RESUMEN
Sera from 88 patients from Santa Catarina and São Paulo states of Brazil, with epileptic seizures who underwent cerebral computed tomography (CT) were analyzed for the detection of antibodies to T. solium cysticercus by ELISA and Immunoblot (IB) with the following antigens: Taenia solium cysticercus total saline (Tso), Taenia crassiceps cysticercus vesicular fluid (Tcra-vf) and T. crassiceps cysticercus glycoproteins (Tcra-gp). ELISA carried out with Tso, Tcra-vf and Tcra-gp antigens showed 95 percent, 90 percent and 80 percent sensitivities, respectively, and 68 percent, 85 percent and 93 percent specificities, respectively. In the epileptic patients group, ELISA positivity was 30 percent, 51 percent and 35 percent with Tso, Tcra-vf and Tcra-gp antigens respectively. Considering the IB as the confirmatory test, the positivity was 16 percent (14/88) in the epileptic patients total group and 22 percent (12/54) in the epileptic patients with positive CT and signals of cysticercosis. We found a significant statistical correlation among ELISA or IB results and the phase of the disease when any antigens were used (p < 0.05). We emphasize the need to introduce in the laboratory routine the search for neurocysticercosis (NC) in patients presenting with epileptic seizures because of the high risk of acquiring NC in our region and its potential cause of epilepsy.
Amostras de soro de 88 pacientes dos Estados de Santa Catarina e São Paulo, Brasil, com crises epilépticas e que se submeteram a exame de Tomografia Computadorizada (TC), foram examinadas para detecção de anticorpos anti-cisticercos de Taenia solium por meio de ELISA e Immunoblot (IB) utilizando-se os seguintes antígenos: extrato salino total de cisticercos de T. solium (Tso); líquido vesicular de Taenia crassiceps (Tcra-vf) e glicoproteínas purificadas de cisticercos de T. crassiceps (Tcra-gp). Os resultados de ELISA com os antígenos Tso, Tcra-vf e Tcra-gp mostraram 95 por cento, 90 por cento e 80 por cento de sensibilidade, respectivamente, e 68 por cento, 85 por cento e 93 por cento de especificidade, respectivamente. No grupo de pacientes epilépticos, a positividade do ELISA foi 30 por cento, 51 por cento e 35 por cento com os antígenos Tso, Tcra-vf e Tcra-gp, respectivamente. Considerando o IB como teste confirmatório, a positividade foi de 16 por cento (14/88) no grupo total de pacientes epilépticos e 22 por cento (12/54) no grupo de pacientes epilépticos com TC positiva e sinais clínicos compatíveis com neurocisticercose. Foi encontrada correlação estatística significativa entre os resultados de ELISA ou IB e a fase da doença com quaisquer dos antígenos utilizados (p < 0,05). Os resultados indicam a necessidade de introduzir na rotina dos laboratórios o diagnóstico de neurocisticercose nos pacientes com convulsões epilépticas devido ao elevado risco de aquisição da cisticercose em nossa região e sua participação na etiologia da epilepsia.
Asunto(s)
Humanos , Animales , Anticuerpos Antihelmínticos/sangre , Antígenos Helmínticos , Epilepsia/parasitología , Neurocisticercosis/diagnóstico , Taenia solium/inmunología , Estudios de Casos y Controles , Ensayo de Inmunoadsorción Enzimática , Immunoblotting , Inmunoglobulina G , Neurocisticercosis/complicaciones , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos XRESUMEN
Sera from 88 patients from Santa Catarina and São Paulo states of Brazil, with epileptic seizures who underwent cerebral computed tomography (CT) were analyzed for the detection of antibodies to T. solium cysticercus by ELISA and Immunoblot (IB) with the following antigens: Taenia solium cysticercus total saline (Tso), Taenia crassiceps cysticercus vesicular fluid (Tcra-vf) and T. crassiceps cysticercus glycoproteins (Tcra-gp). ELISA carried out with Tso, Tcra-vf and Tcra-gp antigens showed 95%, 90% and 80% sensitivities, respectively, and 68%, 85% and 93% specificities, respectively. In the epileptic patients group, ELISA positivity was 30%, 51% and 35% with Tso, Tcra-vf and Tcra-gp antigens respectively. Considering the IB as the confirmatory test, the positivity was 16% (14/88) in the epileptic patients total group and 22% (12/54) in the epileptic patients with positive CT and signals of cysticercosis. We found a significant statistical correlation among ELISA or IB results and the phase of the disease when any antigens were used (p < 0.05). We emphasize the need to introduce in the laboratory routine the search for neurocysticercosis (NC) in patients presenting with epileptic seizures because of the high risk of acquiring NC in our region and its potential cause of epilepsy.