Echinococcosis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Kalsang Dolma, M.B.B.S.[3]; Aditya Ganti M.B.B.S. [4]

Overview

In the patients suspected of echinococcosis enzyme-linked immunosorbent assay (ELISA) and the indirect hemagglutination test are highly sensitive procedures for the initial screening of serum for cystic echinococcosis. In case of alveolar echinococcosis serologic test results are usually positive at high titers. Comparing a patient’s titers with both purified-specific and shared antigens permits the serologic discrimination between patients infected with E. multilocularis and those infected with E. granulosus.

Laboratory Findings

Serologic Tests

Cystic Echinococcosis

Enzyme-linked immunosorbent assay (ELISA) and the indirect hemagglutination test are highly sensitive procedures for the initial screening of serum. Specific confirmation of reactivity can be obtained by demonstrating echinococcal antigens by immunodiffusion (arc 5) procedures or immunoblot assays (8-, 21 –kD bands).

Alveolar Echinococcosis

Serologic test results are usually positive at high titers. Comparing a patient’s titers with both purified-specific and shared antigens permits the serologic discrimination between patients infected with E. multilocularis and those infected with E. granulosus.

Laboratory Tets	Findings
CBC	Lymphopenia Eosinophilia is rare
Antibody testing (Immunoglobulin concentrations)	Increase in levels of gammaglobulins Increase in immunoglobulin G (IgG) levels Mild elevation of immunoglobulin A (IgA) and immunoglobulin M (IgM). CRP levels might be elevated
Liver function tests	GGT is elevated Alkaline phosphatase and aspartate aminotransferase (AST) levels increases Levels of aminotransferases increase only when associated with necrosis. Prothrombin time decreases Factor V levels decrease
Serology tests	Antibody detection is more sensitive than antigen detection ELISA and IHA are the methods most frequently employed for screening Crude antigens such as hydatid fluid or protoscolex extracts are used. Immunoelectrophoresis and immunoblotting are used for confirmation