1例弓形虫IgM抗体假阳性案例分析  

One Case Report of the Analysis of False Positive IgM Antibody of Toxoplasma Gondii and Related Literature Review

作　　者：李虎 杨春秋[1] 王楠楠 朱进进 余莉[3] LI Hu;YANG Chunqiu;WANG Nannan;ZHU Jinjin;YU Li(Department of Laboratory Medicine,Taihe County People's Hospital,The Taihe Hospital of Wannan Medical College,Fuyang 236600,China;Laboratory of Medical Biochemistry and Molecular Biology,School of Basic Medical Sciences,Anhui Medical University,Hefei 230032,China;The Key Laboratory of zoonotic Infectious Diseases of Anhui Province,The Key Laboratory of Zoonoses of High Institutions in Anhui,Department of Microbiology and Parasitology,School of Basic Medical Sciences,Anhui Medical University,Hefei 230032,China)

机构地区：[1]太和县人民医院检验科,安徽阜阳236600 [2]安徽医科大学基础医学院医学生物化学与分子生物学实验室,安徽合肥230032 [3]动物源性传染病安徽省重点实验室,安徽省高校人畜共患病重点实验室,安徽医科大学基础医学院微生物学与寄生虫学教研室,安徽合肥230032

出　　处：《标记免疫分析与临床》2025年第3期656-660,共5页Labeled Immunoassays and Clinical Medicine

基　　金：国家重点研发计划(编号:2021YFC2009300)。

摘　　要：目的通过病原学检测并结合患者临床症状以及影像学检查排除弓形虫感染,通过实验设计以及查阅文献分析患者血清弓形虫IgM抗体假阳性原因,并总结归纳处理流程,为临床提供全面的诊疗思路。方法通过外周血涂片镜检、弓形虫核酸检测以及影像学脑部磁共振成像(MRI)检测排除弓形虫感染;通过不同检测平台复检,增加类风湿因子(RF)、嗜异性抗体、冷凝集素的检测,以及动态监测弓形虫IgM抗体变化趋势分析假阳原因。结果患者血清中升高的弓形虫IgM抗体为假阳性,其血清中存在的EBV-IgM抗体和检测试剂发生交叉反应,干扰了检测结果。结论发现弓形虫IgM抗体异常升高时,应参考相应处理流程,增加相关检测,分析原因,避免误诊。Objective The infection of Toxoplasma gondii was excluded through etiological detection combined with clinical symptoms and imaging examination of patients,and the cause of false positive of serum toxoplasma IgM antibody was analyzed through experimental design and literature review.We summarized these processes to provide a comprehensive diagnosis and treatment strategy for the clinical practice.Methods We excluded the Toxoplasma infection based on the results of peripheral blood smear microscopy,special nucleic acid detection and the brain imaging magnetic resonance imaging(MRI).In addition,we conducted the re-examination through the different detection platforms to increase the detection of rheumatoid factor(RF),heterophile antibody and cold agglutinin.We also monitored the dynamic change pattern of toxoplasma IgM antibody to analyze the cause of the false positive.Results The elevated IgM antibody of Toxoplasma was a false-positive result,and the EBV-IgM antibody in the serum showed a cross-reaction with the reagents,resulting in an interfering effect on the detection.Conclusion When the abnormal increase of Toxoplasma IgM antibody is observed,the corresponding processing process should be referred to,and the relevant detections should be added to analyze the causes and avoid potential misdiagnosis.

关 键 词：弓形虫病 假阳性 IGM抗体 传染性单核细胞增多症 

分 类 号：R382.5[医药卫生—医学寄生虫学]