Subject(s)
Cyanoacrylates/administration & dosage , Duodenal Diseases/therapy , Intestinal Fistula/therapy , Jejunal Diseases/therapy , Postoperative Complications/therapy , Tissue Adhesives/administration & dosage , Aged , Aged, 80 and over , Endoscopy, Gastrointestinal/methods , Feasibility Studies , Fluoroscopy/methods , Humans , Injections, Intralesional , Male , Middle Aged , Radiography, Interventional/methods , Tomography, X-Ray Computed/methodsABSTRACT
We assessed an Echinococcus granulosus hydatid fluid antigen-ELISA (EgHF-ELISA) as a serologic prescreening test for E. granulosus infections, supplemented by more specific confirmatory tests, including arc-5 immunoprecipitation and antigen B subunit 8-kD immunoblotting. The diagnostic sensitivity of the EgHF-ELISA was 91%. With regard to the test specificity of the EgHF-ELISA (overall = 82%), we observed relatively frequent cross-reactions in tumor patients (6%) and in patients with other parasitic diseases. Cestode-related cross-reactivity can be resolved by the complementary use of E. multilocularis-specific antigens or Taenia solium cysticercosis-specific immunoblotting. Immunoblotting based upon the detection of antibody reactivity to the 8-kD antigen of EgHF, or if appropriately detectable, to the 29-kD and 34-kD bands exhibited a 91% diagnostic sensitivity and an overall specificity of 97% or 94%, respectively. Thus, immunoblotting provided a 99% discrimination between seropositive pre-operative cystic hydatid disease cases and cross-reactive non-cestode parasitic infections or malignancies.
