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Circulating immune complexes in prosthetic valve endocarditis.

D C Hooper, A S Bayer, A W Karchmer

    Archives of Internal Medicine
    |November 1, 1983
    PubMed
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    Circulating immune complex (CIC) levels can help diagnose prosthetic valve endocarditis (PVE). Low CIC levels (<30 µg/mL) in patients with prosthetic valves and fever help exclude PVE, aiding clinical decisions.

    Area of Science:

    • Immunology
    • Cardiology
    • Infectious Diseases

    Background:

    • Prosthetic valve endocarditis (PVE) presents diagnostic challenges, especially during febrile episodes.
    • Circulating immune complexes (CICs) are implicated in various inflammatory conditions.

    Purpose of the Study:

    • To evaluate the utility of measuring CIC levels in patients with prosthetic valves experiencing fever.
    • To determine if CIC levels can differentiate PVE from other causes of fever.

    Main Methods:

    • Raji cell radioimmunoassay was used to measure CIC levels in 36 patients with prosthetic valves during 38 febrile episodes.
    • Patients were categorized into definite PVE (27 instances) and other fever causes (11 instances).

    Main Results:

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    • Higher peak initial CIC levels (>100 µg/mL) were more frequent in the PVE group.
    • Lower peak initial CIC values (<30 µg/mL) were more common in the non-PVE group.
    • CIC levels decreased significantly after antibiotic therapy in 78% of PVE patients.

    Conclusions:

    • CIC level measurement shows predictive value in excluding PVE in febrile patients with prosthetic valves.
    • Persistently low CIC levels (<30 µg/mL) are useful for ruling out PVE.