Added Value of Antigen ELISA in the Diagnosis of Neurocysticercosis in Resource Poor Settings 英文参考文献.docVIP
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Added Value of Antigen ELISA in the Diagnosis of Neurocysticercosis in Resource Poor Settings 英文参考文献
AddedValueofAntigenELISAintheDiagnosisof
NeurocysticercosisinResourcePoorSettings
SarahGabrie¨l1.,JoachimBlocher2,3*.,PierreDorny1,EmmanuelNjiAbatih1,ErichSchmutzhard2,
MichaeliOmbay4,BartholomayoMathias4,AndreaSylviaWinkler5
1DepartmentofBiomedicalSciences,InstituteofTropicalMedicine,Antwerp,Belgium,2DepartmentofNeurology,MedicalUniversityofInnsbruck,Innsbruck,Austria,
3DepartmentofNeurology,UniversityMedicalCentreGo¨ttingen,Go¨ttingen,Germany,4MentalHealthUnit,HaydomLutheranHospital,Mbulu,Tanzania,5Department
ofNeurology,TechnicalUniversityMunich,Munich,Germany
Abstract
Background: Neurocysticercosis (NCC) is the most common cause of acquired epilepsy in Taenia solium endemic areas,
primarilysituatedinlow-incomecountries.Diagnosisislargelybaseduponthe‘‘DelBruttodiagnosticcriteria’’usingthe
definitive/probable/no NCC diagnosis approach. Neuroimaging and specific T. solium cysticercosis antibody detection
resultsareatthemainstayofthisdiagnosis,whileantigendetectioninserumhasneverbeenincluded.Thisstudyaimedat
evaluating the addition of antigen detection as a major diagnostic criterion, especially in areas where neuroimaging is
absent.
Methods: The B158/B60 monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA) for the detection of
circulatingcysticercusantigenwascarriedoutretrospectivelyonserumsamplescollectedduringahospital-basedstudy
from83peoplewithepilepsy(PWE)inanendemicarea.
Results:TheadditionofantigenresultsasamajorcriterionallowedthecorrectdiagnosisofdefinitiveNCCin10outof17
patientsasopposedto0/17withoutantigenresultsintheabsenceofneuroimaging.Asensitivityof100%andaspecificity
of84%weredeterminedforthediagnosisofactiveNCCusingantigenELISA.Whiletheuseofahighercutoffimprovesthe
specificityofthetestto96%,itdecreasesitssensitivityto83%.
Conclusions:Inareaswhereneuroimagingisabsent,NCCdiagnosisaccordingtotheexistingcriteriaisproblematic.Taking
intoaccountitslimitationsfordiagnosisofinactiveNCC,antigendetectioncanbeofaddedvaluefordiagnosingNCCin
PW
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