Elevation of Candida IgG antibodies in patients with medically unexplained sympt

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Elevation of Candida IgG antibodies in patients with medically

unexplained symptoms.

Lewith GT, Chopra S, Radcliffe MJ, Abraham N, Prescott P, Howarth PH.

Background: The hypothesis that an immunologic reaction to Candida

yeasts, present in the gastrointestinal tract, causes a diffuse

collection of multisystem symptoms is not generally accepted within

conventional medicine. A questionnaire, the Fungus Related Disease

Questionnaire (FRDQ-7), was previously developed and used to identify

patients for a randomized, placebo-controlled trial of the

nonabsorbed antifungal drug nystatin. Nystatin was superior to

placebo in relieving these symptoms. This provides some support for

the hypotheses that underpin the " Candida syndrome " . Aim: The aim of

this study was to identify a population with a high (>9) FRDQ-7 score

and symptom-free controls and, subsequently, to explore the

relationship between FRDQ-7 scores and Candida immunoglobulin (Ig)A,

IgG, and IgM levels. Design: This was a case-controlled study.

Methods: Santelmann has suggested that the FRDQ-7 describes people

with Candida syndrome if the FRDQ-7 score is >9; 35 patients with

medically unexplained symptoms, between ages 18 and 64, were selected

for the study if they scored > 9 on the FRDQ-7 questionnaire. Serum

Candida IgA, IgG, and IgM measurements were undertaken both for this

group and a group of 45 healthy age- and gender-matched controls, and

the Ig concentrations were compared. Results: Candida IgG

concentration was significantly higher in the noncontrol group than

in the control group (p < 0.001). No significant difference was found

for Candida IgA or IgM concentrations. Conclusions: Further studies

are required to identify whether there is a causal link for the

elevation of serum IgG found in this subgroup of patients with

increased FRDQ-7 scores, or whether these two observations are

parallel manifestations of a common underlying disorder.