title: Strongyloides stercoralis infection in patients with systemic lupus erythematosus: diagnosis and prevention of severe strongyloidiasis.
abstract: OBJECTIVE
  Strongyloides stercoralis infection is usually chronic and asymptomatic and may persist undiagnosed for decades. However, in immunocompromised individuals, the infection can cause hyperinfection and dissemination. Therefore, early diagnosis is essential to prevent severe forms of strongyloidiasis. The aims of this study were: (i) to evaluate the frequency of S. stercoralis infection in patients with systemic lupus erythematous (SLE) and (ii) to estimate specific immunoglobulins G (IgG) and E (IgE) production using an enzyme-linked immunosorbent assay (ELISA) method.
  
  
  METHODS
  Seventy-five SLE patients treated with prophylactic anthelmintic therapy were evaluated using the spontaneous sedimentation (SS), Baermann-Moraes (BM) and agar plate culture (APC) methods. Serum anti-S. stercoralis IgG and IgE antibodies were measured by ELISA.
  
  
  RESULTS
  Using parasitological methods, the frequency of intestinal parasites was 10.7%, whereas the frequency of S. stercoralis infection was 1.3%. The sensitivity of the ELISA to detect anti-S. stercoralis IgG and IgE was 80% and 76.9%, respectively. Both assays presented the same specificity of 96.7%. The frequency of anti-S. stercoralis IgG and IgE was 16% and 28%, respectively. Six patients were positive for both antibodies.
  
  
  CONCLUSIONS
  Diagnostic approaches using high-sensitivity parasitological methods and the detection of specific antibodies are essential for the diagnosis of strongyloidiasis in immunocompromised patients. Early detection of infection can alter the course of the disease via appropriate treatment, preventing the occurrence of severe strongyloidiasis.
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Joelma Nascimento
authors.initials: JN
authors.lastname: de Souza
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Elizabete De Jesus
authors.initials: Ede J
authors.lastname: Inês
authors.affiliation: Centro de Reumatologia, Escola Baiana de Medicina e Saúde Pública, Bahia, Brazil.
authors.forename: Mittermayer
authors.initials: M
authors.lastname: Santiago
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Márcia Cristina Aquino
authors.initials: MC
authors.lastname: Teixeira
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Neci Matos
authors.initials: NM
authors.lastname: Soares
mesh_terms: D000328:Adult; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D000969:Antinematodal Agents / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000276:immunology / Q000469:parasitology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D017171:Strongyloides stercoralis / Q000276:immunology / Q000472:pathogenicity*; D013322:Strongyloidiasis / Q000175:diagnosis* / Q000276:immunology / Q000469:parasitology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000909:Antibodies, Helminth; D000969:Antinematodal Agents; D015415:Biomarkers; D007074:Immunoglobulin G; D007073:Immunoglobulin E
keywords: ELISA; Strongyloides; diagnosis; stercoralis; systemic lupus erythematosus