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However, there are no data concerning detection of IgG subclass in urine. To further explore the utility of diagnosis from urine samples, we evaluated the diagnostic performance of IgG4 in urine compared with parasitological and other immunological methods.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The urine and sera included proven strongyloidiasis (group 1, <jats:italic>n<\/jats:italic>\u2009=\u200993), other parasitic infections (group 2, <jats:italic>n<\/jats:italic>\u2009=\u200940) and parasite negatives (group 3, <jats:italic>n<\/jats:italic>\u2009=\u200993). The performance of <jats:italic>Strongyloides<\/jats:italic>-specific IgG4 in urine for diagnosis of strongyloidiasis using fecal examinations as the reference standard was assessed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>With fecal examination as a gold standard, <jats:italic>Strongyloides<\/jats:italic>-specific IgG4 in urine had 91.4% sensitivity and 93.2% specificity while serum IgG4 had 93.6% sensitivity and 91.0% specificity. IgG4 in both urine and serum had almost perfect diagnostic agreements with fecal examination (Cohen's kappa coefficient was &gt; 0.8). Cross-reactivity to <jats:italic>Opisthorchis viverrini<\/jats:italic> and <jats:italic>Taenia<\/jats:italic> spp. of IgG4 in urine were 7.5% and 12.5% in serum. Concurrent analyses of total IgG in urine and serum showed that the sensitivities (97.9\u2013100%) and specificities (88.7\u201391.0%) were similar (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). The sensitivity for parasitological examination by the formalin-ethyl acetate concentration technique (FECT) was 49.5% and that for agar plate culture technique (APC) it was 92.6%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our findings showed that specific IgG4 detection in urine yielded similar diagnostic performance to the same biomarkers in serum. This suggests that accurate diagnosis of strongyloidiasis can be performed using urine samples and IgG4 is a valid choice of diagnostic marker. Further assessment is required to assess the utility of urine IgG4 for measuring the response treatment in strongyloidiasis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1186\/s13071-023-05935-6","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T11:03:50Z","timestamp":1693220630000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis"],"prefix":"10.1186","volume":"16","author":[{"given":"Phattharaphon","family":"Wongphutorn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanika","family":"Worasith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kulthida Y.","family":"Kopolrat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chutima","family":"Homwong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiraporn","family":"Sithithaworn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chatanun","family":"Eamudomkarn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anchalee","family":"Techasen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patcharaporn","family":"Tippayawat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Opal","family":"Pitaksakurat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuttanan","family":"Hongsrichan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Crellen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paiboon","family":"Sithithaworn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,28]]},"reference":[{"key":"5935_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens9060468","author":"D Buonfrate","year":"2020","unstructured":"Buonfrate D, Bisanzio D, Giorli G, Odermatt P, F\u00fcrst T, Greenaway C, et al. 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Kidney Int. 2003;63:809\u201325.","journal-title":"Kidney Int"}],"container-title":["Parasites &amp; Vectors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-023-05935-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13071-023-05935-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-023-05935-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T17:29:14Z","timestamp":1700242154000},"score":1,"resource":{"primary":{"URL":"https:\/\/parasitesandvectors.biomedcentral.com\/articles\/10.1186\/s13071-023-05935-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,28]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["5935"],"URL":"https:\/\/doi.org\/10.1186\/s13071-023-05935-6","relation":{},"ISSN":["1756-3305"],"issn-type":[{"value":"1756-3305","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,28]]},"assertion":[{"value":"12 March 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 August 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The human subject protocol used in this study was approved by the Human Ethics Committee of Khon Kaen University, Thailand (reference number: HE654013). Written informed consent was obtained from individual subjects in Thung Chomphu subdistrict, Phuwiang district, in Khon Kaen Province, northeast Thailand. The laboratory animal handling and <i>Strongyloides ratti<\/i> antigen production in Wistar rat were approved by the Institutional Animal Ethical Committee, Khon Kaen University (IACUC-KKU-99\/62. The procedure was performed in strict accordance with the guidelines for the Care and Use of Laboratory Animals of the National Research Council of Thailand.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"298"}}