Pediatric neurocysticercosis: usefulness of antibody response in cysticidal treatment follow-up.

Venkata Subba Rao Atluri,Lakshmana Swamy Parasa,Pratibha Singhi,Nancy Malla,Niranjan Khandelwal,Venkateswara Reddy Gogulamudi

doi:10.1155/2014/904046

Abstract

Serum and urine samples were collected from 33 NCC patients before the albendazole treatment, 3–6 and 12 months PT. At 3 months PT, 24 (72.7%) patients had no detectable CT/MRI lesions and 9 (27.2%) patients had persistent lesions. Antibody response to crude soluble extract (CSE), excretory secretory (ES), and lower molecular mass (LMM) (10–30 KDa) antigenic fraction of T. solium cysticerci was detected in serum and urine samples by ELISA. Before the treatment, out of 33 NCC children, 14 (42.4%), 22 (66.6%), and 11 (33.3%) serum samples were found positive with the use of CSE, ES, and LMM antigen, respectively. At 3–6 months PT, positivity rate was 5 (15.1%), 2 (6%), and 4 (12.1%) and at 12 months PT, positivity rate was 5 (15.1%), 0, and 3 (9%) with the use of CSE, ES, and LMM antigen, respectively. There was no significant difference in the positivity with the use of three antigens in pretreatment and PT urine samples. The study suggests that the use of ES antigen to detect antibody in serum samples may serve better purpose to evaluate the therapeutic response in patients with NCC.

Highlights

Neurocysticercosis (NCC) is caused by the presence of Taenia solium larvae, the cysticerci in central nervous system, and is the most common cause of epilepsy in India
We reported that the excretory secretory (ES) antigens are highly sensitive in both ELISA and EITB assay for the detection of antibody in serum samples for the diagnosis of neurocysticercosis in children [26,27,28]
P values a versus b; d versus e; g versus h; e versus f 0.05 (McNemar Test Exact). ∗CSE: crude soluble extract; ∗∗ES: excretory secretory; ∗∗∗LMM: lower molecular mass; n = number studied

Summary

Introduction

Neurocysticercosis (NCC) is caused by the presence of Taenia solium larvae, the cysticerci in central nervous system, and is the most common cause of epilepsy in India. Conservative estimates describe 50,000 deaths every year due to neurocysticercosis [2]. It is regarded as a major public health threat and economic burden in the developing countries of Asia, Africa, and Latin America. In a survey over a period of 20 years in north India, it was found in 5.9% of 103 epileptics and 11.1% amongst patients attending a neurology clinic in Postgraduate Institute of Medical Education and Research, Sawhney et al [5]. Up to 50% of children with partial seizures in the Postgraduate Institute of Medical Education and Research (PGIMER) emergency service of the Nehru hospital, Chandigarh, India, have a recognizable underlying cause, the most common being neurocysticercosis and tuberculoma, both of which are amenable to specific pharmacotherapy [8]

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