Prothrombin time inhibition detected with recombinant but not with conventional thromboplastins in two patients with high-titre IgM and moderate-titre IgA anticardiolipin antibodies

We report two cases of high-titre IgM and moderate-titre IgA anticardiolipin antibodies (ACA) in whom prothrombin times (PT) derived using recombinant thromboplastins (rTP) were prolonged but were normal when measured with conventional thromboplastins. The anticoagulant nature of these antibodies cannot be categorized as the classical lupus type. We suggest that routine screening for the presence of antiphospholipid antibodies (APA) should be performed in patients who fall into this category.

Genetic characterization of a new variant within the ET-37 complex of Neisseria meningitidis associated with outbreaks in various parts of the world

A new variant within the electrophoretic type (ET)-37 complex of Neisseria meningitidis, ET-15, first detected in Canada in 1986, has been associated with severe clinical infections and high mortality rates in several European countries, Israel and Australia. To ascertain the genetic and epidemiological relationships of ET-15 strains from different geographical areas, 72 ET-15 isolates from 10 countries were compared to 13 isolates representing other clones of the ET-37 complex. The 85 strains were analysed by pulsed-field gel electrophoresis (PFGE) using 2 restriction endonucleases and Southern hybridization with 10 genetic markers. Four ET-15 strains and 4 other strains of the ET-37 complex were further examined using an additional restriction enzyme and a total of 18 genetic markers. PFGE fingerprints of the ET-15 strains were closely related. Strains within each country were even more closely related, suggesting single introductions of the clone. Physical mapping of genes in ET-15 and other strains of the ET-37 complex demonstrated that large genetic rearrangements of the genome have occurred in association with the appearance of the ET-15 variant.