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弓蛔虫病:儿童内脏幼虫移行症。

Toxocariasis: visceral larva migrans in children.

机构信息

Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

J Pediatr (Rio J). 2011 Mar-Apr;87(2):100-10. doi: 10.2223/JPED.2074.

Abstract

OBJECTIVES

To present a detailed investigation of risk factors, symptoms, and laboratory and imaging tests that may be useful to establish the clinical laboratory diagnosis of visceral larva migrans (VLM) in children, demonstrating the importance of diagnosis and treatment to prevent complications in the eyes, liver, and other organs.

SOURCES

Literature review using the MEDLINE and LILACS (1952-2009) databases, selecting the most recent and representative articles on the topic.

SUMMARY OF THE FINDINGS

VLM is an infectious disease with non-specific clinical presentation, whose transmission is related to contact with dogs, especially puppies, and which may progress to late systemic complications in vital organs such as the eyes and the central nervous system. IgG (ELISA) anti-T. canis can be used to establish the laboratory diagnosis. Higher cutoff points suggest recent illness and lower cutoff points demonstrate mild infection or infection in remission. Therapeutic response may be assessed by means of eosinophil blood cell count. The present article provides the pediatrician with updated information regarding VLM, a disease of high prevalence worldwide and in Brazil.

CONCLUSIONS

The diagnosis of VLM depends mainly on the presence of dogs in the child's household, associated with ELISA (IgG anti-T. canis), using excretory-secretory antigens of Toxocara canis. Prospective studies are warranted to assess the best drug therapy. Prevention is the most important strategy because of the high prevalence of T. canis in urban areas.

摘要

目的

详细探讨可能有助于确立儿童内脏幼虫移行症(VLM)临床实验室诊断的危险因素、症状以及实验室和影像学检查,强调诊断和治疗的重要性,以预防眼、肝和其他器官的并发症。

资料来源

使用 MEDLINE 和 LILACS(1952-2009)数据库进行文献复习,选择关于该主题的最新和最具代表性的文章。

研究结果概要

VLM 是一种具有非特异性临床表现的传染病,其传播与接触狗有关,尤其是接触小狗,可能会导致眼睛和中枢神经系统等重要器官的晚期系统性并发症。IgG(ELISA)抗 T.canis 可用于建立实验室诊断。较高的截断值提示近期患病,较低的截断值提示轻度感染或缓解期感染。通过嗜酸性粒细胞计数可评估治疗反应。本文为儿科医生提供了有关 VLM 的最新信息,该病在全球和巴西都有较高的流行率。

结论

VLM 的诊断主要取决于儿童家中是否有狗,同时结合 ELISA(IgG 抗 T.canis),使用 Toxocara canis 的排泄分泌抗原。需要进行前瞻性研究来评估最佳药物治疗。由于 T.canis 在城市地区的高流行率,预防是最重要的策略。

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