What is the role of immunologic testing in the workup of tapeworm infestation?

Updated: Apr 15, 2021
  • Author: Lisandro Irizarry, MD, MBA, MPH, FACEP; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Although this type of testing may be useful for primary screening, it is most commonly used for confirmation testing for parasitic disease.

Complement fixation, hemagglutination, radioimmunoassay, enzyme-linked immunosorbent assay (ELISA), and immunoblot can be used for the detection of anticysticercal antibodies in serum, cerebrospinal fluid, and saliva.

Copro-Ag testing has been shown to acheive a sensitivity of 98% and specificity of 99% compared to the sensistity of 38% with direct microscopy.56

The immunoblot (Western blot = enzyme-linked immunoelectrotransfer blot assay) is the most effective, with sensitivity and specificity as high as 100% and 98%, respectively; however, the sensitivity decreases to about 70% in patients with a single cyst or in those with only calcified lesions. ELISA is more reliable when performed in cerebrospinal fluid than in serum, but the accuracy depends on the viability and location of the cysticerci. Stool antigen testing detects at least 2-3 times more cases of Taenia infection than stool microscopy. In echinococcosis, ELISA is positive in only 50% of patients with pulmonary hydatidosis and in more than 90% of patients with hepatic cysts.


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