Detection of hydatid-specific antibodies in the serum and urine for the diagnosis of cystic echinococcosis in patients from the Kashmir Valley, India.

Serological diagnosis of cystic echinococcosis (CE) is usually made by detecting specific antibodies in serum samples. However, collection of blood samples is difficult and may be hazardous and unsafe. Thus, it is important to assess alternative simple methods of sampling body fluids that give similar results. Saliva and urine have been suggested as possible alternatives to detect specific antibodies for the diagnosis of various diseases. To the best of our knowledge, there has been no previously published study regarding the detection of CE-specific immunoglobulin (Ig) G subclass antibodies (IgG1-4) in urine. Therefore, the present study was designed to assess the value of hydatid-specific antibodies of IgG, IgM, IgE and IgG subclass in urine and serum samples for the diagnosis of CE. Serum and urine samples of 41 surgically confirmed patients of CE, 40 patients with other diseases and 16 healthy subjects were included in the study. CE-specific total IgG, IgE and IgG4 in sera and total IgG, IgG4 and IgG1 in the urine of CE patients were the most important specific antibodies for the diagnosis of CE. However, total IgG usually persists for an extended period and has a very high cross-reactivity. The diagnostic sensitivity of hydatid-specific IgM in serum and urine samples was very low and therefore cannot be used as a diagnostic marker. There was no significant difference between IgG1 and IgG4 in serum and urine and both showed the best correlation for the diagnosis of CE. These considerations suggest that detection of antibodies in urine could provide a new approach in the diagnosis of CE.

Detection of specific hydatid antigens and antibodies in serum and urine of experimentally infected sheep.

Immunodiagnostic confirmation of cystic human hydatidosis is frequently required before surgical intervention or of chemotherapy. However, it remains inadequate to detect specific antibodies or antigens in some confirmed cases of echinococcosis. This study was carried out to investigate the accuracy of three different immunodiagnostic tests for detection of specific circulating antigens or antibodies in the serum and urine of 13 experimentally infected sheep. For this purpose, Echinococcus granulosus were collected from small intestine of experimentally infected dogs, and 2000 taenid eggs were orally administered to each of the 13 sheep. There were six other sheep, which were kept as the control group. Biweekly serum and urine samples were collected from all the sheep for 4 months after infection. The sera were subjected to indirect hemagglutination test and the concentrated urine samples were subjected to coagglutination and counter immunoelectrophoresis tests. The results revealed that the sensitivity of these tests in detecting the hydatid antigens in the urine or antihydatid antibodies in the serum of the infected sheep reached their maximum in 12th and 13th week after infection; then it decreased in the following weeks. Examination of the non-infected sheep samples throughout the experiment showed that the aforesaid findings were specific only to the infected sheep. It seems that the appearance of specific hydatid antigen in urine and its antibodies in the serum were simultaneous. Although these tests are highly specific, false negative outcomes were encountered in their detection of cystic echinococcosis. In general, it seems rational to establish some series of diagnostic procedures in order to reveal antibodies and antigen of metacestode in serum and urine of the patients.

Renal hydatid cyst: urinary cytological diagnosis.

Echinococcal disease is endemic in many areas of Asia, Europe, South America, the Near East, Australia, and New Zealand. Hepatic and pulmonary cysts are the most common presentation. Isolated renal hydatid cyst is an uncommon presentation of echinococcal disease, since renal involvement occurs in only 2-3% of cases. We present the case of a young man with renal colic, in whom the diagnosis of renal hydatid disease was established cytologically. Urine cytology, performed because of persistent hematuria, revealed scolices of Echinococcus granulosus and prompted further imaging investigation, and, ultimately, surgical treatment.