Hydatid false positive serological test results in malignancy.

Dar, F.K.; Buhidma, M A; Kidwai, Shafey

doi:10.1136/bmj.288.6425.1197

Cited by 17 publications

(14 citation statements)

References 3 publications

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“…In central Europe, these include primarily the differential diagnosis of AE, cysticercosis, and other parasitic infections with potential cross-reactivity, other hepatic disorders including malignancies that may mimic cyst-like structures in imaging procedures, and malignancies that may putatively lead to false-positive reactions such as those described by Dar and others. 15 The present study was designed to assess the diagnostic performance of an EgHF-ELISA complemented by two confirmatory tests (arc-5 immunoprecipitation and 8-kD immunoblotting test). Our evaluation strategy included discrimination between diagnostic sensitivity and diagnostic sensitivity of the EgHF-ELISA.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to CHD serology, the occurrence of false-positive antibody reactions related to malignancies have already been documented. 15 We designed the present study to comparatively assess the diagnostic performance of three different serologic tests applied either as primary screening tests (ELI-SA) or as confirmation tests for elucidation of the specificity of a seroreaction positive in the primary screening (arc-5 immunoprecipitation and immunoblotting). …”

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confidence: 99%

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Differential immunodiagnosis between cystic hydatid disease and other cross-reactive pathologies.

Poretti

Felleisen²,

Grimm³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

109

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Abstract.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 ϭ 82%), we observed relatively frequent crossreactions 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 preoperative cystic hydatid disease cases and cross-reactive non-cestode parasitic infections or malignancies.For primary serologic diagnosis and for support of clinical diagnosis of cystic echinococcosis (cystic hydatid disease [CHD]), the selection of a particular immunodiagnostic test involves consideration of the diagnostic operating characteristics of the technique and the purpose for which it will be used. The diagnostic sensitivity and specificity of the tests vary according to the nature and quality of the antigen and the methodologic sensitivity of the selected technology. A concise definition of the sera used for the assessment of test parameters is essential, with special attention paid to the definition of pre-or post-operative situations respective to CHD serum sampling time point. One of the most specific conventional immunodiagnostic approaches for CHD relies upon the demonstration of serum antibodies precipitating an antigen called antigen 5 by immunoelectrophoresis or similar techniques.1 Diagnostic sensitivities with respect to hepatic CHD have been reported to vary between 50% and 80%. Antibodies to antigen 5 also occurred in serum of human patients with neurocysticercosis 3 and alveolar echinococcosis (AE). 4 Comparative studies showed that 58% of Swiss patients with AE were arc 5-positive compared with 74% of patients with CHD. 5 Resolution of E. granulosus hydatid cyst fluid by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), followed by immunoblotting, resulted in the identification of the arc-5 subunits, including two subunits with relative molecular masses estimated by different laboratories to be between 37 and 38 kD and 20-22-24 kD, respectively. 2 Diagnostic assessment of these two antigens by immunoblotting performed in different laboratories have resulted in the publication of discrepant sensitivity and specificity parameters. 2,6,7 The second major parasite antigen in hydatid cyst fluid is a thermostable lipoprotein called antigen B. The major components of antigen B r...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Differential immunodiagnosis between cystic hydatid disease and other cross-reactive pathologies.

Poretti

Felleisen²,

Grimm³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

109

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“…Such falsepositive antibody reactions have been related to malignancies (30), the presence of anti-P1 antibodies (14), and liver cirrhosis (66).…”

Section: Immunology Definitive Hostsmentioning

confidence: 99%

Molecular and immunological diagnosis of echinococcosis

Gottstein

1992

Clin Microbiol Rev

122

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Echinococcosis is an infectious disease of humans caused by the larval (metacestode) stage of the cestode species Echinococcus granulosus (cystic echinococcosis or hydatid disease) or Echinococcus multilocularis (alveolar echinococcosis or alveolar hydatid disease). Clinical manifestations depend primarily on localization and size of hepatic lesions and may include hepatomegaly, obstructive jaundice, or cholangitis. Prognostically, alveolar echinococcosis is considered similar to liver malignancies, including a lethality rate of 90% for untreated cases. Diagnosis is based on imaging techniques coupled with immunodiagnostic procedures. Antibody detection tests for E. multilocularis have markedly improved with the use of affinity-purified Em2 antigen and recombinant antigen II/3-10 in enzyme immunoassays. Antigens of corresponding quality for E. granulosus are still unavailable. The detection of circulating antigens and immune complexes in the sera of patients with cystic echinococcosis, the demonstration of in vitro lymphocyte proliferation in response to stimulation with Echinococcus antigens, and the discrimination of serum immunoglobulin isotype activity to various Echinococcus antigens in both cystic and alveolar echinococcosis have been suggested for diagnostic purposes as well as for monitoring patients after treatment. New diagnostic molecular tools include DNA probes for Southern hybridization tests and polymerase chain reaction for the amplification of E. multilocularis and E. granulosus species-specific DNA fragments.

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“…Moreover, sera from cancer patients are also known sometimes to cause serological cross-reactivity, as has been documented, e.g. for echinococcosis serology [1], [2], [3], [17], [18]. Therefore, one of the crucial considerations for the present study was the inclusion of sera from 121 cancer patients that had already been previously investigated for their putative cross- or non-specific reactivity with Echinococcus antigens [2], [3].…”

Section: Introductionmentioning

confidence: 99%

Comparative Assessment of ELISAs Using Recombinant Saposin-Like Protein 2 and recombinant Cathepsin L-1 from Fasciola hepatica for the Serodiagnosis of Human Fasciolosis

et al. 2014

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Two recombinant Fasciola hepatica antigens, saposin-like protein-2 (recSAP2) and cathepsin L-1 (recCL1), were assessed individually and in combination in enzyme-linked immunosorbent assays (ELISA) for the specific serodiagnosis of human fasciolosis in areas of low endemicity as encountered in Central Europe. Antibody detection was conducted using ProteinA/ProteinG (PAG) conjugated to alkaline phosphatase. Test characteristics as well as agreement with results from an ELISA using excretory–secretory products (FhES) from adult stage liver flukes was assessed by receiver operator characteristic (ROC) analysis, specificity, sensitivity, Youdens J and overall accuracy. Cross-reactivity was assessed using three different groups of serum samples from healthy individuals (n = 20), patients with other parasitic infections (n = 87) and patients with malignancies (n = 121). The best combined diagnostic results for recombinant antigens were obtained using the recSAP2-ELISA (87% sensitivity, 99% specificity and 97% overall accuracy) employing the threshold (cut-off) to discriminate between positive and negative reactions that maximized Youdens J. The findings showed that recSAP2-ELISA can be used for the routine serodiagnosis of chronic fasciolosis in clinical laboratories; the use of the PAG-conjugate offers the opportunity to employ, for example, rabbit hyperimmune serum for the standardization of positive controls.

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Hydatid false positive serological test results in malignancy.

Cited by 17 publications

References 3 publications

Differential immunodiagnosis between cystic hydatid disease and other cross-reactive pathologies.

Differential immunodiagnosis between cystic hydatid disease and other cross-reactive pathologies.

Molecular and immunological diagnosis of echinococcosis

Comparative Assessment of ELISAs Using Recombinant Saposin-Like Protein 2 and recombinant Cathepsin L-1 from Fasciola hepatica for the Serodiagnosis of Human Fasciolosis

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