29 July 2022
: Case report 
Systemic Brucellosis with Arrhythmogenic Cardiac Inflammatory Pseudotumor
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare coexistence of disease or pathology
Krzysztof Kaczmarek
1ABCDEF*, Romuald Wojnicz2CDE, Paweł Ptaszyński1BD, Jerzy Krzysztof Wranicz1BD, Iwona Cygankiewicz1BCDE
DOI: 10.12659/AJCR.935259
Am J Case Rep 2022; 23:e935259
Table 1. List of laboratory tests focused on the underlying cause of the inflammatory pseudotumor.
| Blood culture – negative (both aerobic and non-aerobic) [IgM <1: 20 (N <1: 20); IgG <1: 40 (N <1: 20)] sp. 1. [EIA: IgM 16.3U; IgG 6.0U; (N <8.5U)] 2. (after 12 weeks) [EIA: IgM 8.7U; IgG 28.3U (N <8.5U)] (IFA: IgG <1: 10) [IFA: IgA <1: 10 (N <1: 10); IgM <1: 100 (N <1: 100); IgG <1: 320 (N <1: 320)] [IHC: IgA, IgM, IgG <1: 60 (N <1: 60)] [IFA: <1: 10 (N <1: 10)] [ELISA: IgM – negative; IgG 3.24 RU/ml (N <16); IgA – negative] [ELISA: IgM – negative; IgG <2 RU/ml (N <16); IgA – negative] sp. [ELISA: IgA – negative; IgG 5 RU/ml (N <16)] [RPR: negative] [QuantiFERON test – negative] [ELISA: IgM – negative; IgG – negative] [ELISA: IgM – negative; IgG – positive] [QuantiFERON test: 0.0 IU/ml (N <0.35); mitogen 7.59 (N >0.5)] [ELISA: IgM 5 BBU/ml; IgG 2 BBU/ml (N <9 BBU/ml for both), WB IgM – negative, IgG – negative]HCV [anti-HCV – negative]HBV [HBs-antigen – negative]HIV [HIV combo – negative]EBV [ELISA: IgM – negative; IgG – positive]CMV [ELISA: IgM – negative; IgG – positive]: sp. [IHA: IgM<1: 20 (N<1: 10); IgG<1: 40 (N<1: 10)] sp. (EIT: IgG - 1 MONA; N<4) [(IHA: IgG<1: 160 (N<1: 160); EIT () 1–2 MONA; (N<4)] [WB: IgG – negative] (EIT: 1 MONA; N<6) sp. [WB: IgG – negative] [ELISA: IgM 0.1 (N <0.5); IgG 16.8 IU/ml (N <1.6)] [ELISA: IgG 1.1 U (N <9)] [IIA: IgG – negative] sp. [IgG, IgA, IgM 1: 320; (N <1: 80)]Blood culture – negativeParasites in urine and blood (microscopy) [negative]WBC 8900/µlCRP [2.6 mg/l (N <5.0)]ANA [Sep 2015 1: 320; Dec 2015 1: 80 (N <1: 160)]cANCA [1: 20 (N <1: 10)]pANCA [negative]RF [<10 IU/ml (N <14)]IgG4 [65.7mg/dl (N: 5–100)]IgE [15.5 IU/ml (N <100)]Troponin T [6 ng/l; 10 ng/ml (N<14)]CK-MB mass [1.1 ng/ml (N <4.9)]D-dimers [0.49µg/ml (N <0.5)]ACE [18U/l (N: 8–52)]Serum protein electrophoresis (g/l) [TP 73.5; Alb. 38.0; Globulins: α 2.0; α 9.0; β 5.3; β 4.2; γ 15.1] |
| HCV – hepatitis C virus; HBV – hepatitis B virus; HIV – human immunodeficiency virus; EBV – Epstein-Barr virus; CMV – cytomegalovirus; CRP – C-reactive protein; ANA – antinuclear antibodies; cANCA – antineutrophil cytoplasmic antibodies targeting proteinase 3; pANCA – antineutrophil cytoplasmic antibodies targeting myeloperoxidase; RF – rheumatic factor; EIA – enzyme immunoassay; EIT – enzyme immunologic test; MONA – multiple of normal activity; IHA – indirect hemagglutination assay; IFA – indirect immunofluorescence assay; IIA – indirect immunoassay; IHC – immunohistochemical assay; ELISA – enzyme-linked immunosorbent assay; BBU – Biomedica Borrelia units; TP – total proteins; Alb. – albumins; ACE – angiotensin converting enzyme. |