Assuntos
Cianoacrilatos/administração & dosagem , Duodenopatias/terapia , Fístula Intestinal/terapia , Doenças do Jejuno/terapia , Complicações Pós-Operatórias/terapia , Adesivos Teciduais/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Endoscopia Gastrointestinal/métodos , Estudos de Viabilidade , Fluoroscopia/métodos , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Radiografia Intervencionista/métodos , Tomografia Computadorizada por Raios X/métodosRESUMO
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.
