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Convalescent samples were obtained within 6\u00a0weeks of the acute sample. An IFA titer \u2265\u202f80 was considered positive. Overall, 22\u00a0acute and 21\u00a0convalescent samples were tested by all 3\u00a0IFA assays.\n                  <\/jats:p>\n                  <jats:p>On the acute phase serum sample, 14\/22 (63.6%) were positive using the combined IgG\/IgA\/IgM assay, 10\/22 (45.5%) by IgM, 12\/22 (54.5%) by IgG and\u00a013\/22 (59.1%) by either IgM or IgG assays. Only\u00a01 of 8\u00a0(12.5%) samples testing negative by the combined IgG\/IgA\/IgM assay was positive by an individual IFA testing (IgM IFA only). Of the 21\u00a0cases with a\u00a0convalescent phase sample, 100% tested positive on the combined IgG\/IgA\/IgM, 20\u00a0(95.2%) on the IgG and 20\u00a0(95.2%) on the IgM IFA individual assays; all\u00a021 (100%) tested positive by either the IgM or the IgG individual IFA assays.<\/jats:p>\n                  <jats:p>Titers \u2265\u202f640 were found in the acute phase in 58.3\u201380%, and in the convalescent phase for 85%\u201395.2% of the positive samples for the 3\u00a0IFA assays assessed.<\/jats:p>\n                  <jats:p>In conclusion, the 3\u00a0IFA methods tested had comparable sensitivity on acute and convalescent phase serum samples of patients with HGA when using a\u00a0cut-off of \u2265\u202f80. Further studies should be conducted to determine the IFA cut-off values that offer the best sensitivity and specificity.<\/jats:p>","DOI":"10.1007\/s00508-026-02830-9","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:26:01Z","timestamp":1790835961000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Utility of combined detection of IgG\/IgM\/IgA vs. separate IgG and IgM antibodies to Anaplasma phagocytophilum in culture and PCR-confirmed patients with human granulocytic anaplasmosis"],"prefix":"10.1007","author":[{"given":"Gary P.","family":"Wormser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lois","family":"Zentmaier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionysios","family":"Liveris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Aguero-Rosenfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"2830_CR1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00083-18","volume":"33","author":"S Madison-Antenucci","year":"2020","unstructured":"Madison-Antenucci\u00a0S, Kramer\u00a0LD, Gebhardt\u00a0LL, Kauffman\u00a0E. 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