顔面神経麻痺と水痘帯状疱疹ウイルス(第2報) : 血清抗体価の変動およびIgM測定による早期診断について

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In order for early diagnosis of the reactivation of varicella-zoster virus (VZV) in facial paralysis, viral specific IgM determination was performed by fluorescent antibody technique (FA) using anti-human IgM FITC.The sera for the examination were obtained from 16 cases of Ramsay-Hunt syndrome, 10 of Bells palsy suspected of VZV reactivation from significant rise and/or higher antibody levels (Bell(V+)), and 9 of Bells palsy without reactivation of VZV (Bell(V-)).The results were as followes;1) In all the cases of Ramsay-Hunt syndrome, 7 of Bell(V+) and one of Bell(V-), VZV specific IgM antibody was found.2) The higher was IgG antibody level, the higher IgM level was. However, IgM antibody level was always lower than IgG level in all the cases. Cases of Ramsay-Hunt syndrome tended to have higher IgM and IgG antibody levels than those of Bell(V+).3) In most cases, IgM antibody was shown during a few months after the onset.4) Generally, the antibody levels by neutralization (NT), FA (IgG), and immune adherence hemagglutination (IAHA) fluctuated in the same pattern, but the level by complement fixation (CF) was lower than those by NT, FA, IAHA. The levels of IgM and by CF were decreased earlier than those of the three other methods.5) It was concluded that viral specific IgM determination by FA was useful for early diagnosis of Bell(V+).
社団法人日本耳鼻咽喉科学会の論文