韩国一家三级医院葡萄膜炎患者血清抗弓蛔虫IgG滴度对眼弓蛔虫病的诊断价值
Diagnostic Value of the Serum Anti-Toxocara IgG Titer for Ocular Toxocariasis in Patients with Uveitis at a Tertiary Hospital in Korea.
作者信息
Bae Ki Woong, Ahn Seong Joon, Park Kyu Hyung, Woo Se Joon
机构信息
Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.; Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.; Department of Ophthalmology, Hanyang University Hospital, Seoul, Korea.
出版信息
Korean J Ophthalmol. 2016 Aug;30(4):258-64. doi: 10.3341/kjo.2016.30.4.258. Epub 2016 Jul 21.
PURPOSE
This study evaluated the prevalence of ocular toxocariasis (OT) in patients with uveitis of unknown etiology who visited a tertiary hospital in South Korea and assessed the success of serum anti-Toxocara immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) as a diagnostic test for OT.
METHODS
The records of consecutive patients with intraocular inflammation of unknown etiology were reviewed. All participants underwent clinical and laboratory investigations, including ELISA for serum anti-Toxocara IgG. OT was diagnosed based on typical clinical findings. Clinical characteristics, seropositivity, and IgG titers were compared between patients diagnosed with OT and non-OT uveitis. The seropositivity and the diagnostic value of anti-Toxocara IgG was investigated among patients with different types of uveitis.
RESULTS
Of 238 patients with uveitis of unknown etiology, 71 (29.8%) were diagnosed with OT, and 80 (33.6%) had positive ELISA results for serum anti-Toxocara IgG. The sensitivity and specificity of the ELISA test were 91.5% (65 / 71) and 91.0% (152 / 167), respectively. The positive predictive value of the serum anti-Toxocara IgG assay was 81.3%. Among patients with anterior, intermediate, posterior, and panuveitis, the prevalence rates of OT were 8.3%, 47.1%, 44.8%, and 7.1%, respectively; the seropositivity percentages were 18.1%, 47.1%, 43.7%, and 17.9%; and the positive predictive values were 38.5%, 95.8%, 92.1%, and 40.0%. The serum anti-Toxocara IgG titer also significantly decreased following albendazole treatment.
CONCLUSIONS
OT is a common cause of intraocular inflammation in the tertiary hospital setting. Considering that OT is more prevalent in intermediate and posterior uveitis, and that the positive predictive value of the anti-Toxocara IgG assay is high, a routine test for anti-Toxocara IgG might be necessary for Korean patients with intermediate and posterior uveitis.
目的
本研究评估了在韩国一家三级医院就诊的病因不明的葡萄膜炎患者中眼弓蛔虫病（OT）的患病率，并评估了血清抗弓蛔虫免疫球蛋白G（IgG）酶联免疫吸附测定（ELISA）作为OT诊断试验的成功率。
方法
回顾了连续的病因不明的眼内炎症患者的记录。所有参与者均接受了临床和实验室检查，包括血清抗弓蛔虫IgG的ELISA检测。根据典型临床发现诊断OT。比较了诊断为OT的患者和非OT葡萄膜炎患者的临床特征、血清阳性率和IgG滴度。研究了不同类型葡萄膜炎患者中抗弓蛔虫IgG的血清阳性率和诊断价值。
结果
在238例病因不明的葡萄膜炎患者中，71例（29.8%）被诊断为OT，80例（33.6%）血清抗弓蛔虫IgG的ELISA结果为阳性。ELISA试验的敏感性和特异性分别为91.5%（65/71）和91.0%（152/167）。血清抗弓蛔虫IgG检测的阳性预测值为81.3%。在前葡萄膜炎、中间葡萄膜炎、后葡萄膜炎和全葡萄膜炎患者中，OT的患病率分别为8.3%、47.1%、44.8%和7.1%；血清阳性率分别为18.1%、47.1%、43.7%和17.9%；阳性预测值分别为38.5%、95.8%、92.1%和40.0%。阿苯达唑治疗后血清抗弓蛔虫IgG滴度也显著下降。
结论
在三级医院环境中，OT是眼内炎症的常见原因。鉴于OT在中间葡萄膜炎和后葡萄膜炎中更为普遍，且抗弓蛔虫IgG检测的阳性预测值较高，对于韩国中间葡萄膜炎和后葡萄膜炎患者，可能有必要进行抗弓蛔虫IgG的常规检测。
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