TOTAL AND SPECIFIC IGE LEVELS IN HUMAN HYDATID-DISEASE DETERMINED BY ENZYME-IMMUNOASSAY - SEROLOGICAL FOLLOW-UP AFTER SURGERY

The evolution of both specific and nonspecific IgE in a longterm follo w-up after surgery in patients with human hydatid disease was studied. Enzyme immunoassays using cyanogen bromide-activated cellulose discs as solid phase were employed. One hundred and nine postoperative serum samples from 26 patients undergoing surgery for hydatid disease were studied. Imaging studies were also carried out during the follow-up. I n 8 of 26 patients, remaining cysts were detected during the follow-up . One year after surgery, fetal IgE levels decreased to normal values in 84.6% of the total number of patients, in 94.5% of the cases in whi ch no remaining cysts were detected and in 62.5% of the patients with remaining hydatid cysts. These data highlight the poor value of an iso lated postoperative IgE determination as a diagnostic marker for remai ning hydatidosis. On the contrary, I year after surgery, the levels of anti-Echinococcus IgE decreased in 55% of the patients without residu al cysts and in 50% of the fetal number of patients. In sri; patients without remaining hydatid cysts, the levels of specific IgE increased I year after the surgery. In the group of patients with remaining cyst s only in three patients did the values of specific IgE decrease, alth ough they remained significant. Thus, I year after surgery, anti-Echin ococcus IgE levels were still evident in all patients, although in tho se without remaining cysts there was a predominance of decreasing valu es. These data indicate that a positive isolated postoperative determi nation of anti-Echinococcus IgE does not indicate that the patient has current hydatid disease, emphasizing the importance of carrying out a serological follow-up after surgery to interpret the meaning of the t est results. In three of eight patients with remaining cysts after sur gery, both total and specific IgE decreased during the year of follow- up after removal of most of the cysts. The correlation between the pos toperative levels of fetal and anti-Echinococcus IgE revealed that a p atient may show a decrease in total IgE with stable or increasing leve ls of specific IgE.