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Test ID ECHNG Echinococcus Antibody, IgG, Serum

Specimen Required

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.

Useful For

Detection of antibodies to Echinococcus granulosus

Method Name

Enzyme Immunoassay (EIA)

Reporting Name

Echinococcus Ab, IgG, S

Specimen Type


Specimen Minimum Volume

0.4 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  30 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Heat-inactivated Reject

Clinical Information

Echinococcosis, also referred to as hydatidosis or hydatid disease, is 1 of the 17 neglected tropical diseases recognized by the World Health Organization and affects over 1 million people worldwide. Echinococcus species are tapeworms or cestodes, and 2 main species infect humans: Echinococcus granulosus and Echinococcus multilocularis.


With respect to geographic distribution, E granulosus can be found worldwide but, more frequently, is found in rural grazing areas where dogs may feed on infected sheep or cattle carcasses. E multilocularis is largely localized to the northern hemisphere. The definitive hosts for E granulosus are dogs or other canids, while the definitive host for E multilocularis are foxes and, to a much lesser extent, canids. Echinococcus tapeworms reside in the small intestine of definitive hosts and release eggs that are passed in the feces and ingested by an intermediate host, typically sheep or cattle in the case of E granulosus or small rodents for E multilocularis. The eggs hatch in the small bowel, releasing an oncosphere that penetrates the intestinal wall and migrates through the circulatory system to various organs where it develops into a cyst that gradually enlarges, producing protoscolices and daughter cysts, which fill the interior. The definitive host becomes infected following ingestion of these infectious cysts. Humans become accidentally infected following ingestion of Echinococcus eggs.


In humans, E granulosus (cystic echinococcal disease) cysts typically develop in the lungs and liver. The infection may remain silent or latent for years (5-20 years) prior to cyst enlargement and symptom manifestation. Symptomatic manifestations include chest pain, hemoptysis, and cough for pulmonary involvement and abdominal pain and biliary duct obstruction for liver infection. E multilocularis (alveolar echinococcal disease) infections manifest more rapidly than those of E granulosus and similarly to a rapidly growing, destructive tumor, resulting in abdominal pain and biliary obstruction. Rupture of cysts can produce fever, urticaria, and anaphylactic shock.


Diagnosis of echinococcal infections relies on characteristic findings by ultrasound or other imaging techniques and serologic findings. Fine-needle aspirates of cystic fluid may be performed; however, they carry the risk of cyst puncture and fluid leakage, potentially leading to severe allergic reactions. Importantly, infected individuals do not shed eggs in stool.

Reference Values


Reference values apply to all ages.



The absence of antibodies to Echinococcus species suggests that the individual has not been exposed to this cestode. A single negative result should not be used to rule out infection (see Cautions).



Results suggest infection with Echinococcus. False-positive results may occur in settings of infection with other helminths or in patients with chronic immune disorders. Results should be considered alongside other clinical findings (eg, characteristic findings on imaging) and exposure history.


Depending on cyst location, individuals may not develop high enough antibody titers to be detectable by serologic assays, leading to false-negative results. Cysts localized to the lungs, central nervous system, or spleen or cysts that are senescent, calcified, or dead are associated with lower serologic reactivity.


False-positive results may occur in patients with other helminth infections, including with Taenia species, Schistosoma species, and Strongyloides. Careful correlation with imaging findings and exposure history is required.


This assay may not detect antibodies to other species of Echinococcus, including Echinococcus vogeli and Echinococcus oligarthrus, both fairly uncommon causes of hydatid disease in humans.

Clinical Reference

1. Agudelo Higuita NI, Brunetti E, McCloskey C. Cystic Echinococcosis. J Clin Microbiol. 2016;54(3):518-523

2. Sarkari B, Rezaei Z. Immunodiagnosis of human hydatid disease: Where do we stand? World J Methodol. 2015;5(4):185-195

Method Description

The Bordier Echinococcus granulosus IgG ELISA is an enzymatically amplified sandwich-type immunoassay. After a blocking step, diluted serum and controls are incubated in antigen coated microtiter wells, then washed and incubated with anti-human IgG antibody labeled with protein A-alkaline phosphatase conjugate. After a washing step, the wells are incubated with the colorless pNPP substrate. The enzyme converts the substrate to a yellow product. The reaction is stopped by adding potassium phosphate and the degree of enzymatic turnover is determined by absorbance measured at 405 nm on the ELISA microplate reader on the Dynex Agility. OD results of the patient sample are compared to the assay calibrator to establish a final index value for qualitative interpretation.(Package insert: Bordier Echinococcus granulosus IgG ELISA, Bordier Affinity Products SA; 01/2018)

Day(s) Performed


Report Available

Same day/1 to 7 days

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
ECHNG Echinococcus Ab, IgG, S 32171-1


Result ID Test Result Name Result LOINC Value
ECHNG Echinococcus Ab, IgG, S 32171-1