From the Guidelines
The best serological test for amoebic liver abscess is indirect haemagglutination, which has over 90% sensitivity. This is based on the study by 1, which recommends amoebic serology, specifically indirect haemagglutination, for patients with suspected amoebic liver abscess.
Key Points
- Indirect haemagglutination has high sensitivity for amoebic liver abscess, making it a reliable test for diagnosis.
- Faecal microscopy is usually negative in patients with amoebic liver abscess, so serological tests like indirect haemagglutination are preferred.
- An abdominal ultrasound may be indicated in addition to serological testing for diagnosis.
- While ELISA and enzyme immunoassay are also useful tests, the study by 1 specifically recommends indirect haemagglutination due to its high sensitivity.
Considerations
- Clinical correlation with imaging studies like ultrasound or CT scan is still necessary for definitive diagnosis, especially in endemic areas where a positive result may reflect previous exposure rather than active infection.
- The test is relatively quick to perform and widely available in most hospital laboratories, making it a practical choice for diagnosis.
From the Research
Serological Tests for Amoebic Liver Abscess
The best serological test for amoebic liver abscess can be determined by evaluating the sensitivity, specificity, and predictive values of various tests.
- ELISA (Enzyme-Linked Immunosorbent Assay) is a commonly used serological test for diagnosing amoebic liver abscess.
- The sensitivity and specificity of ELISA for amoebic liver abscess have been reported to be high, with values ranging from 95.7% to 100% and 96% to 100%, respectively 2, 3, 4.
- ELISA has been compared to other serological tests, such as counterimmunoelectrophoresis (CIE) and indirect haemagglutination assay (IHA), and has been found to have better diagnostic parameters 3, 4.
- The use of ELISA for diagnosing amoebic liver abscess has been recommended due to its high sensitivity and specificity, as well as its ability to process a large number of samples at a lower cost than other serological tests 2.
Comparison of Serological Tests
- A study comparing ELISA and CIE found that ELISA was more sensitive than CIE, with a sensitivity of 100% compared to 66% for CIE 4.
- Another study comparing ELISA and IHA found that ELISA had better diagnostic parameters, with a sensitivity of 98% and specificity of 96%, compared to 81% and 97% for IHA, respectively 3.
- The use of ELISA for diagnosing amoebic liver abscess has been supported by studies that have found it to be a valuable diagnostic tool, especially in endemic areas 2, 3.
Diagnostic Parameters of ELISA
- The diagnostic parameters of ELISA for amoebic liver abscess have been reported to be: