Bernardo Frider, Argerich Hospital- Buenos Aires-Argentina
11 February 2009
Authors described that " 1323 patients suspected of having echinococcosis were screened serologically by indirect haemagglutination assay (IHA). For confirmation and differentiation of Echinococcus spp. infection, the sera of IHA-positive patients were then retested by western blot (WB)." <br>In results they said " Out of 127 IHA-positive sera, 34 sera were confirmed by WB and considered specific for CE. Of 34 sera of CE-positive patients sera, 32 corresponded to the characteristic imaging findings of a liver cysts and 2 to those of lung cysts For confirmation and differentiation of Echinococcus spp. infection, the sera of IHA-positive patients were then retested by western blot (WB)." It was interesting to know what was the final diagnosis of the 1323 cases of cysts detected by US or other imaging technics. It is well known that serology have not the sensitivity of US in detecting hydatid cysts, but it is a surprise the low sensitivity of the serology found in this population. If not, the other point is to take in account the high prevalence of non parasitic cyst in the population studied. If hydatid cysts are suspected by imaging, the great majority have sure some characteristic of hydatidosis. Therefore, is very important to know the final diagnsotic of the whole population.<br><br>Macpherson CN, Bartholomot B, Frider B. Application of ultrasound in diagnosis, treatment, epidemiology, public health and control of Echinococcus granulosus and E. multilocularis. Parasitology. 2003;127 Suppl:S21-35. <br>Frider B, Ledesma C, Odriozzola M, Larrieu E. [Echographic specificity in the early diagnosis of human hydatidosis] Acta Gastroenterol Latinoam. 1990;20(1):13-5. <br>Frider B, Losada CA, Larrieu E, de Zavaleta O. Asymptomatic abdominal hydatidosis detected by ultrasonography. Acta Radiol. 1988 Jul-Aug;29(4):431-4.<br>Shambesh MA, Craig PS, Macpherson CN, Rogan MT, Gusbi AM, Echtuish EF.An extensive ultrasound and serologic study to investigate the prevalence of human cystic echinococcosis in northern Libya. Am J Trop Med Hyg. 1999 Mar;60(3):462-8.<br>WHO Informal Working Group on Echinococcosis, 2003. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 85: 253–261.<br><br><br>Sincerely<br><br>Bernardo Frider MD<br><br><br>Bernardo Frider MD<br>Head dept. Medicine-Hepatology <br>Argerich Hospital<br>Buenos Aires<br>Argentina<br>bernardo@frider.com.ar<br>
Serology sensitivity in hydatid cysts.
11 February 2009
Authors described that " 1323 patients suspected of having echinococcosis were screened serologically by indirect haemagglutination assay (IHA). For confirmation and differentiation of Echinococcus spp. infection, the sera of IHA-positive patients were then retested by western blot (WB)." <br>In results they said " Out of 127 IHA-positive sera, 34 sera were confirmed by WB and considered specific for CE. Of 34 sera of CE-positive patients sera, 32 corresponded to the characteristic imaging findings of a liver cysts and 2 to those of lung cysts For confirmation and differentiation of Echinococcus spp. infection, the sera of IHA-positive patients were then retested by western blot (WB)." It was interesting to know what was the final diagnosis of the 1323 cases of cysts detected by US or other imaging technics. It is well known that serology have not the sensitivity of US in detecting hydatid cysts, but it is a surprise the low sensitivity of the serology found in this population. If not, the other point is to take in account the high prevalence of non parasitic cyst in the population studied. If hydatid cysts are suspected by imaging, the great majority have sure some characteristic of hydatidosis. Therefore, is very important to know the final diagnsotic of the whole population.<br><br>Macpherson CN, Bartholomot B, Frider B. Application of ultrasound in diagnosis, treatment, epidemiology, public health and control of Echinococcus granulosus and E. multilocularis. Parasitology. 2003;127 Suppl:S21-35. <br>Frider B, Ledesma C, Odriozzola M, Larrieu E. [Echographic specificity in the early diagnosis of human hydatidosis] Acta Gastroenterol Latinoam. 1990;20(1):13-5. <br>Frider B, Losada CA, Larrieu E, de Zavaleta O. Asymptomatic abdominal hydatidosis detected by ultrasonography. Acta Radiol. 1988 Jul-Aug;29(4):431-4.<br>Shambesh MA, Craig PS, Macpherson CN, Rogan MT, Gusbi AM, Echtuish EF.An extensive ultrasound and serologic study to investigate the prevalence of human cystic echinococcosis in northern Libya. Am J Trop Med Hyg. 1999 Mar;60(3):462-8.<br>WHO Informal Working Group on Echinococcosis, 2003. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 85: 253–261.<br><br><br>Sincerely<br><br>Bernardo Frider MD<br><br><br>Bernardo Frider MD<br>Head dept. Medicine-Hepatology <br>Argerich Hospital<br>Buenos Aires<br>Argentina<br>bernardo@frider.com.ar<br>
Competing interests
No conflict of interest