ABSTRACT
Stool examination using modified Kato thick smear method was performed to detect Fasciola eggs and other parasites. Abdominal pain was the major presenting symptom [87.7%], followed by pallor [83.3%] and fever [16.7%]. Anemia and hepatomegaly were recorded in 77.7% of the patients compared with 27.7% with splenomegaly. Abdominal ultrasonography revealed hepatomegaly and common bile duct dilatation in 77.7% of the patients. Moreover, five cases showed diagnostic olympic game rings. All patients had positive IgG4 levels, 55 cases were positive for specific total IgG and IgG1; whereas only 24 cases had positive IgG2 levels. All negative controls showed no cross reactions. On the other hand, ELISA detecting IgG4 showed the highest specificity [95%], followed by IgG2 [85%] and the least specific test was obtained with the detection of IgG [70%] and IgG1 [65%]. One month after treatment, 91.1% of the patients were completely cured and even after another two-month follow up. In completely cured patients, none of anti- Fasciola isotypes was significantly changed. So, the detection of anti- Fasciola isotypes, especially IgG4, is very specific for the accurate diagnosis of human fascioliasis