis obtained via DENV NS1 ELISA deserves further investigation.

Matched MeSH terms: Immunoglobulin G
Fulltext A retrospective study to detect dengue infection in unsuspected fever cases

Sudipta Poddar, Amiya Kumar Hati

Malaysian Journal of Medical Research, 2018;2(1):67-70.
MyJurnal

Dengue is endemic in Kolkata, India. Outbreaks of dengue cases often occur regularly at short intervals. This
retrospective seroepidemiological surveillance was conducted longitudinally. Dengue cases were diagnosed
in the laboratories from suspected patients by dengue specific IgG, IgM antibodies and NS1 antigen, from
suspected persons to investigate, analyze and categorize the cases who were actually suffering from dengue to
diagnose a dengue patient in the laboratory practice along with the status of the patient related to the detection
of disease and duration of primary and secondary infection for effective monitoring of the patient. Age and
Sex of the dengue patients were determined. Detection of dengue in unsuspected fever cases in unfavorable
transmission season was evaluated. The transmission of dengue infection in the non-transmission season is
not remarkable and often remains submerged. Proper measure at this stage may prevent the epidemic
outbreak in the transmission season. This sort of experience will help to enrich the effective control and case
management of the menace.

Matched MeSH terms: Immunoglobulin G
Evaluation of efficacy evaluation of combination vaccine of Recombinant C-Terminal Fragments of ApxIA, ApxIIA and ApxIIIA in piglets

Moon JY, Kim WK, Choi YH, Choi MS, Hur J, Kang JY, et al.

Sains Malaysiana, 2017;46:217-221.

The efficacy of the combination vaccine of the individual C-terminal fragments of ApxIA, ApxIIA and ApxIIIA of Actinobacillus pleuropneumoniae (APP) was evaluated in piglets. Twenty piglets were divided equally into 2 groups (n=10). All piglets were intramuscularly primed at 4 week-of-age (0 week post prime inoculation (WPPI)) and were intramuscularly boosted at 6 week-of-age (2 WPPI). Group A piglets were inoculated with sterile PBS and group B piglets were inoculated with the combination vaccine. Concentrations of each of the C-terminal fragment-specific IgG as determined by ELISA were significantly higher in group B than in group A from 2 WPPI until the end of this study. Clinical signs were observed from only 10% of group B piglets after the challenge with the mixture of APP serotypes 1, 2 and 5 at 4 WPPI, while 50% of group A piglets were protected against APP infections. Overall, intramuscular inoculation with the vaccine candidate can efficiently protect piglets against APP infection.

Matched MeSH terms: Immunoglobulin G
Fulltext Antibody dynamics post-Comirnaty and CoronaVac vaccination in Malaysia

Tan CS, Noni V, Melina WUHU, Abdorahman US, Bimbang JN, Malik NMA, et al.

Sci Rep, 2022 09 19;12(1):15665.
PMID: 36123431 DOI: 10.1038/s41598-022-19776-3

Several vaccines have been fast-tracked through clinical trials to mitigate the progression of the SARS‑CoV‑2 pandemic. We analyzed sequential blood samples from 314 recipients of Comirnaty and CoronaVac in East Malaysia for the spike-binding IgG (IgG-S), nucleocapsid-binding IgG (IgG-N), spike-binding IgM (IgM-S) and serum vitamin D (VitD). A subset of samples was analyzed for the neutralizing antibodies (Ig-RBD). Results showed that IgG-S due to Comirnaty was significantly higher than CoronaVac. IgM-S was detected in 80.0% Comirnaty and 69.5% CoronaVac recipients, while IgG-N was detected in 58.1% CoronaVac but not in Comirnaty recipients. All IgG-S-positive vaccines possessed detectable Ig-RBD after the second dose but with a weak to moderate correlation. The serum VitD levels did not influence the antibody magnitude in both vaccines. In essence, SARS-CoV-2 vaccination is an IgG-S-dominant event, Comirnaty was more effective than CoronaVac in mounting IgG-S and Ig-RBD responses, independent of the patient's VitD level.

Matched MeSH terms: Immunoglobulin G
Fulltext IgG4-related disease: an atypical presentation of steroid-responsive renal mass

Ng SH, Tay JS, Lai EL

BMJ Case Rep, 2021 May 24;14(5).
PMID: 34031075 DOI: 10.1136/bcr-2020-240611

IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disease characterised by dense lymphoplasmacytic infiltration rich in IgG4-positive plasma cells, storiform fibrosis and obliterative phlebitis. Serum IgG4 levels are typically elevated but half of the patients had normal serum IgG4 levels. IgG4-RD represents a spectrum of diseases that involve various organs such as the pancreas, liver, kidneys, and salivary glands often manifesting as diffuse organ enlargement or a mass-like lesion mimicking cancer. An increased incidence of malignancy among patients with IgG4-RD has been reported. Thus, differentiating malignancy from IgG4-RD manifestation is important as the treatment differs. Glucocorticoids are considered first-line therapy and should be started early to prevent fibrosis. Patients usually have an excellent clinical response to steroids, and poor steroid response is indicative of an alternative diagnoses such as malignancy. This case report describes a case of IgG4-RD with renal mass in a young man that resolved with glucocorticoid therapy alone.

Matched MeSH terms: Immunoglobulin G
Fulltext Immunogenicity and reactogenicity of a first booster with BNT162b2 or full-dose mRNA-1273: A randomised VACCELERATE trial in adults ≥75 years (EU-COVAT-1)

Neuhann JM, Stemler J, Carcas AJ, Frías-Iniesta J, Akova M, Bethe U, et al.

Vaccine, 2023 Nov 22;41(48):7166-7175.
PMID: 37919141 DOI: 10.1016/j.vaccine.2023.10.029

BACKGROUND: Vaccination remains crucial for protection against severe SARS-CoV-2 infection, especially for people of advanced age, however, optimal dosing regimens are as yet lacking.
METHODS: EU-COVAT-1-AGED Part A is a randomised controlled, adaptive, multicentre phase II trial evaluating safety and immunogenicity of a 3rd vaccination (1st booster) in individuals ≥75 years. Fifty-three participants were randomised to full-doses of either mRNA-1273 (Spikevax®, 100 µg) or BNT162b2 (Comirnaty®, 30 µg). The primary endpoint was the rate of 2-fold circulating antibody titre increase 14 days post-vaccination measured by quantitative electrochemiluminescence (ECL) immunoassay, targeting RBD region of Wuhan wild-type SARS-CoV-2. Secondary endpoints included the changes in neutralising capacity against wild-type and 25 variants of concern at 14 days and up to 12 months. Safety was assessed by monitoring of solicited adverse events (AEs) for seven days after on-study vaccination. Unsolicited AEs were collected until the end of follow-up at 12 months, SAEs were pursued for a further 30 days.
RESULTS: Between 08th of November 2021 and 04th of January 2022, 53 participants ≥75 years received a COVID-19 vaccine as 1st booster. Fifty subjects (BNT162b2 n = 25/mRNA-1273 n = 25) were included in the analyses for immunogenicity at day 14. The primary endpoint of a 2-fold anti-RBD IgG titre increase 14 days after vaccination was reached for all subjects. A 3rd vaccination of full-dose mRNA-1273 provided higher anti-RBD IgG titres (Geometric mean titre) D14 mRNA-127310711 IU/mL (95 %-CI: 8003;14336) vs. BNT162b2: 7090 IU/mL (95 %-CI: 5688;8837). We detected a pattern showing higher neutralising capacity of full-dose mRNA-1273 against wild-type as well as for 23 out of 25 tested variants.
INTERPRETATION: Third doses of either BNT162b2 or mRNA-1273 provide substantial circulating antibody increase 14 days after vaccination. Full-dose mRNA-1273 provides higher antibody levels with an overall similar safety profile for people ≥75 years.
FUNDING: This trial was funded by the European Commission (Framework Program HORIZON 2020).

Matched MeSH terms: Immunoglobulin G
Fulltext Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women

Andiappan H, Nissapatorn V, Sawangjaroen N, Nyunt MH, Lau YL, Khaing SL, et al.

Parasit Vectors, 2014;7:564.
PMID: 25498432 DOI: 10.1186/s13071-014-0564-9

Toxoplasma gondii, an obligate intracellular protozoan parasite, causes a disease called toxoplasmosis which can sometimes be acquired congenitally by a newborn from an infected mother. This study aimed to determine the seroprevalence of Toxoplasma infection and its associated risks among 219 and 215 pregnant women from Malaysia and Myanmar, respectively.

Matched MeSH terms: Immunoglobulin G/blood
Fulltext The high-affinity human IgG receptor Fc gamma receptor I (FcγRI) is not associated with vascular leakage of dengue

Mohamad Zamberi Z, Zakaria Z, Abdul Aziz AT, Heng BS, Zaid M, Chong CL, et al.

J Negat Results Biomed, 2015;14:1.
PMID: 25566870 DOI: 10.1186/s12952-014-0020-6

Dengue is a major public health problem in many tropical and sub-tropical countries. Vascular leakage and shock are identified as the major causes of deaths in patients with severe dengue. Studies have suggested the potential role of Fc gamma receptors I (FcγRI) in the pathogenesis of dengue. We hypothesized that the circulating level of Fcγ receptor I could potentially be used as an indicator in assisting early diagnosis of severe dengue.

Matched MeSH terms: Immunoglobulin G/blood*
Antiganglioside antibodies in Guillain-Barré syndrome and its related conditions

Shahrizaila N, Yuki N

Expert Rev Neurother, 2011 Sep;11(9):1305-13.
PMID: 21864076 DOI: 10.1586/ern.11.114

Guillain-Barré syndrome (GBS) is typically classified into two major subtypes: acute inflammatory demyelinating neuropathy and acute motor axonal neuropathy. Its most recognizable variant is Fisher syndrome. The last two decades have seen considerable advances in our understanding of GBS. Of note, various autoantibodies against ganglioside antigens have been identified and found to have significant associations with the axonal forms of GBS and Fisher syndrome. In this article, we discuss the different clinical presentations in GBS and the role of antiganglioside antibodies in their underlying pathogenesis. We also discuss the impact that antiganglioside antibodies have had in the development of experimental models and treatment modalities in GBS.

Matched MeSH terms: Immunoglobulin G/physiology
Fulltext Early diagnosis of Dengue infection using a commercial Dengue Duo rapid test kit for the detection of NS1, IGM, and IGG

Wang SM, Sekaran SD

Am J Trop Med Hyg, 2010 Sep;83(3):690-5.
PMID: 20810840 DOI: 10.4269/ajtmh.2010.10-0117

A commercial Dengue Duo rapid test kit was evaluated for early dengue diagnosis by detection of dengue virus NS1 antigen and immunoglobulin M (IgM)/IgG antibodies. A total of 420 patient serum samples were subjected to real-time reverse transcription-polymerase chain reaction (RT-PCR), in-house IgM capture enzyme-linked immunosorbent assay (ELISA), hemagglutination inhibition assay, and the SD Dengue Duo rapid test. Of the 320 dengue acute and convalescent sera, dengue infection was detected by either serology or RT-PCR in 300 samples (93.75%), as compared with 289 samples (90.31%) in the combined SD Duo NS1/IgM. The NS1 detection rate is inversely proportional, whereas the IgM detection rate is directly proportional to the presence of IgG antibodies. The sensitivity and specificity in diagnosing acute dengue infection in the SD Duo NS1/IgM were 88.65% and 98.75%, respectively. The assay is sensitive and highly specific. Detection of both NS1 and IgM by SD Duo gave comparable detection rate by either serology or RT-PCR.

Matched MeSH terms: Immunoglobulin G/analysis
Generation and characterization of monoclonal antibodies against prostate-specific antigen

Karuppaiya A, Cheah SH, Mohd S, Kamal WH, Zulkifli MH

Hybridoma (Larchmt), 2009 Apr;28(2):133-7.
PMID: 19249990 DOI: 10.1089/hyb.2008.0085

Prostate-specific antigen (PSA) is widely used as a diagnostic marker for the detection of prostate cancer in men. We have generated stable hybridomas producing specific monoclonal antibodies (MAbs) of the IgG class against PSA from fusions of splenocytes from immunized mice with myeloma cells. The hybridomas were adapted into serum-free media and cultured in CELLine CL-1000 bioreactors to produce milligram quantities of MAbs. Cross-reactivity study demonstrated that all the MAbs reacted did not cross-react with several other types of tumor antigens. Two of the MAbs were successfully radiolabeled by the iodogen method. The (125)I-labeled MAbs demonstrated strong binding to PSA on the surface of the LNCaP cells (Kd of 1.16 x 10(-9) M and 1.4 x 10(-9) M). Thus the (125)I-labeled MAbs retained their immunoreactivity and possessed high affinity and is potentially useful for binding to tumor cells. In conclusion, the MAbs can be used to develop radioimmunodiagnostic, radioimaging, and immunohistochemistry techniques for the early detection and treatment of prostate cancer.

Matched MeSH terms: Immunoglobulin G/immunology
Comparison of IgG-ELISA and IgG4-ELISA for Toxocara serodiagnosis

Noordin R, Smith HV, Mohamad S, Maizels RM, Fong MY

Acta Trop, 2005 Jan;93(1):57-62.
PMID: 15589798

Diagnosis of human toxocariasis, caused by Toxocara canis or Toxocara cati, normally relies on a combination of the presence of clinical signs and symptoms backed by positive serology. The use of Toxocara excretory-secretory antigen (TES) in ELISA assays increases the test specificity. However, in tropical countries where soil-transmitted helminths are endemic, cross-reactivity from antibodies to these intestinal parasites poses a significant limitation for Toxocara serodiagnosis. To increase the specificity of serodiagnosis, we compared the use of IgG-ELISA to the use of IgG4-ELISA using commercially manufactured TES-coated plates. The sensitivity of the IgG-ELISA was 97.1%, while that of the IgG4-ELISA was 45.7%; the specificities were 36.0 and 78.6%, respectively. The study shows that employing both assays can improve the serodiagnosis of toxocariasis. An IgG4 immunoassay would also be useful in the secondary screening of antigen clones in the effort to develop improved serological tests for toxocariasis.

Matched MeSH terms: Immunoglobulin G/blood
[Hemorrhagic dengue fever after trip to Malaysia]

Hafner C, Koellner K, Vogt T, Landthaler M, Szeimies RM

Hautarzt, 2006 Aug;57(8):705-7.
PMID: 16283129

A 39-year-old patient developed a disseminated rash with scattered petechiae, fever, malaise and arthralgia after a trip to Malaysia. The patient displayed increasing dengue IgG titers and borderline dengue IgM titers. Dengue fever with a hemorrhagic course is a rare condition in adult patients. Patients who have previously had dengue fever and retained non-neutralizing heterotypic antibodies are more likely to develop this complication via the phenomenon of antibody-dependent enhancement.

Matched MeSH terms: Immunoglobulin G/blood

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