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Relationship between Serum IgE level and Absolute Eosinophil Count (AEC)

Both serum IgE (Immunoglobin E) level and blood Absolute Eosinophil Count (AEC) are useful tests in evaluating and diagnosing allergies, but they serve different purposes and have their own strengths and limitations. So, they are often measured together in clinical practice. While IgE and eosinophils are both associated with allergic responses, they do not always change in tandem. It is possible for a person to have high levels of IgE but a normal AEC, or vice versa. This is because allergic reactions are complex and involve multiple components of the immune system, and the specific immune response can vary depending on the type and severity of the allergic condition. IgE is an immunoglobulin that plays a key role in allergic reactions. When a person is expose to an allergen, such as pollen or dust mites, IgE levels in the blood may rise as the immune system mounts an allergic response. High levels of IgE in the blood are often seen in people with allergies, asthma, and other allergic ...

Iron Deficiency Without Anemia: a diagnosis that matters

  Iron deficiency without anemia refers to a condition where there is a decrease in the body's iron stores, but the individual's hemoglobin levels are still within the normal range, and they do not meet the diagnostic criteria for anemia. Anemia is a condition characterized by a reduced number of red blood cells or a decrease in the amount of hemoglobin in the blood, which can result in fatigue, weakness, and other symptoms. Iron is an essential mineral that plays a crucial role in carrying oxygen in the blood and supporting various physiological processes in the body. Iron deficiency can occur due to inadequate dietary intake of iron, poor iron absorption by the body, increased iron demands (such as during pregnancy or growth spurts), or chronic blood loss (such as from menstruation or gastrointestinal bleeding). Iron deficiency without anemia can occur in the early stages of iron depletion when the body's iron stores are becoming depleted, but the hemoglobin levels have ...

Falsely High Prolactin level: A Diagnostic Pitfalls

Prolactin (PRL) is a hormone produced by the pituitary gland in the brain that plays a role in lactation and reproduction.  The elevation of serum PRL levels (hyperprolactinemia) has multiple etiologies that can be divided into physiological, pharmacological, and pathological causes.  There are several potential reasons for a falsely high prolactin level in a blood sample. Prolactin levels of women were significantly higher in the morning than those in the evening. Prolactin is secreted in a circadian and pulsatile pattern. Serum prolactin level reaches its maximum in the early morning hours, returns to the normal value one hour after waking up, and is lower in the evening than that in the morning. Prolactin is often measured in the early morning hours along with other tests that require fasting and is affected by the physiological morning peak. So, it can be falsely higher than the normal range and can lead to further unnecessary investigations.  Certain medications can...

Diagnosis of Celiac disease

Coeliac disease is an autoimmune disease where the lining of the small intestine is damaged by exposure to gluten (a protein found in grains such as wheat, rye, barley and oats) in genetically predisposed children and adults. The reaction to gluten causes inflammation and atrophy of intestinal lining, which can lead to malabsorption of nutrients and related health issues. The diagnosis of Celiac disease is classically based on a combination of findings from a patient’s clinical history, serologic testing and duodenal biopsies. SEROLOGY TEST: Serologic tests are for screening purposes and do not confirm the diagnosis of coeliac disease. Serologic tests for celiac disease include anti-transglutaminase IgA & IgG antibody, anti-endomysium IgA antibody, and Deamidated Gliadin Peptide IgA & IgG antibodies.  The serologic tests that check for IgA antibodies are more sensitive for celiac disease than the tests for IgG antibodies. However, in people who have IgA deficiency, IgG test...

Hepatitis Markers

  Hepatitis means inflammation of the liver. It is commonly the result of a viral infection (hepatitis viruses A, B, C, D, and E), but there are other possible causes of hepatitis like autoimmune hepatitis and hepatitis that occurs as a secondary to medications, drugs, toxins, and alcohol. Hepatitis markers (Antigens, Antibodies & PCR) are useful for determining diagnosis, appropriate treatment, and vaccination status and for monitoring treatment.  Viral Hepatitis Markers: Hepatitis A virus-IgM Antibodies (anti-HAV IgM) : Serum IgM antibody to the hepatitis A virus (antiHAV) appears at about four weeks after initial infection and usually persists for 2-6 months as the initial phase of the immune response. (Test code H018) Hepatitis A virus-IgG Antibodies (anti-HAV IgG) : Serum IgG antibody to HAV generally persists for lifetime, conferring immunity to further HAV infection. (Test code H017) Hepatitis A virus-Total Antibodies (Anti-HAV-Total Ab) : The total HAV antibody te...

Sterile Pyuria: a diagnostic challenge

Pyuria is the pathological finding of the presence of leucocytes or white blood cells, commonly referred to as pus cells, in the urine. It may be indicative of various health conditions, but it is most commonly associated with a urinary tract infection (UTI).   Sterile pyuria can be defined as the presence of leucocytes in the urine but absence of infection with standard culture techniques.  Sterile pyuria is misleading term, as commonest cause for the finding is undoubtedly infection of some sort.  It is a relatively common problem, with a wide range of causes.  It could be infectious or non-infectious, depending on conditions.  Sterile pyuria may be due to a partially treated urinary tract infection (even one dose of antibiotic before urine collection), a recently treated UTI (pyuria often remains for one-two weeks after clearing infection), a UTI with fastidious or slow growing atypical organisms that fail to grow during standard laboratory culture. Ot...

Celiac Disease, Wheat Allergy and Gluten Intolerance: What's the Difference?

Celiac disease, gluten intolerance, and wheat allergy are the three major disorders that are known to trigger unpleasant symptoms following intake of foods made using wheat . Although the three conditions share similar symptoms, their pathogenic mechanism, diagnosis and treatment are quite different. Coeliac disease is permanent, whereas allergies and intolerances can come and go during a person’s life.  Celiac disease is a genetic, autoimmune disorder that occurs in reaction to the ingestion of gluten, a protein found in wheat, barley, and rye. The reaction to gluten causes inflammation and atrophy of intestinal lining, which can lead to malabsorption of nutrients and related health issues. The diagnosis of Celiac disease is classically based on a combination of findings from a patient’s clinical history, serologic testing (anti-transglutaminase IgA antibody, anti-endomysium antibody, Deamidated Gliadin Peptide) and duodenal biopsies. Wheat allergy is an immune reaction (IgE med...

Mucorales RT-PCR: A potential game changer in diagnosis of Mucormycosis

Mucormycosis refers to severe infectious diseases that are caused by filamentous fungi of the Mucorales order that primarily affect immunocompromised patients and patients with diabetes mellitus. Recently, an increasing incidence has been reported among COVID-19 patients in India. The most common genera in invasive mucormycosis are Rhizopus, Rhizomucor, Lichtheimia and Mucor, accounting for 90% of all cases. Clinically and radiographically, mucormycosis is often indistinguishable from other invasive fungal infections such as aspergillosis and remains difficult to diagnose. A definitive diagnosis of mucormycosis typically requires histopathological evidence or positive fungal culture from a specimen from the site of infection, which may be difficult to obtain in some patients. A molecular diagnostic approach, detecting circulating DNA of Mucorales (by PCR) in serum of patients, may help to diagnose invasive mucormycosis more quickly and to introduce directed therapy earlier and eventual...

Serum Galactomannan: A diagnostic tool for Aspergillosis

  Aspergillus is a filamentous fungus known as a common mold (White Fungus). Most people breathe in Aspergillus spores daily with no ill effects. However, people with compromised immune systems or lung diseases are at a higher risk of developing aspergillosis due to aspergillus. Several recent reports describe COVID-19-associated pulmonary aspergillosis. Aspergillus fumigatus was the most common species causing co-infection in COVID-19 patients, followed by Aspergillus flavus.  Aspergillosis is broadly classified into different categories based on the site of infection and recurrence rates- Allergic bronchopulmonary aspergillosis Allergic Aspergillus sinusitis Aspergilloma/fungus ball Cutaneous aspergillosis Chronic pulmonary aspergillosis Invasive aspergillosis Diagnosis of aspergillosis is often difficult due to several factors such as delay in clinical suspicion and the lack of specific clinical findings. Conventional diagnosis of Aspergillosis is dependent on fungal cultu...

Why Regular Health Check-up are Necessary?

“Health is wealth.” It is an old axiom, but most commonly neglected, because of the fast- paced life, sedentary lifestyle, unhealthy food habits, lack of exercise, lack of sleep and stress. People are becoming more and more vulnerable to diseases like diabetes, hypertension, dyslipidemia, heart diseases and various cancers. We pay attention to these factors only when we’ve run out of time. However, the concept of regular/ annual health check-ups for healthy individuals is increasing day by day. Precautionary healthcare is becoming a part of our routine as people are more educated and aware of their health. But, still, majority of the public and health care professionals are speculative regarding the degree if its utility and using these services in a cost-effective manner. Many organizations, all around the world, have made regular health check- ups mandatory for their employees to ensure their workforce stays fit and healthy, working more efficiently and adding to the overall gain...

Falsely Elevated Interleukin-6 (IL-6): The facts

The interleukin-6 (1L-6) is a multifunctional pleiotropic cytokine, and is also known as interferon-ß2 (IFN-ß2), 26 kDa protein, B-cell stimulatory factor-2 (BSF-2), hybridoma/ plasmacytoma growth factor, hepatocyte stimulating factor and macrophage-granulocyte inducing factor 2A (MGI-2A). IL-6 is released by a variety of cell types such as, T cells, B cells, monocytes, fibroblasts, vascular endothelial cells, cardiac myxomas, bladder cell carcinomas, myelomas, astrocytoma and glioblastomas. It has a major role in the mediation of inflammatory and immune response initiated by infection or injury. IL-6 can be elevated with inflammation, infection, autoimmune disorders, cardiovascular diseases, and some cancers also. In few of the cases it has been associated with an increased risk of disease development or worsening prognosis. As the levels of IL-6 are associated with medical diagnosis, therapy, and prognosis, monitoring the fluctuation of its levels may reflect the progression or regre...

Ways To Maintain A Health in Rainy Season

Rainy (Monsoon) season are known to make the climate pleasant and adds scenic beauty to the environment. It gives a new life to the earth. However, monsoon also brings along numerous diseases (esp. food borne and mosquito-borne diseases) due to harmful viruses, bacteria and fungus. Common cold, Flu, Stomach Infection, Diarrhoea, Malaria, Dengue, Typhoid, Chikungunya, Viral fever and Allergy are some of the diseases which make it to the top of the list. The common victims are children and people with low immunity.   Enjoy the monsoon rains the healthy way by eating good food and following certain following precautionary measures.   Eat a healthy, balanced diet to keep you fit. Avoid junk food, street food and pre-cut fruits, especially from the roadside stalls. Eat steamed salads instead of raw vegetables. Thoroughly scrub fruits and vegetables under running water before consuming. Better to avoid milk, and chose other milk-products like yogurt, curd, etc. Include more Vitami...

Clinical significance of NLR, PLR & LMR in COVID-19

The clinical presentation of COVID-19, varies from no symptoms to severe symptoms with complications like acute respiratory failure, acute respiratory distress syndrome, metabolic acidosis, coagulopathy, and septic shock. A full blood count is a routine, inexpensive and easy test that provides information about formed blood contents. Patients with severe COVID-19 disease present with increased leucocytosis, neutrophilia, lymphopenia, eosinopenia and thrombocytopenia than those with non-severe disease. Recently, reports on the feasibility of few new haematological parameters like, Neutrophil to Lymphocyte ratio (NLR) , Lymphocyte to Monocyte ratio (LMR) and Platelet to Lymphocyte ratio (PLR) in predicting prognosis in patients with SARS-CoV-2 infection have been published. The current study shows that these parameters may be a rapid, cost-effective, widely available, useful prognostic factor in the early screening of critical illness in patients with confirmed COVID-19. These parame...

COVID-19 IgG (SARS-CoV-2 IgG) Antibody Test for Sero-surveillance

The SARS-CoV-2 IgG Antibody (COVID-19 IgG) test is intended for the qualitative detection of IgG antibodies to SARS-CoV-2 in human blood. The SARS-CoV-2 IgG test is intended for use as an aid in identifying individuals with an adaptive immune response to SARS-CoV-2, indicating prior infection. Antibodies are proteins produced by the immune system in response to an infection and are specific to that particular infection. They are found in the blood. SARS-CoV-2 IgG Test may help identify if you were exposed to the virus that causes COVID-19 and, if so, whether or not your body has developed antibodies. Although having antibodies usually gives immunity from further infection, there is a lack of evidence on whether having antibodies means you are protected against reinfection with COVID-19 in future.  This antibody develops in most patients at around two weeks after infection and remains in the blood after you have recovered although we do not presently know how long it may ...

Can Cervical Cancer Be Prevented?

Yes, cervical cancer is one of the most preventable types of cancer.  Cervical cancer is cancer of the cervix, that is the narrow opening into the uterus from the vagina. Cervical cancer is the fourth most common cancer in women in worldwide and second most common in India. The current estimates indicate approximately 1,00,000 new cases diagnosed and 60,000 deaths annually in India.   Cervical cancer is mainly caused by  Human Papillomavirus  (HPV) infection, a sexually transmitted infection. There are more than 100 types of HPV and of these about 15 high-risk types cause most of the cases of cervical cancer, two of these types (16 and 18) are responsible for more than 70% of cervical cancer in India.  Because of slow develops, cervical cancer is also one of the most preventable types of cancer.  Cervical cancer can often be prevented by having regular screenings (Pap smear or/ and HPV detection) to find any pre-cancers and treat...