Loa loa filariasis other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Other Diagnostic Studies
Serology
In patients in whom microfilariae are not visualized, blood tests are available to assist in making the diagnosis, though many are not available outside the research setting. There is a general screen for any filarial infection (including Wuchereria, Brugia, Onchocerca, and Mansonellainfections) that is available in some specialty diagnostic labs. Because the test is highly sensitive, it is useful in determining if an individual has had filarial infection, but it is not specific enough to identify which filarial infection. As with any antibody test, the results indicate only that the patient has been exposed to the disease, but they do not indicate if the patient has an active infection. This distinction is less important in symptomatic travelers, but it limits the usefulness of the test in persons from endemic areas. One advantage of the test is that it can pick up evidence of infection in the pre-patent stage of infection. There are several Loa-specific serologic tests in existence, such as the tests for antibodies to the LlSXP-1 recombinant antigen which can be used in both an ELISA and a luciferase immunoprecipitation systems (LIPS) assay, but these are currently available only in the research setting and are not approved for diagnosis in the United States. There is one polymerase chain reaction (PCR) test for loiasis approved for diagnosis in the United Stated.
PCR
In general the diagnosis of L. loa infection should be made with blood smear. However, when blood smears are negative and clinical suspicion of infection is high, the general antibody test could be used in an attempt to exclude infection. If the general antibody test were positive, then it might be necessary to consider seeking additional diagnostic information by enlisting the assistance of researchers who perform antibody and/or PCR tests.