Comparative study of paired serum and cerebrospinal fluid samples from neurocysticercosis patients for the detection of specific antibody to Taenia solium immunodiagnostic antigen

Abstract

Neurocysticercosis (NCC) is an important disease in central nervous system caused by infection with Taenia solium metacestodes. In addition to clinical findings and the imaging analysis, the results of immunological tests are informative to diagnose NCC. To compare the usefulness of serum and cerebrospinal fluid (CSF) samples for antibody detection test, paired serum and CSF samples from NCC and other neurological disease patients were examined by an enzyme-linked immunosorbent assay with low-molecular-weight antigens purified from T. solium cyst fluid in a blinded fashion. Sensitivities of both serum and CSF samples were 25.0% in inactive NCC cases (n = 4) and 90.9% in active NCC cases (n = 33) and specificities of serum and CSF were 100% and 95.8%, respectively. By the combination of serum and CSF samples, sensitivity for active NCC cases became 100%. There was no difference in the test performance between serum and CSF samples. Based on these results, we suggest the detection of specific antibodies in serum for the diagnosis of active NCC because of an easy collection of it. However, in case of the antibody test negative, CSF should be used to confirm NCC and to rule out other medical disorders of central nerve system. For diagnosis of suspected inactive NCC cases, antibody detection test using either serum or CSF has a limited diagnostic value and cannot be recommended.