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Rehman AF, Lazo-Vasquez AF, Bhatt PK, Quiroz T, Joseph JA, Gultekin S, Montreuil N, Sternberg CA, Ayoade F. Neurocysticercosis mimicking craniopharyngioma: A case report. Clin Case Rep 2023; 11:e8166. [PMID: 38046801 PMCID: PMC10689293 DOI: 10.1002/ccr3.8166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
Key Clinical Message In patients with appropriate epidemiological risk factors, neurocysticecosis should be considered as part of the differential diagnosis of suprasellar or parasellar mass lesions. As neuroimaging findings can be nonspecific, serology may be helpful, but when still in doubt, brain biopsy, and histopathology may be necessary to make the correct diagnosis. Abstract Neurocysticercosis (NCC) is a well-documented central nervous system helminth infection that is, frequently observed in developing countries. Known sites of NCC infection include the highly vascular gray-white matter junction, basal cistern, brain parenchyma, subarachnoid space, ventricular system, and spinal cord. This case highlights an uncommon yet intriguing site of NCC infection within the suprasellar area, which presented with similar clinical and imaging characteristics as suprasellar masses or lesions. The 44-year-old female initially complained of headaches and nausea that persisted for 5 years and progressed to vision problems and short-term memory loss. A craniopharyngioma was initially suspected, based on imaging findings of a partially calcified suprasellar tumor. However, cysticercosis was confirmed by histopathology and serological testing positive for Cysticercus IgG antibodies. The patient was successfully treated with albendazole and tapering doses of steroids, which improved her presenting symptoms and resolved prior imaging findings. This case serves as a reminder to consider NCC in the differential diagnosis of sellar and suprasellar masses or lesions, particularly when an epidemiologic risk factor is present.
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Ito A, Budke CM. Genetic Diversity of Taenia solium and its Relation to Clinical Presentation of Cysticercosis. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2021; 94:343-349. [PMID: 34211353 PMCID: PMC8223547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
In this perspectives paper, we discuss fertilization strategies for Taenia saginata and Taenia saginata asiatica as well as heterogeneity in Taenia solium, the causative agent of human cysticercosis. Two different genotypes of T. solium (Asian and Afro/American) were confirmed by mitochondrial DNA analysis approximately two decades ago. Since then, outcrossings of the two genotypes have been identified in Madagascar where the two genotypes are distributed sympatrically. Outcrossings were confirmed by the presence of discordance between mitochondrial and nuclear DNA. Since multiple tapeworm infections are common in endemic areas, outcrossing events likely occur quite frequently. Therefore, mitochondrial DNA from T. solium specimens collected from humans and pigs in endemic areas should be analyzed. If variations are found between specimens, nuclear DNA analysis should be performed to confirm the presence of discordance between mitochondrial and nuclear genes. Additional outcrossings likely add complexity to understanding the existing genetic diversity. Serological surveys are also recommended since serodiagnostic glycoprotein can also differentiate between the two genotypes. Viable eggs from different genotypes or from hybrids of two different genotypes should be used for experimental infection of pigs or dogs in order to observe any pathological heterogeneity in cysticercosis development. Although genetic diversity of T. solium is expected to result in clinical heterogeneity of cysticercosis in humans and pigs, there is currently no evidence showing that this occurs. There are also no comparative experimental studies on this topic. Therefore, studies evaluating the link between parasite heterogeneity and clinical outcome are warranted.
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Affiliation(s)
- Akira Ito
- Department of Parasitology, Asahikawa Medical
University, Asahikawa, Japan
| | - Christine M. Budke
- Department of Veterinary Integrative Biosciences,
College of Veterinary Medicine & Biomedical Sciences, Texas A & M
University, College Station, TX, USA
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Sutisna P, Kapti IN, Wandra T, Dharmawan NS, Swastika K, Raka Sudewi A, Susilawathi NM, Sudarmaja IM, Yanagida T, Okamoto M, Yoshida T, Donadeu M, Lightowlers MW, Ito A. Towards a cysticercosis-free tropical resort island: A historical overview of taeniasis/cysticercosis in Bali. Acta Trop 2019; 190:273-283. [PMID: 30385216 DOI: 10.1016/j.actatropica.2018.10.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/27/2018] [Accepted: 10/27/2018] [Indexed: 12/22/2022]
Abstract
Taeniasis and cysticercosis are known to be endemic in several Indonesian islands, although relatively little recent epidemiological data are available. As most Indonesian people are Muslims, taeniasis/cysticercosis caused by the pork tapeworm, Taenia solium, has a restricted presence in non-Muslim societies and is endemic only among some Hindu communities on the island of Bali. Bali has long been known to be endemic for taeniasis/cysticercosis; almost a century ago levels of cysticercosis of 20-30% were described in cattle and 2-3% in pigs. Few studies of taeniasis/cysticercosis were undertaken in Bali prior to a series of research programs commenced since the 1990s. Both Taenia saginata and T. solium continue to be endemic in Bali. Molecular studies have revealed that all T. saginata-like tapeworms detected in Bali are T. saginata. No evidence has been found for the presence of Taenia asiatica in Bali. Economic, sanitary and education improvements across much of the island over the past decades have been associated with a decline in the amount of transmission of T. solium such that the parasite now seems to be restricted to the eastern part of the island, a small area on the northeastern slope of Mt. Agung, the highest mountain in Bali. The living environment including sanitation and hygiene condition in this endemic area remains relatively poor especially during the half-year dry season, and pigs continue to roam freely. In this review, historical records and ongoing projects towards elimination of taeniasis/cysticercosis in Bali are reviewed to provide a better understanding of the present situation of taeniasis/cysticercosis in Bali towards a future, cysticercosis-free tropical resort island.
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Recent Advances in the Diagnosis of Neurocysticercosis. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2018. [DOI: 10.1007/s40506-018-0173-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Abstract
Neurocysticercosis accounts for approximately 30% of all epilepsy cases in most developing countries. The immunodiagnosis of cysticercosis is complex and strongly influenced by the course of infection, the disease burden, the cyst location, and the immune response of the host. The main approach to immunodiagnosis should thus be to evaluate whether the serological results are consistent with the diagnosis suggested by imaging. Antibody detection is performed using lentil lectin-purified parasite antigens in an enzyme-linked immunoelectrotransfer blot format, while antigen detection uses a monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA). Promising new assay configurations have been developed for the detection of both antibody and antigen, including assays based on synthetic or recombinant antigens that may reduce costs and improve assay reproducibility and multiplex bead-based assays that may provide simultaneous quantitative results for several target antigens or antibodies.
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Ganesh SK, Priyanka. Analysis of Clinical Profile, Investigation, and Management of Ocular Cysticercosis Seen at a Tertiary Referral Centre. Ocul Immunol Inflamm 2018; 26:550-557. [DOI: 10.1080/09273948.2017.1413395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sudha K. Ganesh
- Uvea and Ocular Pathology, Medical Research Foundation, Nungambakkam, Chennai, India
| | - Priyanka
- Sankara Nethralya, Uvea, Medical Research Foundation, Nungambakkam, Chennai, India
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Dhiman R, Devi S, Duraipandi K, Chandra P, Vanathi M, Tandon R, Sen S. Cysticercosis of the eye. Int J Ophthalmol 2017; 10:1319-1324. [PMID: 28861361 DOI: 10.18240/ijo.2017.08.21] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/16/2017] [Indexed: 11/23/2022] Open
Abstract
Cysticercosis is a preventable and eradicable cause of blindness endemic in the Indian subcontinent, South-East Asia and other developing countries. Ocular and orbital cysticercosis has varied presentations depending upon the site of involvement, number of lesion and the host immune response. In this article we present a review of the various clinical manifestations, diagnosis and management protocol for orbital and ocular cysticercosis. Owing to its varied presentation, cysticercosis may pose a diagnostic challenge to the health professionals. Early diagnosis and management can prevent the vision loss and optimize visual outcomes.
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Affiliation(s)
- Rebika Dhiman
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Saranya Devi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Kavitha Duraipandi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Parijat Chandra
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Murugesan Vanathi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Radhika Tandon
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Seema Sen
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
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Debacq G, Moyano LM, Garcia HH, Boumediene F, Marin B, Ngoungou EB, Preux PM. Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy. PLoS Negl Trop Dis 2017; 11:e0005153. [PMID: 28267746 PMCID: PMC5340353 DOI: 10.1371/journal.pntd.0005153] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 11/01/2016] [Indexed: 11/27/2022] Open
Abstract
Background We reviewed studies that analyzed cysticercosis (CC), neurocysticercosis (NCC) and epilepsy across Latin America, Asia and Sub-Saharan Africa, to estimate the odds ratio and etiologic fraction of epilepsy due to CC in tropical regions. Methodology We conducted a systematic review of the literature on cysticercosis and epilepsy in the tropics, collecting data from case-control and cross-sectional studies. Exposure criteria for CC included one or more of the following: serum ELISA or EITB positivity, presence of subcutaneous cysts (both not verified and unverified by histology), histology consistent with calcified cysts, and brain CT scan consistent with NCC. A common odds-ratio was then estimated using meta-analysis. Principal findings 37 studies from 23 countries were included (n = 24,646 subjects, 14,934 with epilepsy and 9,712 without epilepsy). Of these, 29 were case-control (14 matched). The association between CC and epilepsy was significant in 19 scientific articles. Odds ratios ranged from 0.2 to 25.4 (a posteriori power 4.5–100%) and the common odds ratio was 2.7 (95% CI 2.1–3.6, p <0.001). Three subgroup analyses performed gave odds ratios as: 2.2 (EITB-based studies), 3.2 (CT-based studies), 1.9 (neurologist-confirmed epilepsy; door-to-door survey and at least one matched control per case). Etiologic fraction was estimated to be 63% in the exposed group among the population. Significance Despite differences in findings, this meta-analysis suggests that cysticercosis is a significant contributor to late-onset epilepsy in tropical regions around the world, and its impact may vary depending on transmission intensity. Cysticercosis is a helminthic infection of the central nervous system (CNS) and the leading cause of late onset epilepsy in low-and middle-income countries. This neurological disease is a public health problem in Sub-Saharan Africa, Asia and Latin America, affecting impoverished rural and peri-urban populations where sanitation is inadequate. Diagnostic criteria for NCC vary according to regional availability and access to imaging and serological tests. This systematic review highlights the lack of appropriate methodology in most observational studies, with few studies including control groups, a basic epidemiological criteria needed to demonstrate an association. EITB for cysticercosis was widely used to measure exposure, and brain CT scan was a non-invasive alternative used to identify cysts. Neurocysticercosis (NCC) is a preventable neurological condition in the tropics despite resource limitations in LMIC regions. Well-designed studies are needed to provide quality evidence to support control interventions and surveillance systems for this important zoonotic disease.
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Affiliation(s)
- Gabrielle Debacq
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Luz M. Moyano
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Perú
- Epidemiology Unit. Hospital Regional II-2 Tumbes, Perú
- * E-mail:
| | - Héctor H. Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Perú
- Instituto Nacional de Ciencias Neurológicas. Unidad de Cisticercosis. Lima, Perú
| | - Farid Boumediene
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Benoit Marin
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Edgard B. Ngoungou
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
- Université des Sciences de la Santé, EA NEMIT, Faculté de Médecine, Libreville, Gabon
| | - Pierre-Marie Preux
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
- CHU, CEBIMER, Limoges, France
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Pediatric neurocysticercosis: usefulness of antibody response in cysticidal treatment follow-up. BIOMED RESEARCH INTERNATIONAL 2014; 2014:904046. [PMID: 25215297 PMCID: PMC4158118 DOI: 10.1155/2014/904046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/09/2014] [Accepted: 07/10/2014] [Indexed: 11/17/2022]
Abstract
Serum and urine samples were collected from 33 NCC patients before the albendazole treatment, 3-6 and 12 months PT. At 3 months PT, 24 (72.7%) patients had no detectable CT/MRI lesions and 9 (27.2%) patients had persistent lesions. Antibody response to crude soluble extract (CSE), excretory secretory (ES), and lower molecular mass (LMM) (10-30 KDa) antigenic fraction of T. solium cysticerci was detected in serum and urine samples by ELISA. Before the treatment, out of 33 NCC children, 14 (42.4%), 22 (66.6%), and 11 (33.3%) serum samples were found positive with the use of CSE, ES, and LMM antigen, respectively. At 3-6 months PT, positivity rate was 5 (15.1%), 2 (6%), and 4 (12.1%) and at 12 months PT, positivity rate was 5 (15.1%), 0, and 3 (9%) with the use of CSE, ES, and LMM antigen, respectively. There was no significant difference in the positivity with the use of three antigens in pretreatment and PT urine samples. The study suggests that the use of ES antigen to detect antibody in serum samples may serve better purpose to evaluate the therapeutic response in patients with NCC.
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Rodriguez S, Wilkins P, Dorny P. Immunological and molecular diagnosis of cysticercosis. Pathog Glob Health 2013; 106:286-98. [PMID: 23265553 DOI: 10.1179/2047773212y.0000000048] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Cysticercosis, the infection with the larval stage of Taenia solium, is a cause of neurological symptoms including seizures, affecting the quality of life of patients and their families. Diagnosis focuses on brain imaging and serological tests are mostly used as confirmatory tools. Most cases, however, occur in poor endemic areas, where both kinds of diagnostic tools are poorly available. Development of point of care diagnostic tests is one of the most important priorities for cysticercosis researches today. The ideal point of care test would require detection of viable cysticercosis and hopefully identify cases with severe or progressive forms of neurocysticercosis, leading to referral of the patient for specialized medical attention. This manuscript describes the evolution of the serological diagnosis of cysticercosis over time, and the characteristics of the most common currently available tools, their advantages and disadvantages, and their potential use in future diagnostic tests.
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Affiliation(s)
- Silvia Rodriguez
- Infectious Diseases, Instituto Nacional de Ciencias Neurológicas, Jr. Anchash 1271, Lima 1, Peru.
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Prabhakar S, Rangdal SS. Isolated Muscular Cysticercosis: A Rare Pseudotumor and Diagnostic Challenge, can It be treated Nonoperatively? A Report of Two Cases and Review of Literature. ACTA ACUST UNITED AC 2012. [DOI: 10.5005/jp-journals-10028-1011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Cysticercosis, an infection with the larval form of pork tape worm, Taenia solium, commonly presents with multiple muscular cysts or CNS involvement. Due to vague clinical presentation and unfamiliarity of clinicians with this entity, it is difficult to diagnosis when seen as an isolated cyst. Traditional treatment is surgical excision and a course of deworming agents. We present two cases of isolated muscular cysticercosis diagnosed by USG, MRI and blood tests, who responded successfully to oral medication without need of operative intervention.
Case reports
A 45-year-old male patient had a tender 2 week swelling of 4 × 5 cm on medial right proximal calf. A 26-year male presented with discomfort and diffuse 6 cm swelling at inner left forearm. In both ultrasound showed characteristic hypoechoic cyst with hyperechoic scolex, and MRI revealed isolated cyst surrounded by inflamed muscles. FNAC confirmed cysticercosis, and the patient responded to oral albendazole (3 weeks) with oral steroids (2 weeks).
Conclusion
Although rare, possibility of isolated muscular cysticercosis should always be considered in any small musculoskeletal soft tissue swelling presenting with nonspecific clinical findings. Both our patients responded to medical therapy and were disease free, as confirmed at 3 months by follow-up MRI. These cysts can be confidently diagnosed on the basis of ultrasound and MRI, and can be very well-treated nonsurgically with an oral drug regimen consisting of albendazole and steroid.
How to cite this article
Rangdal SS, Prabhakar S, Dhatt S S, Prakash M, Dhillon MS. Isolated Muscular Cysticercosis: A Rare Pseudotumor and Diagnostic Challenge, can It be treated Nonoperatively? A Report of Two Cases and Review of Literature. J Postgrad Med Edu Res 2012;46(1):43-48.
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Piña R, Gutiérrez AH, Gilman RH, Rueda D, Sifuentes C, Flores M, Sheen P, Rodriguez S, García HH, Zimic M. A dot-ELISA using a partially purified cathepsin-L-like protein fraction from Taenia solium cysticerci, for the diagnosis of human neurocysticercosis. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2011; 105:311-8. [PMID: 21871167 DOI: 10.1179/136485911x12987676649782] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Human neurocysticercosis (NCC), caused by the cestode Taenia solium, is responsible for a significant amount of neurological morbidity and epilepsy in developing countries. The disease remains highly endemic in many areas, despite several efforts and interventions to control it. A simple, cheap and fast diagnostic assay that is suitable for use in field conditions is highly desired. In immunodiagnostics based on western immunoblots or standard ELISA, a cathepsin-L-like protein purified from the cysticercus fluid has previously performed well as an antigen. In a recent study in Peru, the same 53/25-kDa antigen was therefore used in the development of a dot-ELISA that could be employed for mass screenings under field conditions. The assay was standardized and tested not only against sera from a large group of NCC cases but also against sera from patients with other common parasitic infections, so that sensitivity and specificity could be assessed. For NCC, the assay gave better sensitivity in the detection of individuals with extraparenchymal cysts (94·4%-100%) or multiple parenchymal cysts (74·6%-80·0%) than in the detection of individuals with single parenchymal cysts (29·4%-45·1%). The assay also showed a high specificity for NCC (99·0%-100%), with a very low level of cross-reactivity with other parasitic infections. The dot-ELISA developed in this study is a highly specific, simple, cheap and rapid test for NCC that could be used under field conditions, even in the low-resource settings that are common in developing countries.
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Affiliation(s)
- R Piña
- Unidad de Bioinformática y Biología Molecular, Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, San Martín de Porres, Lima, Peru
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Parija SC, Raman GA. Anti-Taenia solium larval stage Ig G antibodies in patients with epileptic seizures. Trop Parasitol 2011; 1:20-5. [PMID: 23508037 PMCID: PMC3593467 DOI: 10.4103/2229-5070.72113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background: Cysticercosis is the most common differential diagnosis for epilepsy. The present study was carried out to assess the serological response among patients with epileptic seizures visiting JIPMER Hospital Puducherry. Materials and Methods: A total of 934 serum samples were collected from patients with epileptic seizures. A standardized questionnaire was designed to obtain information on the demographic, socioeconomic, environmental, and behavioral characteristics related to the transmission of infection. An enzyme-linked immunosorbent assay (ELISA) was used to detect the anti-Taenia solium larval stage IgG antibodies. Samples found reactive and inconclusive by ELISA were further tested by the enzyme immunotransfer blot (EITB). Results: The frequency of antibodies in the serum samples of the above-mentioned population was 16.2% by EITB. Anti-Taenia solium larval stage antibodies were detected in serum samples of 163 patients, out of which 27 (16.56%) patients belonged to the 0 – 15-year age group, 82 (50.30%) patients were in the 16 – 40-year age group, and 52 (31.90%) patients were above 41 years, respectively. Although the sera from males had higher OD values than those from females, the difference was not statistically significant. Out of 163 seropositive by ELISA, 152 (93.25%) were found to be positive by EITB. Out of the 152, 61 (40.13%) were farmers and 79 (51.97%) were office or factory workers. Conclusions: In conclusion, the results indicate a probable endemic situation and a high prevalence of cysticercosis in patients with epileptic seizures. Living in poor sanitary conditions seems to be an important factor related to human cysticercosis in Puducherry and the neighboring districts of Tamil Nadu.
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Affiliation(s)
- Subhash Chandra Parija
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry - 605 006, India
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Quet F, Guerchet M, Pion SDS, Ngoungou EB, Nicoletti A, Preux PM. Meta-analysis of the association between cysticercosis and epilepsy in Africa. Epilepsia 2009; 51:830-7. [PMID: 19919664 DOI: 10.1111/j.1528-1167.2009.02401.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The association between cysticercosis and epilepsy has been widely studied in Latin America and Asia and has proven to be one of the main causes of epilepsy. Despite high prevalences of both diseases in Africa, their association remains unclear. In this article we quantified the strength of the association between epilepsy and cysticercosis in Africa and we proposed some guidelines for future studies. METHODS We performed a systematic review of literature on cysticercosis (considered as exposure) and epilepsy (considered as the disease) and collected data from both cross-sectional and case-control studies. A common odds ratio was estimated using a random-effects meta-analysis model of aggregate published data. RESULTS Among 21 retrieved documents, 11 studies located in 8 African countries were included in the meta-analysis. Odds ratio of developing epilepsy when presenting cysticercosis (defined as Taenia solium seropositivity) ranged from 1.3-6.1. Overall, association between cysticercosis and epilepsy was found significant with a common odds ratio of 3.4 [95% confidence interval (CI) 2.7-4.3; p < 0.001]. DISCUSSION The variability of the association found between the studies could be due to differences in study design or in pathogenesis of cysticercosis. Further studies should overcome identified problems by following some guidelines to improve epidemiologic and clinical assessment of the association. Better understanding of the relation between cysticercosis and epilepsy is a key issue in improving prevention of epilepsy in Africa.
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Affiliation(s)
- Fabrice Quet
- Université de Limoges, IFR 145 GEIST, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, EA 3174 NeuroEpidémiologie Tropicale et Comparée, Limoges, France
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Atluri SRV, Singhi P, Khandelwal N, Malla N. Neurocysticercosis immunodiagnosis using Taenia solium cysticerci crude soluble extract, excretory secretory and lower molecular mass antigens in serum and urine samples of Indian children. Acta Trop 2009; 110:22-7. [PMID: 19161966 DOI: 10.1016/j.actatropica.2008.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Revised: 12/07/2008] [Accepted: 12/19/2008] [Indexed: 11/25/2022]
Abstract
Neurocysticercosis (NCC), the most common neurological disorder of parasite etiology, results from lodgement of Taenia solium cysticerci in the central nervous system and is now increasingly being recognized in children. The confirmed diagnosis is based collectively on radiological findings and serodiagnostic techniques. The serodiagnostic techniques have variable sensitivity and specificity depending upon the technique, antigens used, location and number of cysts. Crude soluble extract (CSE), excretory secretory (ES) and lower molecular mass (LMM) (10-30 kDa) antigenic fraction of T. solium cysticerci were evaluated for antibody detection in serum and urine samples by ELISA. Serum and urine samples were collected each from 125 clinically suspected and radiologically proven NCC (111 with single Computed Tomography (CT) lesions and 14 with multiple CT lesions) and 125 control subjects (60 with neurological disorders other than NCC, 40 with other parasitic diseases and 25 apparently healthy subjects). The sensitivity of the ELISA with the use of CSE, ES and LMM antigenic fractions was 38.4%, 63.2% and 30.4% with serum (cut off dilution 400), 46.4%, 44% and 47.2% with neat urine and the specificity was 88%, 76.8% and 85.6% with serum (cut off dilution 400), 66.4%, 65.2% and 58.4% with neat urine samples, respectively. The study suggests that detection of antibody to ES antigen in serum samples may serve useful purpose for the serodiagnosis of human NCC.
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Abstract
Cysticercosis is an infection caused by Taenia solium larvae (cysticerci). When the cysticercus is lodged in the central nervous system (CNS), the disease is known as neurocysticercosis (NCC). NCC is the most frequent and most widely disseminated human neuroparasitosis. It is endemic in many parts of the world, particularly Latin America, Africa, and Asia, and still relatively frequent in Portugal, Spain and Eastern European countries It is also endemic in developed countries with high rates of immigration from endemic areas. Man may act as an intermediate host after ingestion of mature, viable T. solium eggs via the fecal-oral route. The development of lesions in the brain and leptomeninges, and the consequent of onset of symptoms associated with NCC are mainly due to the host immune-inflammatory response. As long as the cysticercus remains viable, there is relative host immune tolerance. It is only when the parasite dies that massive antigen exposure occurs, with intensification of the immune response/inflammatory reaction and the appearance or worsening of symptoms. NCC can be asymptomatic or cause widely varied clinical manifestations, such as seizures, increased intracranial pressure, ischemic cerebrovascular disease, dementia, and signs of compression of the spinal roots/cord. The combination of two or more symptoms is common. Such clinical polymorphism is determined by 1) the number of lesions (single or multiple cysticerci); 2) the location of CNS lesions (subarachnoid, intracerebral, intraventricular, intramedullary); 3) the type of cysticercus (Cysticercus cellulosae, Cysticercus racemosus); 4) the stage of development and involution of the parasite (vesicular or viable, necrotic, fibrocalcified nodule); and 5) the intensity of the host immune-inflammatory response (no inflammatory reaction, leptomeningitis, encephalitis, granular ependymitis, arteritis).
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Affiliation(s)
- J E Pittella
- Department of Pathology and Legal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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Evaluation of lower molecular mass (20-24 kDa) Taenia solium cysticercus antigen fraction by ELISA and dot blot for the serodiagnosis of neurocysticercosis in children. Parasitol Res 2008; 102:1097-101. [PMID: 18322701 DOI: 10.1007/s00436-008-0933-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Accepted: 02/14/2008] [Indexed: 10/22/2022]
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Husain N, Shukla N, Kumar R, Husain M, Chaturvedi A, Agarwal GG, Gupta RK. ELISA in the evaluation of therapeutic response to albendazole in neurocysticercosis. J Infect 2008; 56:65-73. [DOI: 10.1016/j.jinf.2007.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2007] [Revised: 09/26/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022]
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19
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Margono SS, Wandra T, Swasono MF, Murni S, Craig PS, Ito A. Taeniasis/cysticercosis in Papua (Irian Jaya), Indonesia. Parasitol Int 2005; 55 Suppl:S143-8. [PMID: 16376603 DOI: 10.1016/j.parint.2005.11.051] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Reports showed that an important parasitic zoonotic disease caused by Taenia solium, Taenia saginata and Taenia asiatica is found endemic in several areas of Indonesia including Papua, Bali and North Sumatra. At present it is known that the highest prevalence of taeniasis/cysticercosis in Indonesia, caused by T. solium is among the indigenous communities in Papua (formerly Irian Jaya). In the early 1970s, 8-9% of stool samples from the Enarotali hospital, Paniai District (Irian Jaya) were found positive with Taenia eggs. The samples were from members of the Ekari (Kapauku) ethnic group. Stool samples from the Moni ethnic group, living east of surrounding lakes, were egg negative. Cysticerci of T. solium were discovered in pigs. During the years 1973-1976 cases of burns increased and were ultimately found to be primarily associated with epileptic seizures induced by neurocysticercosis cases. Among 257 cases of burns, 88 cases (62.8%) were suffering from epileptic seizures before or during hospitalization. In the year 1981 T. solium seropositive persons were mostly (16%) found in the endemic Obano village. In 1997 the parasite was discovered in Jayawijaya District, which is located approximately 250 km east of Paniai District. During 1991-1995, a local health center in Assologaima, Jayawijaya District reported 1120 new cases with burns and a further 293 new cases of epileptic seizures among 15,939 inhabitants. The histopathologic appearance and mitochondrial DNA analysis found the cysts to be similar to those of T. solium from other regions of the world. Sensitive and specific serological diagnostic methods were used and improved. Cysticerci were detected in dogs, as well as in pigs. A coproantigen test for detection of adult tapeworms in patients was carried out. Medical treatment with praziquantel for taeniasis and albendazole for cysticercosis (with prednisone and sodium phenytoin treatment in cases with neurocysticercosis) was undertaken. Lifestyle, religion, and socioeconomic aspects are important issues in the perpetuation and enhancing the endemicity of T. solium taeniasis and cysticercosis in Papua, Indonesia.
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Affiliation(s)
- Sri S Margono
- Department Research and Community Service, University of Indonesia.
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Arruda GC, da Silva ADT, Quagliato EMAB, Maretti MA, Rossi CL. Evaluation of Taenia solium and Taenia crassiceps cysticercal antigens for the serodiagnosis of neurocysticercosis. Trop Med Int Health 2005; 10:1005-12. [PMID: 16185235 DOI: 10.1111/j.1365-3156.2005.01480.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We evaluated the usefulness of seven cysticercal antigen extracts, four from Taenia solium cysticerci (whole parasite-TsoW, membrane-TsoMe, vesicular fluid-TsoVF and scolex-TsoSc) and three from T. crassiceps cysticerci (whole parasite-TcraW, membrane-TcraMe and vesicular fluid-TcraVF), for serodiagnosis of neurocysticercosis with an enzyme-linked immunosorbent assay (ELISA). Cysticercus-specific IgG were screened in serum samples from 23 patients with neurocysticercosis, 32 patients with other infections and 48 healthy persons. The best results were obtained with the TsoVF-ELISA (91.3% sensitivity; 96.2% specificity) and TcraVF-ELISA (91.3% sensitivity; 95% specificity). The ELISA done with whole parasite and membrane extracts from cysts of T. solium and T. crassiceps and the scolex extract from T. solium cysts showed a low performance in terms of sensitivity, ranging from 47.8% to 73.9%. None of the antigen preparations from T. solium and T. crassiceps cysticerci used in this study showed outstanding performance for the serodiagnosis of neurocysticercosis. However, considering the results obtained with the seven antigen preparations, vesicular fluid from T. solium and T. crassiceps cysticerci may be useful for detecting specific antibodies in sera from patients with neurocysticercosis.
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Affiliation(s)
- G C Arruda
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
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Kaliaperumal S, Rao VA, Parija SC. CYSTICERCOSIS OF THE EYE IN SOUTH INDIA – A CASE SERIES. Indian J Med Microbiol 2005. [DOI: 10.1016/s0255-0857(21)02526-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sundaram PM, Jayakumar N, Noronha V. Extraocular muscle cysticercosis - a clinical challenge to the ophthalmologists. Orbit 2005; 23:255-62. [PMID: 15590528 DOI: 10.1080/01676830590889866] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To report our experience with extraocular myocysticercosis, to highlight the role of ultrasound and orbital computerized tomography (CT) scan in these cases and to discuss the management. METHODS This is retrospective study of 35 cases of orbital myocysticercosis confirmed on ultrasound and CT scan of the orbit. RESULTS There were 18 males and 17 females. The average age of these patients was 19.6 years. The most common presenting feature was restricted ocular motility with diplopia and recurrent pain and redness. Ultrasound examination and CT scan of the orbit done for all these patients identified the cyst and the affected muscle. All extraocular muscles were noted to be involved in myocysticercosis. However the lateral rectus, medial rectus and the superior oblique were affected to a greater extent. All cases dramatically improved on treatment with albendazole and oral steroids. Surgical excision of cyst was done in 6 cases. CONCLUSION A high index of suspicion should be entertained for extraocular muscle cysticercosis, especially in cases of acquired ocular motility disorder with recurrent ocular congestion. Ultrasound and CT scans of orbit play a vital role in diagnosis. Medical therapy with albendazole under cover of steroids is effective in most of the cases.
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Mohan K, Saroha V, Sharma A, Pandav S, Singh U. Extraocular muscle cysticercosis: clinical presentations and outcome of treatment. J Pediatr Ophthalmol Strabismus 2005; 42:28-33. [PMID: 15724896 DOI: 10.3928/01913913-20050101-04] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To report various clinical presentations and treatment outcomes in a series of patients with extraocular muscle cysticercosis. METHODS This retrospective study reviewed the charts of 43 patients diagnosed with extraocular muscle cysticercosis with computed tomography and orbital B-scan ultrasonography between January 1991 and December 2002. Clinical presentation, results of investigations, treatment, and outcome were recorded. RESULTS The superior rectus was the most commonly affected extraocular muscle. Restricted ocular motility was present in 88% of patients, and inflammatory signs were noted in the involved quadrant in 70% of patients. Eleven patients were treated with oral albendazole alone and 31 patients were treated with oral albendazole and prednisolone. Four extraocular muscle cysts were excised surgically, and five extruded spontaneously. Inflammatory signs subsided in all patients, and residual restriction of ocular motility was seen in 16 (50%) of 32 patients at a mean follow-up of 5 months. Type of treatment made no significant difference in the ocular motility outcome. CONCLUSIONS Extraocular muscle cysticercosis should be considered in patients who present with restricted ocular motility and inflammatory signs. The direction of motility restriction does not indicate the muscle involved. Residual restriction of ocular motility is common despite the addition of corticosteroids to albendazole therapy.
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Affiliation(s)
- Kanwar Mohan
- Squint Clinic, Grewal Eye Institute, Chandigarh, India
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Abstract
The aim of the present study was to standardize and evaluate dot-Enzyme linked immunosorbent assay (Dot-ELISA), a simple and rapid test for the detection of cysticercus antibodies in the serum for the diagnosis of neurocysticercosis (NCC). The antigen used in the study was a complete homogenate of Cysticercus cellulosae cysts obtained from infected pigs and dotted on to nitrocellulose membrane. Test sera were collected from the patients of NCC, and control sera from patients with other diseases and healthy students and blood donors of the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Hospital, Pondicherry, during a study period from 2001 to 2003. Dot-ELISA detected antibodies in 14 of 25 (56%) in clinically suspected cases of NCC, 13 of 23 (56.5%) in CT/MRI proven cases of NCC and 2 of 25 (8%) each in non-cysticercal CNS infection controls and healthy controls. The test showed a sensitivity of 56.25%, specificity of 92%, positive predictive value of 87.09%, and negative predictive value of 70.76%. Results of the present study shows that the Dot-ELISA as a simple test can be used in the field or poorly equipped laboratories for diagnosis of NCC .
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Affiliation(s)
- Rakhi Biswas
- Department of Microbiology, Jawaharlal Institute of Postgraduate, Medical Education & Research, Pondicherry 605006, India
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Abstract
The larval stage of the pork tapeworm (Taenia solium) infects the human nervous system, causing neurocysticercosis. This disease is one of the main causes of epileptic seizures in many less developed countries and is also increasingly seen in more developed countries because of immigration from endemic areas. Little information is available on the natural evolution of taeniasis or cysticercosis. Available therapeutic measures include steroids, treatments for symptoms, surgery, and, more controversially, antiparasitic drugs to kill brain parasites. Efforts to control and eliminate this disease are underway through antiparasitic treatment of endemic populations, development of pig vaccines, and other measures.
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Affiliation(s)
- Héctor H García
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Jr Ancash 1271, Barrios Altos, Lima, Peru.
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Katti MK. Evaluation of current immunodiagnostic criteria for diagnosis of neurocysticercosis. Clin Infect Dis 2003; 37:461-2; author reply 462-3. [PMID: 12884178 DOI: 10.1086/376644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Nsengiyumva G, Druet-Cabanac M, Ramanankandrasana B, Bouteille B, Nsizabira L, Preux PM. Cysticercosis as a major risk factor for epilepsy in Burundi, east Africa. Epilepsia 2003; 44:950-5. [PMID: 12823579 DOI: 10.1046/j.1528-1157.2003.55302.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE Human cysticercosis is a direct consequence of infection by Taenia solium larvae (Cysticercus cellulosae). Results of studies on the impact of neurocysticercosis on epilepsy in Africa are inconsistent. The objective was to evaluate the role of cysticercosis in epilepsy in Burundi. METHODS A prevalent matched case-control design was used in the Kiremba area, Burundi, between March and April 2001. One case with epilepsy was matched to two control subjects, according to their age. Cases were subjects who had shown at least two unprovoked epileptic seizures within a 24-h time range and who lived in the Kiremba area. The control subjects also lived in Kiremba and had neither neurologic illness nor kinship with the people with epilepsy. Seropositivity for cysticercosis was the exposure variable. Three hundred twenty-four prevalent cases, with onset of epilepsy between 1950 and 2000, and 648 age-matched controls were included. RESULTS This study found a link between cysticercosis infestation and the occurrence of epilepsy (odds ratio, 3.8; 95% confidence interval, 2.5-5.1). CONCLUSIONS The study highlighted the importance of cysticercosis in the area of Kiremba, as 31.5% of the control subjects screened positive for this parasite. The attributable risk for cysticercosis was 50% (95% confidence interval, 42-57) in this population.
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Affiliation(s)
- Georges Nsengiyumva
- Institute of Neuroepidemiology and Tropical Neurology (EA 3174), Limoges, France
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Hancock K, Khan A, Williams FB, Yushak ML, Pattabhi S, Noh J, Tsang VCW. Characterization of the 8-kilodalton antigens of Taenia solium metacestodes and evaluation of their use in an enzyme-linked immunosorbent assay for serodiagnosis. J Clin Microbiol 2003; 41:2577-86. [PMID: 12791883 PMCID: PMC156563 DOI: 10.1128/jcm.41.6.2577-2586.2003] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Western blot for cysticercosis, which uses lentil lectin purified glycoprotein (LLGP) antigens extracted from the metacestode of Taenia solium, has been the "gold standard" serodiagnostic assay since it was first described in 1989. We report that the diagnostic antigens at 14, 18, and 21 kDa, as well as some larger disulfide-bonded antigens, are actually all members of a very closely related family of proteins, the 8-kDa antigens. The genes for 18 unique, mature proteins have been identified. Nine of these were chemically synthesized and tested in an enzyme-linked immunosorbent assay with a battery of defined serum samples, including 32 cysticercosis-positive serum samples reactive with the 8-kDa antigens of LLGP on Western blotting, 34 serum samples from patients with other parasitic infections, and 15 normal human serum samples. One of the 8-kDa antigens, TsRS1, is 100% sensitive and 100% specific. TsRS1 will be one component of a cocktail of three to four synthetic or recombinant antigens, based on the diagnostic bands of the Western blot, which will be used for the serodiagnosis of cysticercosis.
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Affiliation(s)
- Kathy Hancock
- Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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Abstract
Orbital and adnexal cysticercosis is emerging as a far commoner disease than previously considered, both in endemic and nonendemic areas of cysticercosis. A review of the literature on orbital and adnexal cysticercosis found that it has a predilection for children and young adults with no definite sex predilection. The extraocular muscle form is the commonest type of orbital and adnexal cysticercosis. Lodgement of cysts in the subconjunctival space is another common site, followed by the eyelid, optic nerve, retro-orbital space and lacrimal gland. Association of orbital cysticercosis with systemic cysticercosis is quite rare. The clinical manifestations of orbital or adnexal cysticercosis are entirely different and depend on the location, size, relation to adjacent structures and stage of evolution of the cyst. Diagnosis of cysticercosis is based mainly on orbital imaging because of its highly specific appearance. Tissue diagnosis is not essential for initiating treatment. Medical therapy is the recommended treatment for the extraocular muscle form and retro-orbital cysticer-cosis. Surgical removal is advocated for subconjunctival and eyelid cysticercosis. Because of the limited number of cases of optic nerve and lacrimal gland cysticercosis, their treatment is controversial.
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Affiliation(s)
- Neelam Pushker
- Oculoplastic and Paediatric Ophthalmology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Odashima NS, Takayanagui OM, Figueiredo JFDC. Enzyme linked immunosorbent assay (ELISA) for the detection of IgG, IgM, IgE and IgA against Cysticercus cellulosae in cerebrospinal fluid of patients with neurocysticercosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2002; 60:400-5. [PMID: 12131940 DOI: 10.1590/s0004-282x2002000300012] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this study was to analyze different immunoglobulins classes (IgG, IgM, IgE and IgA) against Cysticercus cellulosae in the cerebrospinal fluid (CSF), through enzyme linked immunosorbent assay (ELISA), correlating them to clinical and tomographic profiles in patients with neurocysticercosis (NCC). Eighty-five specimens of CSF were obtained from 43 cases with NCC (26 with the active form and 17 with the inactive form) and from 42 patients with other neurological diseases. The inactive form of NCC presented a profile in CSF similar to the group without NCC. The active form of NCC presented elevation of specific immunoglobulins (IgG, IgM, IgE, and IgA) in decreasing order, with the highest values being detected among the cases with intraventricular cysts, or with inflammation signs in CSF or in those with multiple clinical manifestations. The highest sensitivity and specificity were obtained with ELISA-IgG (88.5% and 93.2%, respectively). This study confirmed the importance of ELISA in the immunologic diagnosis of NCC.
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Affiliation(s)
- Newton Satoru Odashima
- Department of Neurology, Psychiatry and Medical Psychology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Das S, Mahajan RC, Ganguly NK, Sawhney IMS, Dhawan V, Malla N. Detection of antigen B of Cysticercus cellulosae in cerebrospinal fluid for the diagnosis of human neurocysticercosis. Trop Med Int Health 2002; 7:53-8. [PMID: 11851955 DOI: 10.1046/j.1365-3156.2002.00810.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neurocysticercosis (NCC) is a major cause of morbidity and mortality in developed and developing countries. The diagnosis of this disease remains a problem. We report the detection of specific antigenic fraction (antigen B) of Cysticercus cellulosae by enzyme-linked immunosorbent assay (ELISA) in various fractions of cerebrospinal fluid (CSF) obtained by high performance liquid chromatographic (HPLC) separation, for the diagnosis of human NCC. Forty patients attending or admitted to Nehru Hospital, Chandigarh were included in the study: 10 with suspected NCC, 20 with other neurological diseases and 10 undergoing surgery under spinal anaesthesia for non-neurological conditions, who served as controls. CSF samples collected from all patients and controls were subjected to chromatographic separation on an HPLC system. Antigen B (AgB) was detected in separated fractions by an ELISA test and compared with the detection of antibody response in CSF samples by indirect haemagglutination (IHA) technique. Antigen B was detected in 9 out of 10 patients with suspected NCC based on clinical symptoms and radioimaging reports, but in none of the control subjects. However, antigen B was also detected in 9 out of 20 patients with other neurological disorders, mostly tubercular meningitis. Antibody response by IHA was found positive in only 2 of 10 cases clinically suspected of NCC. In conclusion, antigen B detection in CSF samples may be a useful adjunct to clinical suspicion and radiological reports for the diagnosis of NCC as there is no gold standard criteria to confirm this disease. However, the test needs to be evaluated on more patients in countries where tuberculosis and cysticercosis are endemic due to the high cross reactivity with samples from tubercular meningitis patients.
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Affiliation(s)
- Sanchita Das
- Department of Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Barcelos IS, Mineo JR, de Oliveira Silva DA, Ferreira MS, de Moura LP, Biondi GF, Costa-Cruz JM. Detection of IgG in cerebrospinal fluid for diagnosis of neurocysticercosis: evaluation of saline and SDS extracts from Taenia solium and Taenia crassiceps metacestodes by ELISA and immunoblot assay. Trop Med Int Health 2001; 6:219-26. [PMID: 11299039 DOI: 10.1046/j.1365-3156.2001.00701.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We compared saline (S) and sodium dodecyl sulphate (SDS) extracts from Taenia solium (homologous species - HO) and Taenia crassiceps (heterologous species - HE) metacestodes in order to detect IgG by ELISA and immunoblot assay (IBA) in cerebrospinal fluid (CSF) for the diagnosis of human neurocysticercosis (NC). CSF samples were obtained from 93 patients. Of these, 40 had NC, five had a diagnosis of probable NC, nine had central nervous system schistosomiasis or strongyloidiasis and 39 had other neurological alterations. Samples were analysed by ELISA and the results were compared with IBA in all samples with confirmed and probable NC diagnosis, in all samples with other central nervous system parasitic infection, and in 10 of those with another neurological alterations. ELISA sensitivity was 100%, 85%, 95% and 87.5% for the S-HO, S-HE, SDS-HO and SDS-HE extracts, respectively, and ELISA specificity was 100% for S-HO, S-HE, SDS-HO extracts and 97.9% for SDS-HE antigen. Immunodominant peptides detected by IBA were, by decreasing percentage of recognition: 64-68 and 45 kDa for S-HO; 108-114, 92-95, 64-68, 83 and 88 kDa for S-HE; 64-68, 108-114, 77 and 86 kDa for SDS-HO; and 108-114, 88 and 92-95 kDa for SDS-HE. Overall the homologous antigenic extracts showed higher sensitivity than the heterologous extracts in the diagnosis of NC in CSF samples. The heterologous extracts contained most of the immunodominant peptides presented in the homologous extracts, which are recognized by IgG antibodies in CSF samples.
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Affiliation(s)
- I S Barcelos
- Department of Immunology, Microbiology and Parasitology, Federal University of Uberlândia, Brazil
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Shiguekawa KY, Mineo JR, de Moura LP, Costa-Cruz JM. ELISA and western blotting tests in the detection of IgG antibodies to Taenia solium metacestodes in serum samples in human neurocysticercosis. Trop Med Int Health 2000; 5:443-9. [PMID: 10929145 DOI: 10.1046/j.1365-3156.2000.00567.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A comparative study of total saline extract (SE) and cyst vesicular fluid (VF) of Taenia solium metacestodes by ELISA and Western blotting assay (WB) tests was conducted to detect IgG in sera for diagnosis of human cysticercosis. Sera were obtained and analysed by ELISA in 1 : 20 and 1 : 100 dilutions from 208 individuals: 22 confirmed neurocysticercosis (NC) (group 1), 101 suspected NC (group 2), 55 with various intestinal parasitosis (group 3) and 30 healthy individuals (group 4). The WB test was carried out on SE and VF extracts with and without reducing agent, 2-beta-mercaptoethanol (2-ME) in 20 sera of each group. WB using extracts without 2-ME and ELISA at 1 : 100 dilution were compared in 20 sera from each group; sensitivity and specificity were calculated using samples from groups 1, 3 and 4. By ELISA, in the 1 : 100 sera dilution reactivity was reduced for both antigens without changes in the sensitivity of the test. By WB, antigens treated with 2-ME demonstrated low specificity. For SE and VF antigens, the proteins of 24, 39-42, 47-52, 56, 64-68, 126-155 kDa and 18, 24, 26-28, 32-36, 47-52, 75 kDa, respectively, were considered immunodominant markers, with high indices of specificity, suggesting a profile for NC patients. However, as the sensitivity was found to be low, it might still not be a definitive test for NC when used alone. These data suggest WB as an indicative test to determine exposure to T. solium. ELISA and WB together may supply reliable results for the diagnosis of human cysticercosis, since appropriate purified antigens are not available yet.
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Affiliation(s)
- K Y Shiguekawa
- Department of Immunology, Microbiology and Parasitology, Federal University of Uberlândia, Uberlândia, Brazil
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Abstract
BACKGROUND Human cysticercosis is secondary to an infestation by cysticercus cellulosae, the larval form of Taenia solium. Cysticercosis is endemic to regions with poor sanitation. The purpose of this report is to present a large series of patients with orbital cysticercosis and to discuss the current treatment. METHODS A retrospective chart analysis of all patients with orbital cysticercosis from an urban practice in southern India was performed. The clinical features, the results of investigations, the therapies instituted, and the outcomes realized were recorded. RESULTS Twenty patients diagnosed with orbital cysticercosis were identified (11 female and 9 male). Their ages ranged from 5 to 25 years with a mean age of 12.5 years. Nine patients manifested subconjunctival cysts. Eight were excised and 5 of these were densely adherent to the adjacent extraocular muscle (EOM). The remaining 11 patients had a cyst in a single EOM. The EOM cysts had proptosis, restricted motility, recurrent inflammation, and blepharoptosis. Two of the EOM cysts were excised surgically and four extruded spontaneously. Six patients with EOM cysts were treated medically: they all received oral corticosteroids and, additionally, five were given oral albendazole and one was given oral praziquantel. CONCLUSIONS Excisional biopsy is recommended for subconjunctival cysticercosis. Idiopathic cystic myositis can present like EOM cysticercosis, but is differentiated by resolution with corticosteroid treatment. Medical therapy in orbital cysticercosis with oral albendazole and corticosteroids can arrest recurrent inflammation and improve ocular motility.
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Affiliation(s)
- G C Sekhar
- Oculoplastic and Orbital Disease Service, L. V. Prasad Eye Institute, Hyderabad, India
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Kaur M, Joshi K, Ganguly NK, Mahajan RC, Malla N. Evaluation of the efficacy of albendazole against the larvae of Taenia solium in experimentally infected pigs, and kinetics of the immune response. Int J Parasitol 1995; 25:1443-50. [PMID: 8719956 DOI: 10.1016/0020-7519(95)00057-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Cysticercosis, a disease of economic and public health importance, is caused by Cysticercus cellulosae, the metacestode stage of Taenia solium. Experimental induction of cysticercosis was achieved in young pigs by feeding an optimum dose of 20,000 T. solium (Indian strain) eggs after immunosuppression, to assess the effect of albendazole and development of the immune response to cysticercus antigens before and after treatment. Histopathological studies revealed the presence of cysticerei in liver, lungs and muscles. Treatment with albendazole at 15 mg kg-1 body weight daily for 30 days starting from day 0 or 15 days post-infection resulted in 100% cure rates. Increases in antibody titre to crude soluble extract and a Sephadek G-200 purified antigenic fraction of Cysticercus cellulosae were found on days 25, 40 and 55 post-infection in untreated pigs and those in which treatment started on day 15 post-infection, whereas no increase in antibody response was observed in pigs in which treatment started on day 0.
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Affiliation(s)
- M Kaur
- Department of Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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36
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Plancarte A, Fexas M, Flisser A. Reactivity in ELISA and dot blot of purified GP24, an immunodominant antigen of Taenia solium, for the diagnosis of human neurocysticercosis. Int J Parasitol 1994; 24:733-8. [PMID: 7928076 DOI: 10.1016/0020-7519(94)90128-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In this paper we report the purification of GP24, one of the seven specific and highly antigenic Taenia solium glycoproteins previously identified by Western blot (WB) with serum, cerebrospinal fluid (CSF) and saliva samples from patients with neurocysticercosis (NC). GP24 was purified and evaluated in ELISA and dot blot for diagnosis. A lentil-lectin-bound glycoprotein fraction (LL-GP) from T. solium cysticerci was submitted to polyacrylamide gel electrophoresis, and the band that corresponded to GP24 was sliced, minced and electroeluted; an aliquot was used to immunize a rabbit, and the antiserum obtained was analysed by WB against LL-GP fraction; only GP24 was detected. ELISA and dot blot were performed with purified GP24 and serum and CSF samples from patients with NC that were previously positive for GP24 in WB and control samples; the latter were negative, while all NC samples were positive. To test for specificity, purified GP24 was incubated in dot blot against 44 sera from patients with other parasitic diseases; no positive reactions were found. Results indicate that GP24 was adequately purified and retained its reactivity; thus in combination with ELISA or dot blot may facilitate immunodiagnosis of NC.
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Affiliation(s)
- A Plancarte
- Departamento de Microbiología y Parasitología, Facultad de Medicina, UNAM, Ciudad Universitaria, México D.F
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Montenegro T, Gilman RH, Castillo R, Tsang V, Brandt J, Guevara A, Sanabria H, Verastegui M, Sterling C, Miranda E. The diagnostic importance of species specific and cross-reactive components of Taenia solium, Echinococcus granulosus, and Hymenolepis nana. Rev Inst Med Trop Sao Paulo 1994; 36:327-34. [PMID: 7732263 DOI: 10.1590/s0036-46651994000400005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Sera from patients infected with Taenia solium, Hymenolepis nana and Echinococcus granulosus were tested against homologous and heterologous parasite antigens using an ELISA assay, and a high degree of cross-reactivity was verified. To identify polypeptides responsible for this cross reactivity, the Enzyme Linked Immunoelectro Transfer Blot (EITB) was used. Sera from infected patients with T.solium, H.nana, and E.granulosus were assessed against crude, ammonium sulphate precipitated (TSASP), and lentil-lectin purified antigens of T.solium and crude antigens of H.nana and E.granulosus. Several bands, recognized by sera from patients with T.solium, H.nana, and E.granulosus infections, were common to either two or all three cestodes. Unique reactive bands in H.nana were noted at 49 and 66 K-Da and in E.granulosus at 17-21 K-Da and at 27-32 K-Da. In the crude cysticercosis extract, a specific non glycoprotein band was present at 61-67 K-Da in addiction to specific glycoprotein bands of 50, 42, 24, 21, 18, 14, and 13 K-Da. None of the sera from patients with H.nana or E.granulosus infection cross reacted with these seven glycoprotein bands considered specific for T.solium infection.
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Affiliation(s)
- T Montenegro
- Depto. Microbiologia, Universidad Peruana Cayetano Heredia, Lima-Peru
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Shankar SK, Suryanarayana V, Vasantha S, Ravi V, Kumar BR. BIOLOGY OF NEUROCYSTICERCOSIS - PARASITE RELATED FACTORS MODULATING HOST RESPONSE. Med J Armed Forces India 1994; 50:79-88. [PMID: 28769174 PMCID: PMC5529711 DOI: 10.1016/s0377-1237(17)31004-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Neurocysticercosis, caused by infestation of the nervous system by the larval form of Taenia solium, continues to baffle the neurologist, because of varied clinical manifestations. A large body of the literature related to this disease is clinically oriented, enough attention has not been given to parasite related factors modulating the host response. Using immunohistochemical techniques, three features related to the biology of the Cysticercus cellulosa e were studied. Firstly, to the question as to which part of the worm is recognised by the host immune system, the surface glycoprotein is found to be immunolabelled by the CSF from patients of neurocysticercosis. This surface protein is depleted following specific antihelmenthic therapy, thus accounting for a fall in anticysticercal antibosy level in the CSF. Secondly, the cysticercal cyst, by immunochemical and histochemical methods, is found to have "ACTH like" molecule in the body wall and has neurotransmitter and mitochondrial metabolic pathways similar to the host, facilitating the immune evasion and successful parasitisation. Finally, Cysticercus cellulosae is found to contain a "peptide" opening the blood brain barrier at the arteriolar level when injected into mice intravenously. Similar phenomenon may be functional in the patients as well, resulting in cerebral oedema, especially following praziquintel therapy.
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Affiliation(s)
- S K Shankar
- Department of Neuropathology and Neurovirology, National Institute of Mental Health and Neurosciences, Bangalore 560 029
| | - V Suryanarayana
- Department of Neurovirology, National Institute of Mental Health and Neurosciences, Bangalore 560 029
| | - S Vasantha
- Department of Neuropathology and Neurovirology, National Institute of Mental Health and Neurosciences, Bangalore 560 029
| | - V Ravi
- Astra Research Centre India, P.O. Box No. 359, Malleswaram, Bangalore 560 003
| | - Bv Ravi Kumar
- Department of Neurovirology, National Institute of Mental Health and Neurosciences, Bangalore 560 029
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Garcia HH, Gilman R, Martinez M, Tsang VC, Pilcher JB, Herrera G, Diaz F, Alvarado M, Miranda E. Cysticercosis as a major cause of epilepsy in Peru. The Cysticercosis Working Group in Peru (CWG). Lancet 1993; 341:197-200. [PMID: 8093496 PMCID: PMC2917763 DOI: 10.1016/0140-6736(93)90064-n] [Citation(s) in RCA: 131] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In countries where cysticercosis is endemic, the proportion of epilepsy due to cysticercosis is not well documented. To investigate the association between cysticercosis and epilepsy, we used the enzyme-linked immunoelectrotransfer blot (EITB) assay to detect serum antibodies to Taenia solium in 498 consecutive outpatients at a neurology clinic in Lima, Peru. Every patient was classified as epileptic (n = 189) or non-epileptic (n = 309) after neurological, and where possible electroencephalographic, examination. A substantially higher proportion of epileptic than non-epileptic patients was seropositive in the EITB (22 [12%] vs 8 [3%], p < 0.001). 19% of epileptic patients born outside Lima, 20% of those with late-onset epilepsy, and 29% of patients with both these characteristics were seropositive. Thus, in Peru, cysticercosis is an important aetiological factor for epilepsy.
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Affiliation(s)
- H H Garcia
- Universidad Peruana Cayetano Heredia, Lima
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40
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Hansen NJ, Hagelskjaer LH, Christensen T. Neurocysticercosis: a short review and presentation of a Scandinavian case. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1992; 24:255-62. [PMID: 1509231 DOI: 10.3109/00365549209061330] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cysticercosis is a disease entity caused by the larval form (Cysticercus cellulosae) of the pork tapeworm (Taenia solium). When man becomes the intermediate host, cysticercal cysts can develop in various organs. Neurocysticercosis, i.e. cysticercosis of the central nervous system, can lead to a broad range of neurological disturbances. The disease is usually confined to geographical regions where sanitation is poor but can occur among immigrants or travellers from such regions. Due to increased travel and immigration the disease may appear in non-endemic areas. We describe a recent case of neurocysticercosis in a 28-year-old Danish woman, who had been travelling in the Far East. She was successfully treated with praziquantel. A short review of the literature is given as the knowledge of the diagnosis and treatment of the disease has increased greatly in the last decade.
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Affiliation(s)
- N J Hansen
- Department of Neurology, Arhus University Hospital, Denmark
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41
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Katti MK, Chandramukhi A. Comparative evaluation of cysticercal antigens and immunoassays in the diagnosis of neurocysticercosis. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 1991; 85:605-15. [PMID: 1811438 DOI: 10.1080/00034983.1991.11812616] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Enzyme linked immunosorbent assay (ELISA), dot immunobinding assay (DIA) and passive haemagglutination assay (PHA) were evaluated for the detection of anticysticercal antibodies in cerebrospinal fluids (CSF) from neurocysticercosis (NCC) patients. Results from the three tests were similar. Higher titres of antibodies were observed to the antigens in porcine whole-cyst sonicate than to those in vesicular fluid or scolex or membrane sonicates. Affinity purified parasitic antigens showed a higher degree of specificity and sensitivity in PHA than in ELISA or DIA. Western blot analyses with cyst antigens showed that CSF antibodies from confirmed NCC patients consistently recognized a protein in the region of 64-68 kDa. Other proteins, of 110, 94-97, 80, 72-75, 52, 45, 26-28 and 16-18 kDa, showed heterogenous reactivity, whereas the partially purified antigen of 64-68 kDa showed a high degree of sensitivity and specificity.
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Affiliation(s)
- M K Katti
- Department of Medical Microbiology and Immunology, National Institute of Mental Health and Neurosciences, Bangalore, India
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Affiliation(s)
- G C Cook
- Department of Clinical Sciences, Hospital for Tropical Diseases, London, UK
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Castillo RM, Grados P, Carcamo C, Miranda E, Montenegro T, Guevara A, Gilman RH. Effect of treatment on serum antibody to Hymenolepis nana detected by enzyme-linked immunosorbent assay. J Clin Microbiol 1991; 29:413-4. [PMID: 2007652 PMCID: PMC269781 DOI: 10.1128/jcm.29.2.413-414.1991] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
An enzyme-linked immunosorbent assay (ELISA) was developed to measure serum immunoglobulin G antibodies in 65 patients infected with Hymenolepis nana and 30 noninfected patients. Antibody was detected in 51 of 65 (sensitivity, 79%) and 5 of 30 H. nana-negative patients (specificity, 83%). Nine patients infected with H. nana were treated with praziquantel (20 to 25 mg/kg of body weight). Antibody disappeared from the sera at 90 days in six patients, five of whom had eliminated H. nana. Antibody persisted in three patients in whom H. nana infection did not clear after treatment. The H. nana ELISA had a high rate of cross-reactions with sera from patients with cysticercosis (8 of 29 [28%]) and hydatidosis (8 of 23 [35%]). The ELISA for H. nana may be useful for defining the epidemiology of H. nana infections, especially in areas free from cysticercosis and hydatidosis.
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Affiliation(s)
- R M Castillo
- Department of Microbiology, Cayetano Heredia University, Lima, Peru
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Abstract
We studied 143 cases of cerebral cysticercosis over a 30-year period. In 46 there was hydrocephalus due to cysts obstructing the cerebrospinal fluid pathways, with signs of hydrocephalus and cerebellar dysfunction. In 97 there were cysts in the cerebral parenchyma, causing symptoms of intracranial hypertension alone in 22 cases, with additional neurological deficits in the remainder. Before 1980 diagnosis was made by pneumoencephalography and ventriculography, but since then it has mostly been done by computed tomography. In 28 cases scanned, typical abnormalities were present in 25. Complement fixation tests were positive in serum in 74% of cases and in cerebrospinal fluid in 73%, and the enzyme-linked immunosorbent assay test was positive in serum in 90% and in cerebrospinal fluid in 92%. Treatment of cases with hydrocephalus was by removal of the cysts at craniotomy, with placement of a shunt where necessary. Intracranial hypertension caused by parenchymal cysts was treated with steroids and osmotic agents, if possible. In resistant cases subtemporal decompression was needed, unilateral in 55 cases and bilateral in eight. Mortality in the acute stage was 11%, with a further 20% at follow up.
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Affiliation(s)
- S Y Yang
- Department of Neurosurgery, Tianjin Medical College Hospital, People's Republic of China
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Abstract
A prospective study of Nepalese adults (Gurkhas) based in Hong Kong who presented with adult-onset epileptiform seizures determined that cerebral cysticercosis was causative in 7 out of 8 cases. The relative roles of specific cysticercal serology and computerised axial tomography in diagnosis are discussed. Serum IgE levels were found to be raised in all patients with cerebral cysticercosis in the absence of other parasitic infection and reverted to normal after the patients were treated with praziquantel. Evidence suggests that the Gurkhas acquired their cysticercal infections in Nepal.
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Affiliation(s)
- B J Heap
- Royal Army Medical College, Millbank, London
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Zini D, Farrell VJ, Wadee AA. The relationship of antibody levels to the clinical spectrum of human neurocysticercosis. J Neurol Neurosurg Psychiatry 1990; 53:656-61. [PMID: 2213042 PMCID: PMC488166 DOI: 10.1136/jnnp.53.8.656] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
One hundred proven cases of cerebral cysticercosis were studied with an enzyme linked immunoassay (ELISA) employing cyst fluid as antigen, with a view to detecting specific antibodies in serum and cerebrospinal fluid (CSF). Antibody levels were correlated with the clinical presentation of the patients, the type and number of cysts detected on their brain scans, the anatomical position of these cysts and the presence of lymphocytes in the CSF. Patients could be divided into two distinct categories, one with low levels of antibody in the serum and absent antibody in the CSF, and the other with high levels in both the serum and the CSF. This differentiation matched the clinical presentation of a benign and a malignant group. Antibody levels could not be related to the type of cysts as observed on the brain scan, but depended on the anatomical position of the cyst, being lower if the cysts were confined to the cerebral cortex. A correlation of antibody levels with the number of cysts was only found in the benign group.
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Affiliation(s)
- D Zini
- Department of Immunology, School of Pathology South African Institute for Medical Research, Johannesburg
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Vaz AJ, Ferreira AW, Silva MVD, Camargo ED, Batista L, Souza AMCD. Teste imunoenzimático para pesquisa de anticorpos anti-Cysticercus cellulosae em líquidos cefalorraquianos de pacientes com meningites de etiologia indeterminada. Rev Inst Med Trop Sao Paulo 1990. [DOI: 10.1590/s0036-46651990000300009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Foi empregado o teste imunoenzimático com componentes antigênicos de Cysticercus cellulosae quimicamente ligados a suporte inerte constituído por discos de tecido-resina, ELISA-d, com a finalidade de investigar a entidade neurocisticercose (NC) em líquidos cefalorraquianos (LCR) de pacientes com meningites de etiologia indeterminada. Foram ensaiados 277 LCR de 128 crianças e 149 adultos. A densidade óptica média (DO) obtida para os 22 LCR de pacientes nos quais foi afastada a possibilidade diagnóstica de meningite foi de 0,03. Os 44 LCR de pacientes com meningites determinadas por diversos agentes etiológicos, não cisticercose, apresentaram DO de 0,05. O limiar de reatividade do teste ELISA-d calculado a partir desses dois grupos (controle) foi de 0,13 (DO + 3SD). No grupo de 13 LCR de pacientes com NC comprovada em episódio meningítico por essa causa, foi observada DO de 0,41 (0,10 a 0,91) no teste ELISA-d. Dos 198 LCR de meningites por agente etiológico não identificado pelos métodos usualmente empregados, 23 (11,6%) apresentaram DO acima de 0,13, sugerindo que a possível causa da meningite tenha sido por cisticercose, uma vez que o teste ELISA-d tem apresentado elevadas sensibilidade, especificidade e reprodutibilidade. Em cinco dos 23 LCR a alteração no exame quimiocitológico era às custas do aumento do número de células predominantemente linfomononucleares, em 13 o predomínio era de polimorfonucleares e nos cinco restantes ambos os tipos de células estavam em número aumentado.
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48
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Vaz AJ, Hanashiro AS, Chieffi PP, Ferreira AW. [Frequency of patients with anti-Cysticercus cellulosae blood antibodies in 5 municipalities of the state of Sao Paulo]. Rev Soc Bras Med Trop 1990; 23:97-9. [PMID: 2104458 DOI: 10.1590/s0037-86821990000200006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Considering the important health public problem that human cysticercosis represents, the frequency of anti-Cysticercus cellulosae antibodies was studied in 1,264 serum samples, 1,064 being from the general population individuals (821 adults and 243 children) living in five municipalities of São Paulo State, Brazil; and 200 from patients admitted to the Psychiatric Hospital Bezerra de Menezes (Presidente Prudente). Discs of synthetic fabric-resin with the valently bound were employed for ELISA tests. Among the sera from adults, nineteen (2.30%) were reactive 2 (0.82%) among the children sera. Ten (5.00%) among the psychiatric patients sera presented reactivity. This was significantly higher than that observed for the adults of the general population group (p less than 0.05).
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Affiliation(s)
- A J Vaz
- Seção de Sorologia, Serviço de Microbiologia e Imunologia, Instituto Adolfo Lutz, São Paulo, SP, Brasil
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49
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Acosta E. Antibodies to the metacestode of Taenia solium in the saliva from patients with neurocysticercosis. J Clin Lab Anal 1990; 4:90-4. [PMID: 2313474 DOI: 10.1002/jcla.1860040204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
IgG antibodies to antigens of Taenia solium metacestodes were detected in saliva samples from patients with intracerebral cysticercosis by means of an enzyme-linked immunosorbent assay (ELISA). When compared for IgG antibody activity, saliva samples from patients with various nonparasitic neurological disorders and from clinically healthy individuals yielded significantly lower (p less than 0.001) absorbance values than saliva samples from patients with neurocysticercosis. However, no differences were observed in IgA anti-T. solium activity between patients with neurocysticercosis and controls. These results indicate that the detection of anticysticercus IgG antibodies in saliva by means of ELISA may be of value in the diagnosis of neurocysticercosis. Moreover, collection of saliva provides a noninvasive sampling method for immunoepidemiological surveys on this disease.
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Affiliation(s)
- E Acosta
- Departamento de Inmunologia, Instituto de Investigaciones Biomedicas, UNAM, Mexico DF
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50
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Rossi CL. [Evaluation of antigenic fractions of Cysticercus cellulosae for the immunodiagnosis of neurocysticercosis using antibody-lectin conjugates]. ARQUIVOS DE NEURO-PSIQUIATRIA 1989; 47:287-90. [PMID: 2619605 DOI: 10.1590/s0004-282x1989000300006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In an attempt to find out some fraction with high antigenic activity for the immunodiagnosis of neurocysticercosis a crude extract from Cysticercus cellulosae was fractioned by Sephadex G-200 column chromatography. The protein elution profile revealed two distinct peaks (fractions I and III) and a heterogeneous fraction containing several peaks (fraction II). The crude extract and the fractions were tested by Erythro-Lectin Immuno Test (Erythro-LIT) using cerebrospinal fluid samples from patients with neurocysticercosis. The results of Erythro-LIT antibody titers showed that most of the anticysticercus antibodies recognized antigenic components contained in the fraction II.
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Affiliation(s)
- C L Rossi
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade, Estadual de Campinas, Brasil
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