Dot ELISA for measuring anti-Fasciola IgG isotypes among patients with fascioliasis.

Stool examination using modified Kato thick smear method was performed to detect Fasciola eggs and other parasites. Forty-five patients were proved to have Fasciola infection by passing eggs in their stool samples. Pallor was the major presenting symptom (95.5%) followed by abdominal pain (93.3%) and fever (15.5%). Hepatomegaly was recorded in 86.6% of patients compared to 33.3% with splenomegaly. Abdominal, ultrasonography revealed hepatomegaly in 38 cases (84.4%) and common bile duct dilatation in 35 patients (77.7%). Moreover, 4 cases showed Olympic game rings which are diagnostic. All of patients had positive IgG4 levels, 40 cases were found positives for specific total IgG and 42 cases for IgG1, whereas, only 30 cases had positive IgG2 levels (66.6%). Dot-ELISA showed that IgG2 and IgG4 giving the highest specificity (>99%), followed by IgG1 (90%) and the least specific test was obtained with detection of IgG (85%). From the present work, it was concluded that detection of anti-Fasciola isotypes especially IgG4 is very specific for accurate diagnosis of fascioliasis.