Serum Eosinophil Cationic Protein in Urticaria Patients with Anti-Toxocara IgG Antibodies

Abstract

Background: Toxocariasis is a parasitic disease that affects both humans and animals and is caused by migration of helminth larvae of Toxocara spp. in the host. It often presents with allergization such as urticaria, asthma-like symptoms and/or eosinophilia. Standard diagnosis is via the discovery of specific anti-Toxocara IgG antibodies which are difficult to interpret, which is why additional diagnostic criteria are necessary. We aimed to determine the levels of eosinophil cationic protein in patients with acute and chronic spontaneous urticaria with or without anti-Toxocara IgG antibodies, in order to assess the value of eosinophil cationic protein (ECP) for the diagnosis of covert cases of toxocariasis among patients with clinical allergy.

Methods: We examined ECP levels in 48 patients with urticaria who were Toxocara-IgG positive, in 45 patients with urticaria with a negative result for anti-Toxocara IgG and in 50 healthy controls without allergic symptoms or anti-Toxocara antibodies.

Results: Median serum ECP levels were significantly higher in patients with urticaria compared to the controls (P=0.007). We also determined that median ECP levels were significantly higher in patients with acute urticaria that were carriers of anti-Toxocara antibodies, compared to acute urticaria patients without anti-Toxocara antibodies (P=0.040). There was a significant positive correlation between ECP and anti-Toxocara IgG antibody levels (P = 0.024).

Conclusion: ECP could be used as an additional marker to assess cases of potential "latent" toxocariasis among urticaria patients.