Barsak amöbiyazlı çocuklarda serolojik yöntemlerinin tanısal değeri

Abstract

SUMMARY THE DIAGNOSTICAL VALUE OF SEROLOGICAL TESTS IN CHILDREN WITH INTESTINAL AMOEBIASIS In this study the presence of IgG antibodies for E.histolytica was investigated by ELİSA in a total of 105 patients with acute gastroenteritis. Out of 105 people that were screened, 76 were diagnosed as acute amebic gastroenteritis by the presence of amebic cystes or trofozoites in their stools. The stool examination of the remaining 29 patients were negative for E.histolytica as well as other parasites. The presence of IgG class of antibodies for E.histolytica were also investigated in the sera of 35 healthy children whose stool examination showed E.histolytica cystes or trofozoites. The presence of anti-amebic IgM antibody was also investigated in 42 of 76 patients with gastroenteritis and in 10 of the 35 healthy children, concomitantly. Thus, the seroprevelance of the amebic gastroenteritis in children in our region and the use of the serological tests in the diagnosis of amebic gastroenteritis were investigated. Where as in 11 of the 76 (14.4%) patients with amebic gastroenteritis, anti-amebic IgG antibodies were detected with ELİSA, all of the 29 patients in the non-parasitic group were found to be seronegative. Meanwhile, among the 35 healthy children, only one (2.8%) child was seropositive for the IgG antibodies of E.histolytica. The mean levels of the IgG antibodies of patients with amebic gastroenteritis patients with gastroenteritis of non-amebic nature, and the controls were 0.490±0.23, 0.280±0.23, 0.270±0.41, respectively (p<0.05). At the same time, the percentages for anti-amebic IgM antibodies were found to be 52.3% and 30% in the patients with amebic gastroenteritis and controls, respectively. No significant statistical difference between these two groups were found (p>0.05). In this study, the specificities and the sensitivities of the amebic ELİSA IgG and IFA IgM tests were found to be 98.4%, 14.4%, 71.4% and 52.3% respectively. 59In conclusion, it can be drawn that the sensitive tests such as amebic IFA IgM and specificity tests such as amebic ELİSA IgG, may be useful in the diagnosis of amebic gastroenteritis next to the conventional direct microscopic examination of the stool. But it should also be added that the specifity and the sensitivity of these tests can be increased by the standartization of the test procedures and with the purification of the antigen used in the tests. Also, we believe that zymodem ascertaining, the use of PCR and monoclonal antibodies in the identification of E. histolytica will decrease the failure of morfological diagnosis and answer the unknowns in therapy. ^r

SUMMARY THE DIAGNOSTICAL VALUE OF SEROLOGICAL TESTS IN CHILDREN WITH INTESTINAL AMOEBIASIS In this study the presence of IgG antibodies for E.histolytica was investigated by ELİSA in a total of 105 patients with acute gastroenteritis. Out of 105 people that were screened, 76 were diagnosed as acute amebic gastroenteritis by the presence of amebic cystes or trofozoites in their stools. The stool examination of the remaining 29 patients were negative for E.histolytica as well as other parasites. The presence of IgG class of antibodies for E.histolytica were also investigated in the sera of 35 healthy children whose stool examination showed E.histolytica cystes or trofozoites. The presence of anti-amebic IgM antibody was also investigated in 42 of 76 patients with gastroenteritis and in 10 of the 35 healthy children, concomitantly. Thus, the seroprevelance of the amebic gastroenteritis in children in our region and the use of the serological tests in the diagnosis of amebic gastroenteritis were investigated. Where as in 11 of the 76 (14.4%) patients with amebic gastroenteritis, anti-amebic IgG antibodies were detected with ELİSA, all of the 29 patients in the non-parasitic group were found to be seronegative. Meanwhile, among the 35 healthy children, only one (2.8%) child was seropositive for the IgG antibodies of E.histolytica. The mean levels of the IgG antibodies of patients with amebic gastroenteritis patients with gastroenteritis of non-amebic nature, and the controls were 0.490±0.23, 0.280±0.23, 0.270±0.41, respectively (p<0.05). At the same time, the percentages for anti-amebic IgM antibodies were found to be 52.3% and 30% in the patients with amebic gastroenteritis and controls, respectively. No significant statistical difference between these two groups were found (p>0.05). In this study, the specificities and the sensitivities of the amebic ELİSA IgG and IFA IgM tests were found to be 98.4%, 14.4%, 71.4% and 52.3% respectively. 59In conclusion, it can be drawn that the sensitive tests such as amebic IFA IgM and specificity tests such as amebic ELİSA IgG, may be useful in the diagnosis of amebic gastroenteritis next to the conventional direct microscopic examination of the stool. But it should also be added that the specifity and the sensitivity of these tests can be increased by the standartization of the test procedures and with the purification of the antigen used in the tests. Also, we believe that zymodem ascertaining, the use of PCR and monoclonal antibodies in the identification of E. histolytica will decrease the failure of morfological diagnosis and answer the unknowns in therapy. ^r