Seroprevalence of IgG anti-Toxocara species antibodies in a population of patients with suspected allergy

Rosanna Qualizza¹, Cristoforo Incorvaia², Romualdo Grande³, Eleni Makri², Luigi Allegra^3
1Allergy Service, ²Allergy/Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, ³IRCCS Fondazione Cà Granda, Milan, Italy

Background: Toxocara canis is an intestinal nematode affecting dogs and cats, which causes human infection when embryonated eggs excreted in dog feces are ingested. Humans are paratenic hosts. Although the larvae do not develop into adult worms in the human body, they may migrate to various tissues and organs where they can survive for several years, giving rise to several clinical symptoms, which can present in allergy-like form.
Methods: Over 5 years, we examined 9985 patients referred for suspected allergies, based on symptoms such as dermatitis, urticaria, rhinitis, asthma, and conjunctivitis; 753 patients who had allergy tests negative or unrelated to clinical history were tested for seropositivity to T. canis by enzyme-linked immunosorbent assay (ELISA) or Western blotting (WB).
Results: In 240 patients (31.8%), ELISA or WB or both tests were positive for T. canis immunoglobulin G (IgG) antibodies: in particular, 64 of them (26.7%) were positive to ELISA, 110 (45.8%) to WB, and 66 (27.5%) to both tests. Asthma was the most common clinical presentation. Two thirds of patients underwent subsequent anthelmintic therapy and showed a complete remission of symptoms and, in 43% of patients retested by ELISA and WB, became negative to Toxocara.
Conclusion: These findings strongly suggest that T. canis plays a significant role in inducing chronic symptoms presenting as suspected allergies.

Keywords: suspected allergy, Toxocara canis, enzyme-linked immunosorbent assay, Western blotting, anthelmintic therapy