Serologic follow-up study in neurocysticercosis patients by ELISA after praziquantel treatment

, Cho, Seung Yull; , Kim, Suk Il; , Kang, Shin Yong

doi:1986.24.2.159

Korean J Parasito > Volume 24(2):1986 > Article

Original Article


Korean J Parasitol. 1986 Dec;24(2):159-170. English. Published online Mar 20, 1994. http://dx.doi.org/10.3347/kjp.1986.24.2.159
Copyright © 1986 by The Korean Society for Parasitology


Serologic follow-up study in neurocysticercosis patients by ELISA after praziquantel treatment
Seung-Yull Cho,Suk Il Kim and Shin Yong Kang
Department of Parasitology, College of Medicine, Chung-Ang University, Seoul 151, Korea.


Abstract
/A total of 69 patients of confirmed neurocysticercosis was followed serologically by ELISA up to 22 months after praziquantel treatment. The intervals and numbers of follow-up were variable by patients. Serially collected samples of serum and CSF were examined simultaneously for their specific IgG antibody levels by ELISA, using cystic fluid, saline extracts of bladder wall and scolex as antigen. Within 4 months after praziquantel treatment, the antibody levels were elevated temporarily in both serum and CSF in most patients. In some cases antibody levels exhibited steady declining tendency after the treatment. Concomitant administration of dexamethasone appeared to suppress the elevation of antibody levels. The rate of mean absorbance of antibody changed more in serum than in CSF. The rate of elevation was greater in antibodies to parenchymal antigens than that to cystic fluid, but absolute difference of antibody levels was greater in anitbody to cystic fluid. Previously negative samples for IgG antibody may become positive after praziquantel treatment, which could be used as a complementary tool(provocation test) in serodiagnosis. One month was considered to be sufficient interval for the follow-up test for that purpose. In the follow-up of up to 22 months, only few cases of chronic neurocysticercosis showed declining tendency of IgG antibody levels below negative range. During acute encephalitic attacks in chronic patients, IgG antibody to parenchymal antigen were elevated in CSF temporarily. These results indicated that serologic follow-up of every year was recommendable to differentiate the cured patients from chronic patients with slowly calcifying lesions.

Figures


	Fig. 1 Changing patterns of specific IgG antibody levels to CF in sera and CSF as shown by individual patient in Group I. Transverse dotted line at absorbance 0.18 is differential criterion. B: Before treatment.


	Fig. 2 Changing patterns of specific IgG antibody levels to CF antigen as shown by individual patient in Group II a who were treated without concomitant dexamethasone.


	Fig. 3 Changing patterns of specific IgG antibody levels to CF antigen as shown by individual patient in Group II b who were treated with dexamethasone during praziquantel treatment.


	Fig. 4 Changing patterns of specific IgG antibody levels to CF antigen as shown by individual patient in Group III.


	Fig. 5 Changing patterns of specific IgG antibody levels to CF antigen as shown by individual patient in Group IV.


	Fig. 6-1 Changing patterns of specific IgG antibody levels to CF(○), BW(▾) and SC(▿) antigens in serum (-) and CSF(...) before and after the treatment as shown by individual patient in Group V (Cases 1-10). ↓ : Concomitant dexamethasone treatment, ⇑ : Acute encephalitic attack. -4YB in Case 11 means the antibody level in a serum secured 4 years before.


	Fig. 6-2 Changing patterns of specific IgG antibody levels to CF(○), BW(▾) and SC(▿) antigens in serum (-) and CSF(...) before and after the treatment as shown by individual patient in Group V (Cases 11-15). ↓ : Concomitant dexamethasone treatment, ⇑ : Acute encephalitic attack.

Tables


	Table 1 Grouping the cases of follow-up study


	Table 2 Mean and standard deviation (SD) of absorbance in ELISA measuring IgG antibody to 3 antigens in serum and CSF of 6 patients in Group I


	Table 3 Absorbance in ELISA measuring IgG antibody to 3 antigens in serum and CSF of patients in Group IIa and IIb before and within 4 weeks after praziquatel treatment


	Table 4 Absorbance in ELISA measuring IgG antibody to 3 antigens in serum and CSF of 16 patients in Group III before and 1~3 months after praziquatel treatment (last follow-up)


	Table 5 Absorbance in ELISA measuring IgG antibody to 3 antigens in serum and CSF of 9 patients in Group IV before and 4~16 months after praziquatel treatment


	Table 6 Case summaries of patients in Group V

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