title: Diagnostics in cystic echinococcosis: serology versus ultrasonography.
abstract: OBJECTIVE
  Cystic echinococcosis (CE) is the most widespread zoonosis worldwide. The objective of the present study was to compare diagnostic methods in the work-up of suspected cystic echinococcosis of the liver.
  
  
  METHODS
  Data from a total of 68 patients were compiled and analyzed.
  
  
  RESULTS
  A diagnosis of cystic echinococcosis was made in 36.8% of patients. Broken down according to WHO criteria, patients with at least one echinococcus cyst were determined in 12.0% of cases to exhibit cysts consistent with stage 1 disease (CE1), while in 24.0%, cysts consistent with CE2 and CE3 were identified. CE4 and CE5 cysts were identified in 32.0% and 8.0% of patients, respectively. Solitary cysts were found in 60.0% of patients with cystic echinococcosis, while in patients with at least one cystic lesion, there were most often multiple cysts. The indirect hemagglutination test (IHA) and echinococcus-specific immunoglobulin E (IgE) concentration showed a higher sensitivity (60.9%, 68.4%) than did the enzyme-linked immunosorbent assay (ELISA) for Echinococcus multilocularis (Em2+) and total IgE (11.1%, 38.9%). The respective specificities of all four serological methods lay between 83.9% and 88.9%.
  
  
  CONCLUSIONS
  Our data show that ultrasound remains the diagnostic method of choice in the work-up of cystic lesions of the liver suspected to be due to Echinococcus granulosus. Serological methods can serve an adjunctive role.
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany. wolfgang.kratzer@uniklinik-ulm.de.
authors.forename: Johanna
authors.initials: J
authors.lastname: Wuestenberg
authors.forename: Beate
authors.initials: B
authors.lastname: Gruener
authors.forename: Suemeyra
authors.initials: S
authors.lastname: Oeztuerk
authors.forename: Richard A
authors.initials: RA
authors.lastname: Mason
authors.forename: Mark M
authors.initials: MM
authors.lastname: Haenle
authors.forename: Tilmann
authors.initials: T
authors.lastname: Graeter
authors.forename: Atilla S
authors.initials: AS
authors.lastname: Akinli
authors.forename: Peter
authors.initials: P
authors.lastname: Kern
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kratzer
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000947:Antigens, Helminth / Q000276:immunology*; D004444:Echinococcosis, Hepatic / Q000175:diagnosis* / Q000000981:diagnostic imaging; D048209:Echinococcus granulosus / Q000276:immunology*; D048210:Echinococcus multilocularis / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods; D014463:Ultrasonography
chemical_list: D000947:Antigens, Helminth; C000594589:Em2 antigen, Echinococcus multilocularis; D007073:Immunoglobulin E