Diagnóstico sorológico da estrongiloidíase humana através do método imunoenzimático

Abstract

O presente trabalho demonstra a eficácia do método imunoenzimático utilizando antígeno solúvel de larvas de Strongyloides stercoralis no diagnóstico da estrongiloidíase humana. Foram avaliados 27 pacientes com as diversas formas clínicas da parasitose, sendo demonstrados títulos significativos em 25 (92%) dos casos. Em 17 controles, com ou sem outrasparasítoses intestinais, títulos significativos estavam presentes em 3 (18%). A sensibilidade do teste foi de 92% e a especificidade de 82%. São também relatados 3 casos clínicos, nos quais o diagnóstico da doença foi feito inicialmente pela determinação de anticorpos contra larvas de S. stercoralis, havendo posteriormente demonstração parasitológica em 2 dos casos. É ressaltada a importância do teste no diagnóstico da estrongiloidíase aguda e em situações onde eosinofilia não esteja associada a outras condições clínicas.

The value of an immunoenzymatic test (enzyme-linked immunosorbent assay) for the diagnosis of strongyloidiasis in patients immunosuppressed by hematologic malignancies.

“…14,15,17,[28][29][30] In a previous study done in Brazil in a region endemic for strongyloidiasis, the sensitivity was 92% in the general population of immunocompetent individuals. 27 Our lower sensitivity may be explained by the reduction of antibody production because of the immunosuppression. Indeed, the optical density values of the sera from the immunocompromised patients were significantly lower than the values of the control sera.…”

“…20 The specificity of the test observed in the present study was similar to the results reported in immunocompetent people, which ranged from 82% to 100%. 14,15,18,27,30,31 Although sensitivity and specificity are intrinsic properties of any given test, the positive and negative predictive values are the most useful information for the user of the test because they represent the rate of true positive and true negative cases, with the results varying depending on the prevalence of the infection in the study area. In our study, the positive predictive value of the ELISA was very low, reflecting a very high rate of false-positive results (half of the positive results).…”

Parasitological and immunological diagnoses of strongyloidiasis in immunocompromised and non-immunocompromised children at Uberlândia, state of Minas Gerais, Brazil

“…Several studies support the view that detection of parasite-specific antibodies may be a useful complement to the traditional parasitological diagnosis of strongyloidiasis using the indirect immunofluorescence antibody test (IFAT) 4,12 and enzyme-linked immunosorbent assay (ELISA) 3,13,22 .…”